Quantitative assessment of visceral and subcutaneous fat with hepatosteatosis by computed tomography in metabolic syndrome
Abstract
Purpose: We aimed to evaluate visceral and subcutaneous fat tissue and its association with hepatosteatosis on computed tomography (CT) scans to determine cut-off criteria for metabolic syndrome, measure abdominal obesity directly based on the visceral fat tissue area (VFTA) rather than indirectly based on waist circumference and obtain supportive findings by density measurements in addition to the VFTA measurements.
Materials and Methods: The Hounsfield unit (HU) values, visceral, subcutaneous fat areas and HU values of 108 patients diagnosed with metabolic syndrome (MS) were determined according to the National Cholesterol Education Program Adult Treatment Panel III 2001 Criteria by retrospectively analyzing their abdominal CT images taken for various reasons. The relationships of the obtained values with each other and to MS were evaluated.
Results: The strongest predictor of MS was VFTA, and 156.47 cm² was the most significant value with 74.1% sensitivity and 58.6% specificity. An HU value of -102.99 for visceral fat tissue density (VFTD) was found as the second most significant finding with 75% sensitivity and 57.6% specificity. The VFTA values of the patients with hepatosteatosis were higher, and increased VFTA values were associated with lower VFTD values.
Conclusion: The most important supportive finding was the demonstration of the possibility of measuring abdominal obesity, which has an important place among criteria, directly by measuring VFTA, rather than indirectly based on waist circumference.
Keywords
Metabolic syndrome Computed tomography Hepatosteatosis Visceral fatty tissue subcutaneous fatty tissue
Supporting Institution
YOK
Thanks
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References
- 1. Cornier MA, Dabelea D, Hernandez TL, et al. The Metabolic Syndrome. Endocrine Reviews, December 2008, 29(7):777–822.
- 2. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation, 2005. 112(17): p. 2735-2752.
- 3. Carr DB, Utzschneider KM, Hull RB, et al. Intra-Abdominal Fat Is a Major Determinant of the National Cholesterol Education Program Adult Treatment Panel III Criteria for the Metabolic Syndrome. Diabetes, August 2004: p:2087-2094
- 4. Sottier D, Petit JM, Guiu S, et al. Quantification of the visceral and subcutaneous fat by computed tomography: interobserver correlation of a single slice technique. Diagnostic and Interventional Imaging. 2013;94(9):879-884.
- 5. Yoshizumi T, Nakamura T, Yamane M, et al. Abdominal Fat:Standardized Technique for measurement at CT, Radiology 1999; 211:283–286.
- 6. Kvist H, Chowdhury B, Grangard U, Tylen U, Sjöström L. Total and visceral adipose tissue volumes derived from measurements with computed tomography in adult men and women: predictive equations. Am J Clin Nutr 1988;48:1351-61.
- 7. Hamer WO, Aquirre DA, Casola G, Lavine JE, Woenckhaus M, Sirlin CB. Fatty Liver: Imaging Patterns and Pitfalls. RadioGraphics 2006; 26:1637–1653
- 8. Türkiye Kalp ve Damar Hastalıkları Önleme ve Kontrol Programı Eylem Planı (2015-2020)
- 9. Pickhardt PJ, Graffy PM, Zea R, et al. Automated CT biomarkers for opportunistic prediction of future cardiovascular events and mortality in an asymptomatic screening population: a retrospective cohort study. Lancet Digit Health. 2020 Apr;2(4):e192-e200.
- 10. Seo JA, Kim BG, Cho H, et al., The cutoff values of visceral fat area and waist circumference for identifying subjects at risk for metabolic syndrome in elderly Korean: Ansan Geriatric (AGE) cohort study. BMC Public Health, 2009. 9: p. 443.
- 11. Gursoy Coruh A, Uzun C, Akkaya Z, Elhan AH. The relation of CT quantified pancreatic fat index with visceral adiposity and hepatic steatosis. Turk J Surg 2020; 36 (3): 241-248.
- 12. Nguyen-Duy TB, Nichaman MZ, Church TS, Blair SN, Ross R. Visceral fat and liver fat are independent predictors of metabolic risk factors in men. Am J Physiol Endocrinol Metab, 2003. 284(6): p. E1065-71.
- 13. Mathieu D, Luciani A, Achab A, Zegai B, Bouanane M, Kobeiter H. Les pseudo-lésions hépatiques. Gastroenterol Clin Biol 2001;25:B158-B166
- 14. Neeland IJ, Ross R, Després JP, Matsuzawa Y, et al. International Atherosclerosis Society; International Chair on Cardiometabolic Risk Working Group on Visceral Obesity. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. Lancet Diabetes Endocrinol. 2019 Sep;7(9):715-725. doi: 10.1016/S2213-8587(19)30084-1. Epub 2019 Jul 10. PMID: 31301983.
- 15. Rytka JM, Wuesst S, Schoenle EJ, Konrad D. The portal theory supported by venous drainage-selective fat transplantation. Diabetes, 2011. 60(1): p. 56-63.
- 16. Nakajima T, Nakashima T, Yamaoka J, Shibuya A, Itoh Y, Yoshikawa T. Age is a Negative, and Visceral Fat Accumulation is a Positive, Contributor to Hepatic Steatosis, Regardless of the Fibrosis Progression in Non-alcoholic Fatty Liver Disease. Journal of Gastroenterology and Hepatology Research2012; 1(11): 315-319.
- 17. Lee HW, Kim KJ, Jung KS, et al. (2017) The relationship between visceral obesity and hepatic steatosis measured by controlled attenuation parameter. PLOS ONE 12(10): e0187066
- 18. Idilman IS, Low MH, Gidener T, et al. Association between Visceral Adipose Tissue and Non-Alcoholic Steatohepatitis Histology in Patients with Known or Suspected Non-Alcoholic Fatty Liver Disease. J Clin Med. 2021;10(12):2565. Published 2021 Jun 10.
Metabolik sendromda visseral ve subkutan yağ miktari ve hepatosteatozun bilgisayarli tomografi ile kantitatif değerlendirilmesi
Abstract
Amaç: Bu çalışmada, metabolik sendrom hastalarında bilgisayarlı tomografi ile visseral ve subkutan yağlı doku alanı, dansitesi ve karaciğer yağlanmasında eşik değerleri elde etmek, metabolik sendromla vücut yağ dağılımı ve hepatosteatoz ilişkisini değerlendirmek amaçlandı .
Gereç ve Yöntem: Çeşitli nedenlerle çekilmiş kontrastsız abdomen bilgisayarlı tomografi (BT) görüntüleri retrospektif olarak taranıp National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATPIII)-2001 kriterlerine göre Metabolik sendrom tanılı 108 hastanın karaciğere yönelik Hounsfield Unit (HU) değeri, visseral, subkutan yağ doku alanı ve HU değerleri, Osirix Dicom Viewer programı ile belirlendi. Elde edilen değerlerin birbiri ve metabolik sendromla ilişkisi değerlendirildi.
Bulgular: En güçlü prediktör visseral yağlı doku alanı (VYDA) bulunmuş olup 156.47 cm² değerinin %74.1 sensitivite ve %58.6 spesifiteye sahip en anlamlı değer olduğu saptanmıştır. Ayrıca visseral yağlı doku dansitesi (VYDD) için -102.99 HU değeri %75 sensitivite, %57.6 spesifite ile ikinci en önemli bulgu olarak saptanmıştır. Hepatosteatoz saptanan hastalarda VYDA’nın daha fazla olduğu ve VYDA artışı ile birlikte VYDD’nin de daha düşük dansitede ölçüldüğü saptanmıştır.
Sonuç: En önemli destekleyici bulgu: kriterler içinde en önemli yere sahip olan abdominal obezitenin indirek olarak bel çevresi ile değil direk olarak visseral yağlı doku alanının ölçülebilmesi ile gösterilmesi olmuştur.
References
- 1. Cornier MA, Dabelea D, Hernandez TL, et al. The Metabolic Syndrome. Endocrine Reviews, December 2008, 29(7):777–822.
- 2. Grundy SM, Cleeman JI, Daniels SR, et al. Diagnosis and Management of the Metabolic Syndrome: An American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation, 2005. 112(17): p. 2735-2752.
- 3. Carr DB, Utzschneider KM, Hull RB, et al. Intra-Abdominal Fat Is a Major Determinant of the National Cholesterol Education Program Adult Treatment Panel III Criteria for the Metabolic Syndrome. Diabetes, August 2004: p:2087-2094
- 4. Sottier D, Petit JM, Guiu S, et al. Quantification of the visceral and subcutaneous fat by computed tomography: interobserver correlation of a single slice technique. Diagnostic and Interventional Imaging. 2013;94(9):879-884.
- 5. Yoshizumi T, Nakamura T, Yamane M, et al. Abdominal Fat:Standardized Technique for measurement at CT, Radiology 1999; 211:283–286.
- 6. Kvist H, Chowdhury B, Grangard U, Tylen U, Sjöström L. Total and visceral adipose tissue volumes derived from measurements with computed tomography in adult men and women: predictive equations. Am J Clin Nutr 1988;48:1351-61.
- 7. Hamer WO, Aquirre DA, Casola G, Lavine JE, Woenckhaus M, Sirlin CB. Fatty Liver: Imaging Patterns and Pitfalls. RadioGraphics 2006; 26:1637–1653
- 8. Türkiye Kalp ve Damar Hastalıkları Önleme ve Kontrol Programı Eylem Planı (2015-2020)
- 9. Pickhardt PJ, Graffy PM, Zea R, et al. Automated CT biomarkers for opportunistic prediction of future cardiovascular events and mortality in an asymptomatic screening population: a retrospective cohort study. Lancet Digit Health. 2020 Apr;2(4):e192-e200.
- 10. Seo JA, Kim BG, Cho H, et al., The cutoff values of visceral fat area and waist circumference for identifying subjects at risk for metabolic syndrome in elderly Korean: Ansan Geriatric (AGE) cohort study. BMC Public Health, 2009. 9: p. 443.
- 11. Gursoy Coruh A, Uzun C, Akkaya Z, Elhan AH. The relation of CT quantified pancreatic fat index with visceral adiposity and hepatic steatosis. Turk J Surg 2020; 36 (3): 241-248.
- 12. Nguyen-Duy TB, Nichaman MZ, Church TS, Blair SN, Ross R. Visceral fat and liver fat are independent predictors of metabolic risk factors in men. Am J Physiol Endocrinol Metab, 2003. 284(6): p. E1065-71.
- 13. Mathieu D, Luciani A, Achab A, Zegai B, Bouanane M, Kobeiter H. Les pseudo-lésions hépatiques. Gastroenterol Clin Biol 2001;25:B158-B166
- 14. Neeland IJ, Ross R, Després JP, Matsuzawa Y, et al. International Atherosclerosis Society; International Chair on Cardiometabolic Risk Working Group on Visceral Obesity. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. Lancet Diabetes Endocrinol. 2019 Sep;7(9):715-725. doi: 10.1016/S2213-8587(19)30084-1. Epub 2019 Jul 10. PMID: 31301983.
- 15. Rytka JM, Wuesst S, Schoenle EJ, Konrad D. The portal theory supported by venous drainage-selective fat transplantation. Diabetes, 2011. 60(1): p. 56-63.
- 16. Nakajima T, Nakashima T, Yamaoka J, Shibuya A, Itoh Y, Yoshikawa T. Age is a Negative, and Visceral Fat Accumulation is a Positive, Contributor to Hepatic Steatosis, Regardless of the Fibrosis Progression in Non-alcoholic Fatty Liver Disease. Journal of Gastroenterology and Hepatology Research2012; 1(11): 315-319.
- 17. Lee HW, Kim KJ, Jung KS, et al. (2017) The relationship between visceral obesity and hepatic steatosis measured by controlled attenuation parameter. PLOS ONE 12(10): e0187066
- 18. Idilman IS, Low MH, Gidener T, et al. Association between Visceral Adipose Tissue and Non-Alcoholic Steatohepatitis Histology in Patients with Known or Suspected Non-Alcoholic Fatty Liver Disease. J Clin Med. 2021;10(12):2565. Published 2021 Jun 10.
Details
| Primary Language | English |
|---|---|
| Subjects | Clinical Sciences |
| Journal Section | Research |
| Authors | |
| Publication Date | June 30, 2022 |
| Acceptance Date | February 1, 2022 |
| Published in Issue | Year 2022 Volume: 47 Issue: 2 |
