Automatic Quantication of Abdominal Visceral Fat Content: a True Marker for Metabolic Syndrome?

Purpose: Metabolic syndrome (MetS) is a widely accepted concept that identifies the centrally obese patient with increased risk for cardiovascular disease. However, most studies indicate that the syndrome does not predict cardiovascular disease any better than the sum of its components. In addition, the single components seem to be interrelated. Therefore, we evaluated the use of automatic quantification of abdominal visceral fat content as a new marker of MetS, the single components and long-term cardiac survival. Methods: Prior to aortic aneurysm repair, 106 patients underwent computed tomography (CT) scanning of the abdominal aorta. Using a fully automated and intrinsically CT-3D image analysis method, visceral fat volume was calculated. MetS was defined according the Adult Treatment Panel III report (ATP III) and central obesity as body-mass-index (BMI) >30 kg/m2. Correlations between visceral fat volumes, MetS, the single components and long-term cardiac survival were investigated. Median follow-up was 2.6 years (IQR 1.2-3.6). Results: Metabolic syndrome was diagnosed in 46 (43%) patients. Increased visceral fat volume was not associated with the presence of MetS (p=0.26). In contrast, visceral fat volumes were significantly correlated with BMI and HDL-cholesterol. (Pearson's coefficient: BMI: r=0.51, HDL: r=-0.35). During follow-up 9 (8%) patients died. Increased visceral fat volume was significantly associated with increased mortality risk (p=0.03) (Table). Conclusion: The automatic quantified abdominal visceral fat content was not correlated with MetS. However, increased visceral fat volume seems to be a true marker of increased BMI, reduced HDL-cholesterol and increased long-term cardiac mortality.