Computed tomography reference values for visceral obesity and increased metabolic risk in a Caucasian cohort

Clinical Nutrition ESPEN, vol. 48, pp. 408–413

Abstract

Background Visceral obesity is associated with the metabolic syndrome. The metabolic risk differs per ethnicity, but reference values for visceral obesity for body composition analyses using Computed Tomography (CT) scans in the Caucasian population are lacking. Therefore, the aim of this study was to define gender specific reference values for visceral obesity in a Caucasian cohort based upon the association between the amount of visceral adipose tissue (VAT) and markers of increased metabolic risk. Methods Visceral Adipose Tissue Area Index (VATI cm 2 /m 2 ) at the level of vertebra L3 was analyzed using CT scans of 416 healthy living kidney donor candidates. The use of antihypertensive drugs and/or statins was used as an indicator for increased metabolic risk. Gender specific cut-off values for VATI with a sensitivity ≥80% were calculated using receiver operating characteristic (ROC) curves. Results In both men and women who used antihypertensive drugs, statins or both, VATI was higher than in those who did not use these drugs ( p ≤ 0.013). In males and females respectively, a value of VATI of ≥38.7 cm 2 /m 2 and ≥24.9 cm 2 /m 2 was associated with increased metabolic risk with a sensitivity of 80%. ROC analysis showed that VATI was a better predictor of increased metabolic risk than BMI (area under ROC curve (AUC) = 0.702 vs AUC = 0.556 in males and AUC = 0.757 vs AUC = 0.630 in females). Conclusion Gender and ethnicity specific cut-off values for visceral obesity are important in body composition research, although further validation is needed. This study also showed that quantification of VATI is a better predictor for metabolic risk than BMI.

Authors 6

1. Michelle R. Baggerman corresponding

   Maastricht University · Maastricht University Medical Centre · Laurentius Ziekenhuis

   Affiliation as printed

   Maastricht UMC+, Department of Intensive Care Medicine, P. Debyelaan 25, Maastricht, the Netherlands; Maastricht University, School for Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, Maastricht, the Netherlands; Laurentius Hospital, Department of Intensive Care Medicine, Monseigneur Driessenstraat 6, Roermond, the Netherlands. Electronic address: michelle.baggerman@mumc.nl

   Laurentius Hospital, Department of Intensive Care Medicine, Monseigneur Driessenstraat 6, Roermond, the Netherlands

   Maastricht UMC+, Department of Intensive Care Medicine, P. Debyelaan 25, Maastricht, the Netherlands

   Maastricht University, School for Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, Maastricht, the Netherlands

2. Ingeborg M. Dekker

   Vrije Universiteit Amsterdam · Amsterdam University Medical Centers

   Affiliation as printed

   Amsterdam UMC, Department of Nutrition and Dietetics, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands

3. Björn Winkens

   Maastricht University · Care and Public Health Research Institute

   Affiliation as printed

   Maastricht University, Care and Public Health Research Institute (CAPHRI), Methodology and Statistics, P. Debeyeplein 1, Maastricht, the Netherlands

4. Steven W.M. Olde Damink Aachen Department of General, Visceral and Transplantation Surgery

   RWTH Aachen University · Universitätsklinikum Aachen · Maastricht University · Maastricht University Medical Centre

   Affiliation as printed

   Maastricht University, School for Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, Maastricht, the Netherlands; Maastricht UMC+, Department of Surgery, P. Debyelaan 25, Maastricht, the Netherlands; RWTH University Hospital Aachen, Department of General, Visceral and Transplantation Surgery, Pauwelsstraße 30, Aachen, Germany

   Maastricht UMC+, Department of Surgery, P. Debyelaan 25, Maastricht, the Netherlands

   Maastricht University, School for Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, Maastricht, the Netherlands

   RWTH University Hospital Aachen, Department of General, Visceral and Transplantation Surgery, Pauwelsstraße 30, Aachen, Germany

5. Peter J.M. Weijs

   Vrije Universiteit Amsterdam · Amsterdam University Medical Centers · Amsterdam UMC Location Vrije Universiteit Amsterdam · Amsterdam University of Applied Sciences

   Affiliation as printed

   Amsterdam UMC, Department of Nutrition and Dietetics, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam UMC, Department of Intensive Care Medicine, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam University of Applied Sciences, Department of Nutrition and Dietetics, Dr. Meurerlaan 8, Amsterdam, the Netherlands

   Amsterdam UMC, Department of Intensive Care Medicine, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands

   Amsterdam UMC, Department of Nutrition and Dietetics, Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, the Netherlands

   Amsterdam University of Applied Sciences, Department of Nutrition and Dietetics, Dr. Meurerlaan 8, Amsterdam, the Netherlands

6. Marcel C.G. van de Poll

   Maastricht University · Maastricht University Medical Centre

   Affiliation as printed

   Maastricht UMC+, Department of Intensive Care Medicine, P. Debyelaan 25, Maastricht, the Netherlands; Maastricht University, School for Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, Maastricht, the Netherlands; Maastricht UMC+, Department of Surgery, P. Debyelaan 25, Maastricht, the Netherlands

   Maastricht UMC+, Department of Intensive Care Medicine, P. Debyelaan 25, Maastricht, the Netherlands

   Maastricht UMC+, Department of Surgery, P. Debyelaan 25, Maastricht, the Netherlands

   Maastricht University, School for Nutrition and Translational Research in Metabolism (NUTRIM), Universiteitssingel 40, Maastricht, the Netherlands