Visceral fat area measured by computed tomography is widely used to evaluate the risk of obesity and metabolic syndrome. However, the best cross-sectional imaging level of visceral fat area to predict metabolic syndrome is still unclear.
Computed tomography examination was performed to measure the visceral adipose tissue at the four different cross-sectional CT planes (L1-2, L2-3, L3-4 and L4-5 level) in healthy volunteers (151 men, 99 women). Metabolic syndrome was defined as the presence of two or more of: raised blood pressure, high triglyceride level, low HDL cholesterol, or high glucose. To determine the best imaging level of visceral fat area to predict metabolic syndrome, stepwise multiple logistic regression model was constructed. Receiver-operating characteristic (ROC) curve analysis was performed to analyze the optimal cut-off point to predict metabolic syndrome.
In a stepwise logistic regression model including age, visceral fat areas at 4 different levels as independent variables, visceral fat area measured at L1-2 level was identified as single best predictor for metabolic syndrome in both sex group. The optimal cut-off point of visceral fat area measured at L1-2 level to predict metabolic syndrome was 109.0 cm2 (men: 109.0 cm2, women: 66.6 cm2) in this study subjects.
Findings in this study suggest that visceral fat area measured at L1-2 level may be superior to predict metabolic syndrome than L4-5 level which is most frequently used in clinical setting.