Comparison of Visceral Fat and Liver Fat as Risk Factors of Metabolic Syndrome

Abstract

The principal objective of this study was to determine whether visceral fat or liver fat is a more relevant risk factor for metabolic syndrome. A total of 98 subjects aged 18-65 yr, who visited a health promotion center in a university hospital, were enrolled in this study. Metabolic syndrome was diagnosed based on the modified National Cholesterol Education Program's Adult Treatment Panel III report (NCEP-ATPIII) criteria. We defined the visceral obesity as a visceral fat area of ≥ 100 cm2 which was acquired by CT at the L4-5 level. To evaluate fatty liver, we applied a liver-to-spleen attenuation ratio ≤ 1.1 as measured by CT at the T12 level. We employed binary logistic regression models that used the presence or absence of metabolic syndrome as a dependent variable and age, sex, and the presence or absence of visceral obesity and fatty liver as independent variables. Visceral obesity was not found to be an independent variable as a risk factor of metabolic syndrome (odds ratio 2.7; 95% confidence interval 0.55-13.30), but fatty liver was found to be significant in this model (odds ratio 71.3; 95% CI 13.04-389.53). Our study suggests that liver fat may be a more important risk factor than visceral fat in terms of its association with metabolic syndrome.

Beyond central adiposity: Liver fat and visceral fat area are associated with metabolic syndrome in morbidly obese patients

“…NAFLD is independently correlated with MS [5,6], such that liver fat percentage is 4 times higher in patients with MS [25]. We report that patients with more liver fat were more likely to express MS (86% vs 60%; p ¼ .039) and higher levels of triglycerides, HBP and T2DM.…”

“…Although both abdominal adiposity and liver steatosis are important factors in the development of MS [26], liver fat seems to be a more relevant risk factor [4,5]. In the multivariable analysis, only liver fat and age were independently related to the expression of MS.…”

“…According to Li [7], in this group of patients, the only significant factors in predicting the presence of MS were fasting triglycerides and glucose levels; and Despr es [20] reported that waist circumference and increased triglycerides can't be used to assess absolute cardiovascular risk factors, but rather to identify patients at high risk of having increased VAT and excess liver fat. Thus, it is not overall adiposity but visceral fat, that seems to be related with increased cardiometabolic risk factors [5,20].…”

“…In the multivariable analysis, only liver fat and age were independently related to the expression of MS. The fact that VAT increases with age [5,27] might be an explanation for the different findings in the univariable and multivariable models. An alternative explanation is that all morbidly obese patients are in the higher category of risk concerning visceral adiposity, which explains previous findings that the relation of visceral obesity with MS is more important at lower BMI's [6].…”

“…Even if obesity is one of the strongest risk factors for MS, its expression is not directly dependent on body mass index [BMI] [1] and the site of fat accumulation seems to be a more important risk factor than obesity in itself [5,6].…”