Efficacy of visceral fat estimation by dual bioelectrical impedance analysis in detecting cardiovascular risk factors in patients with type 2 diabetes

Abstract

BackgroundVisceral fat area (VFA) is a good surrogate marker of obesity-related disorders, such as hypertension, dyslipidemia and glucose intolerance. Although estimating the VFA by X-ray computed tomography (CT) is the primary index for visceral obesity, it is expensive and requires invasive radiation exposure. Dual bioelectrical impedance analysis (BIA) is a simple and reliable method to estimate VFA; however, the clinical usefulness of dual BIA remains unclear in patients with type 2 diabetes (T2D).MethodsWe estimated the VFAs by dual BIA and CT in 98 patients with T2D and assessed anthropometric parameters, blood test results, and the presence of comorbid hypertension and dyslipidemia. We compared the correlation between the VFAs examined by dual BIA and CT. Furthermore, we performed the receiver operating characteristic (ROC) analyses for the VFAs to detect the presence of comorbid hypertension and/or dyslipidemia with T2D, which are major comorbidities of visceral obesity, and estimated the area under the curve (AUC).ResultsThe measurement error between the VFAs by dual BIA and CT was significantly higher among patients with brain natriuretic peptide (BNP) ≥ 100 pg/mL than those with BNP < 100 pg/mL (39.2% ± 31.1% vs. 24.1% ± 18.6%, P < 0.05). After excluding patients with BNP ≥ 100 pg/mL, the VFA by dual BIA significantly correlated with the VFA by CT (r = 0.917; P < 0.0001). The AUC in the ROC analysis for the VFA by dual BIA to detect the presence of comorbid hypertension and/or dyslipidemia with T2D was almost equivalent to that for the VFA by CT.ConclusionsIn patients with T2D without elevated BNP > 100 pg/mL as indicator for fluid accumulation interfering with BIA, estimation of the VFA by dual BIA significantly correlated with that by CT and also detected comorbid hypertension and/or dyslipidemia with T2D equivalent to those detected by CT. Hence, dual BIA could be an alternative to CT as a standard method for estimating the VFA in patients with diabetes.

Analysis of risk factors for carotid intima-media thickness in patients with type 2 diabetes mellitus in Western China assessed by logistic regression combined with a decision tree model

“…Therefore, in this study, VFA ≥ 80 cm 2 was used as the standard to evaluate the increase in visceral fat. The VFA measurement method in our study was bioelectrical impedance, which has a good correlation with CT [61]. Previous studies have illustrated that VFA is a crucial risk factor for CIMT thickening in middle-aged and elderly Chinese populations [60,62].…”

Associations between abdominal obesity indices and diabetic complications: Chinese visceral adiposity index and neck circumference

“…In fact, the methods to detect abdominal adiposity include dual-energy X-ray absorptiometry (DEXA), computed tomography (CT), magnetic resonance imaging (MRI) and dual bioelectrical impedance analysis (BIA) [ 7 , 8 ], which are unsuitable for routine clinical practices in a general population on account of the radiation exposure, time requirements and high costs [ 9 , 10 ]. Thus, many indices to estimate central or abdominal obesity have been established, including the visceral adiposity index (VAI) and the lipid accumulation product (LAP), which are calculated using the data of WC, BMI, triglycerides (TG), and high-density lipoprotein (HDL) [ 11 ].…”

The Association of Body Composition Parameters and Simultaneously Measured Inter-Arm Systolic Blood Pressure Differences

“…However, it may also be clinically important to evaluate body composition parameters such as visceral fat accumulation (VFA) when performing a risk assessment. In support of this notion, VFA was found to be specifically associated with the metabolic alterations of obesity, such as metabolic syndrome or normal weight obesity, in both men and women [9,10]. Increased visceral fat accumulation was likewise found to be associated with higher cardiovascular risk and all-cause mortality [11].…”

“…Therefore, it is important to detect and treat VFA at an early stage in the general population. VFA can be measured by magnetic resonance imaging (MRI), dual-energy X-ray absorptiometry (DEXA), or computed tomography (CT) [10,12]. However, these methods have limitations (e.g., being expensive and impractical; causing radiation exposure) that are not suitable for general health checkup examinations [12].…”