Ultrasound-assessed visceral fat and associations with glucose homeostasis and cardiovascular risk in clinical practice

M. Bellan, M. Menegatti, C. Ferrari, G. P. Carnevale Schianca, M. Pirisi

Research output: Contribution to journalArticlepeer-review

Abstract

Background and Aims: Despite the lack of evidence that assessing the global cardiovascular risk leads to a decreased incidence of cardiovascular events, accurate patient profiling is paramount in preventive medicine. An excess of visceral fat (VF) is associated with an enhanced cardiovascular risk; importantly, VF is quantifiable rapidly, cheaply and safely by ultrasound, which makes it suitable for use in clinical practice. In the present study, we aimed to evaluate if US-measured VF (USVF) could be a better predictor of glucose homeostasis and cardiovascular risk than simple anthropometric measures. Methods and Results: One-hundred sixty-two patients attending a Metabolic Disorders Clinic underwent a cross-sectional study for which USVF, anthropometric measures, a standard oral glucose tolerance test (OGTT), and calculation of cardiovascular Framingham score and vascular age were obtained. USVF was directly correlated with fasting and 2-h plasma glucose (respectively: r = 0.26, p < 0.001; r = 0.28, p < 0.0001), fasting and 2-h plasma insulin (for both: r = 0.41, p < 0.0001), homeostatic model assessment of insulin resistance (HOMA-IR; r = 0.42, p < 0.0001), cardiovascular Framingham score (r = 0.44 p < 0.0001) and vascular age (r = 0.30 p < 0.001). In receiver operator characteristic curves USVF had good diagnostic abilities for type 2 diabetes mellitus, fatty liver and metabolic syndrome, in both genders. At multivariate analysis, body mass index (BMI) outperformed USVF in the prediction of HOMA-IR; neverthless, USVF, not BMI, was an independent predictor of cardiovascular risk. Finally, models including USVF were the most parssimonious to predict Framingham score, vascular age and HOMA-IR. Conclusion: In overweight and obese subjects, USVF could usefully complement other parameters for cardiovascular risk stratification.

Original languageEnglish
Pages (from-to)610-617
Number of pages8
JournalNutrition, Metabolism and Cardiovascular Diseases
Volume28
Issue number6
DOIs
Publication statusPublished - Jun 2018

Keywords

  • Cardiovascular risk
  • Diabetes mellitus
  • Metabolic syndrome
  • Oral glucose tolerance test
  • Visceral fat

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