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Jung, Chung, and Lee: The Correlation Between Visceral Fat Distance Measured by Ultrasonography and Visceral Fat Amount by Computed Tomography in Type 2 Diabetes
Original Article
Korean Diabetes Journal

Korean Diabetes Journal 2008; 32(5): 418-427.

Published online: 31 October 2008

DOI: https://doi.org/10.4093/kdj.2008.32.5.418

The Correlation Between Visceral Fat Distance Measured by Ultrasonography and Visceral Fat Amount by Computed Tomography in Type 2 Diabetes

Eui Dal Jung, Duck Soo Chung1, Jihyun Lee

Department of Internal Medicine, School of Medicine, Catholic University of Daegu, Korea.

1Department of Radiology, School of Medicine, Catholic University of Daegu, Korea.

Corresponding author: jhlee9@cataegu.ac.kr

Received 17 July 2008       Accepted 10 October 2008

Copyright © 2008 Korean Diabetes Association

Abstract

Background

Visceral adipose tissue accumulation highly correlates with metabolic abnormalities and cardiovascular disease. Computed tomography (CT) is considered to be the standard method for visceral fat evaluation, but it is not used as a routine procedure. Ultrasonography (US) is a safe method, fairly inexpensive and widely available modality for measuring abdominal fat thickness. The aim of this study was to investigate the correlation between the intra-abdominal fat distance by US measurement and the visceral fat amount by CT and cardiovascular risk factors and to evaluate whether the intra-abdominal fat distance is better correlate with visceral fat amount by CT than other anthropometric parameters and to assess the cut-off value of intra-abdominal fat distance for visceral obesity in type 2 diabetic patients.

Methods

We obtained abdominal subcutaneous and intra-abdominal fat distance by using a high-resolution US (HDI 5000, ATL, Phillps, USA) at 1 cm above umbilical level in one hundred twenty-eight type 2 diabetic patients. CT scan (Light Speed plus, GE, USA) for the measurement of subcutaneous and intra-abdominal visceral fat area was also performed in the supine position at the L4-5 level. Lean body mass and % body fat were measured in a bioimpedance using DSM (Direct Segmental Measurement by 8-point electrode) method (InBody 3.0, Biospace, Seoul, Korea). We measured patient's height, weight, BMI (Body mass index), waist circumference, WHR(Waist-hip ratio) and blood pressure and also measured fasting blood glucose, HbA1c and lipid profiles.

Results

Abdominal subcutaneous and visceral fat distance measured by US is 2.05 ± 0.52 cm, 4.43 ± 1.54 cm, respectively. In pearson's correlations, visceral fat distance were correlated with BMI (r = 0.681, P < 0.001), waist circumference (r = 0.661, P < 0.001), WHR (r = 0.571, P < 0.001), triglyceride (r = 0.316, P < 0.001), HDL-cholesterol (r = -0.207, P < 0.004). US-determined visceral fat distance was also correlated with visceral fat amount by CT (r = 0.674, P < 0.001) and BMI (r = 0.610, P < 0.001), waist circumference (r = 0.626, P < 0.001), WHR (r = 0.557, P < 0.001). When we used waist circumference (men: 90 cm, women: 85 cm) as parameters for visceral obesity, the cutoff value of visceral fat distance, obtained by the receiver operating characteristic curve analysis, were 4.670 cm in men, 3.695 cm in women diabetic patients.

Conclusion

Intra-abdominal fat distance measured by US reveals strongly correlated with visceral fat area, which is determined by CT and also well correlated with anthropometric parameters and lipid profiles. We suggest that US provided a better index compared to anthropometry for the prediction of visceral obesity and could be an alternative method for CT for visceral fat determination in diabetic patients.

Keywords: Computed tomography, Ultrasonography, Visceral obesity

Figures and Tables

Fig. 1
Abdominal subcutaneous and intra-abdominal fat distance by using a high-resolution US (HDI 5000, ATL, Phillps) at 1 cm above umbilical level.
kdj-32-418-g001
Fig. 2
CT scanning (Light Speed plus, GE) for measuring subcutaneous and intra-abdominal visceral fat area was performed with subjects in the supine position, at the L4-5 level.
kdj-32-418-g002
Fig. 3
Receiver operating characteristic (ROC) analysis of visceral fat distance as a predictor of the visceral obesity.
kdj-32-418-g003
Table 1
Anthropometric and biochemical data of the subjects
kdj-32-418-i001

* P < 0.05. BMI, body mass index; BP, blood pressure; FBS, fasting blood sugar; HDL, high density lipoprotein cholesterol; LDL, low density lipoprotein cholesterol; T-Chol, total-cholesterol; TG, triglyceride; WC, waist circumference; WHR, waist hip ratio.

Table 2
Body fat measurements by US and CT of the subjects
kdj-32-418-i002

* P < 0.05.

Table 3
Correlation between intra-abdominal fat distance by US and cardiovascular risk factors
kdj-32-418-i003

FBS, fasting blood sugar; HDL, high density lipoprotein; LDL, low density lipoprotein; SBP, systolic blood pressure; TG, triglyceride; WHR, waist hip ratio.

Table 4
Correlation between visceral fat amounts by CT and cardiovascular risk factors
kdj-32-418-i004

FBS, fasting blood sugar; HDL, high density lipoprotein; LDL, low density lipoprotein; SBP, systolic blood pressure; TG, triglyceride; WHR, waist hip ratio.

Table 5
Pearson's correlation coefficients between visceral fat amounts by CT and intra-abdominal fat distance by US and central obesity parameters
kdj-32-418-i005

* P < 0.05.

Table 6
Area under curve (AUC) and cut-off value and sensitivity and specificity of visceral fat distance as a predictor of the visceral obesity
kdj-32-418-i006

WC, Waist Circumference.

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