Single-slice MRI-derived visceral adipose tissue was strongly associated with incident type 2 diabetes (HR 1.82; 95% CI 1.57-2.11) and liver-related hospitalisation (HR 1.56; 95% CI 1.37-1.78).
Cohort (n=75,331)
Is MRI-derived visceral adipose tissue associated with incident cardiometabolic outcomes in a general population cohort?
MRI-derived visceral adipose tissue, measured via single-slice or volumetric approaches, is independently associated with incident cardiometabolic outcomes including T2D, MACE, and CKD.
Hazard Ratio: 1.82 (95% CI 1.57–2.11)
Introduction and Objective: Visceral adipose tissue (VAT) is a key driver of cardiometabolic risk, including insulin resistance and type 2 diabetes (T2D), with growing relevance for risk stratification and treatment response in obesity and cardiometabolic disease trials. This study used large-scale UK Biobank imaging data to evaluate the association between MRI-derived VAT, measured using both single-slice and volumetric approaches, with incident cardiometabolic clinical outcomes. Methods: VAT was segmented automatically from 3D Dixon MRI using U-Net models to derive whole-volume VAT, while cross-sectional VAT area was extracted from a single axial slice at the L3 vertebral level. Cox proportional hazards models (adjusted for age, sex, BMI) were used to estimate associations with incident type 2 diabetes (T2D), liver-related hospitalisation, major adverse cardiovascular events (MACE), and chronic kidney disease (CKD). Results: A total of 75,331 UK Biobank participants were included (median age 66 years, 52% female, median BMI 26 kg/m2, 31% had preclinical obesity, and 38% had clinical obesity). Single-slice VAT showed strong associations with incident T2D (HR 1.82, 95% CI 1.57-2.11) and liver-related hospitalisation (HR 1.56, CI 1.37-1.78), with more modest associations for MACE (HR 1.17, CI 1.10-1.24) and CKD (HR 1.16, CI 1.02-1.31). Volumetric VAT showed comparable associations across outcomes. Conclusion: Both single-slice and volumetric MRI-derived VAT measurements were independently associated with major cardiometabolic outcomes. Volumetric VAT provides a comprehensive reference-standard assessment, while single-slice VAT demonstrated comparable prognostic performance, supporting its use as a complementary, scalable approach that can be incorporated within existing MRI protocols. These findings support MRI-based VAT as a clinically meaningful imaging biomarker for large population studies and obesity trials to improve risk stratification beyond BMI. Disclosure M. Nowak: Employee; Current; Perspectum Ltd. Y. Deng: Employee; Ended; Perspectum Ltd. L.F. Cardiel Castro: None. A. Mermekli: Employee; Current; Perspectum. H.B. Thomaides Brears: Employee; Current; Perspectum Ltd. Stock/Shareholder; Current; Perspectum Ltd.
Nowak et al. (Fri,) conducted a cohort in Cardiometabolic risk (n=75,331). MRI-derived visceral adipose tissue (VAT) was evaluated on Incident type 2 diabetes (T2D) (HR 1.82, 95% CI 1.57-2.11). Single-slice MRI-derived visceral adipose tissue was strongly associated with incident type 2 diabetes (HR 1.82; 95% CI 1.57-2.11) and liver-related hospitalisation (HR 1.56; 95% CI 1.37-1.78).