The Threshold of Visceral Adipose Tissue Areas Measured With QCT On Cardiometabolic Risk Factors In A Nationwide Study In China

Background: Abdominal adiposity is associated with increased cardiometabolic risk and visceral adipose tissue (VAT) area obtained from computed tomography (CT) is a key anthropometric index. The present study investigated the VAT criteria on cardiometabolic risk factors in a large-scale nationwide Chinese population. Method: A total of 21,772 adults who underwent a low dose chest CT (LDCT) for lung cancer screening at one of 13 health checkup centers throughout China and had complete ancillary health records were evaluated. Abdominal VAT area at the center of L2 vertebra was measured with Mindways quantitative CT software using the existing LDCT dataset. Relevant anthropometric, serum and blood pressure measurements were obtained from the participants’ records. The VAT distribution of the LDCT cohort was age-adjusted using the Chinese national census. Results: The prevalence of metabolic syndrome based on the Chinese national guidelines was 29.5% and 10.5% in men and women respectively. Using ROC curves, the optimum threshold values for VAT area to identify metabolic syndrome were 213 cm 2 in men, and 136 cm 2 in women. For participants with VAT area above threshold, the odds ratio (95% confidence interval) for metabolic syndrome was 6.15 (5.65, 6.69) and 9.25 (7.58, 11.4) for men and women respectively. A further analysis of population attributable risk showed that VAT above threshold was significantly associated with an increased risk for metabolic syndrome. Conclusion: In this large-scale nationwide population of China, sex-specific threshold values for VAT area measured by CT were established to identify the risk of metabolic syndrome. VAT area is a key anthropometric index of interventions to control cardiometabolic risk.