Risk of Significant Coronary Artery Disease as Determined by CT Measurement of the Distribution of Abdominal Adipose Tissue

PURPOSE: The purpose of this work was to determine if CT measurement of the distribution of abdominal adipose tissue is reproducible between observers and is associated with patient risk of significant coronary artery disease. METHOD: We compared 11 male patients having abdominal CT who had a history of significant coronary artery disease and 9 male patients having abdominal CT without a history of coronary artery disease. Two observers, at the level of the umbilicus, independently measured the ratio of visceral adipose tissue (VAT) to total abdominal adipose tissue (TAT). VAT is equal to the sum total of intraperitoneal and retroperitoneal adipose tissue. TAT equals the sum total of visceral and subcutaneous adipose tissue. Measurements were made using a standard software package. RESULTS: The mean ratio of VAT to TAT was significantly different (p < 0.05) between patients with a history of coronary artery disease (mean = 0.51, SD = 0.10, range = 0.38-0.69) and without a history of coronary artery disease (mean = 0.40, SD = 0.12, range = 0.23-0.51). Agreement in measurements between observers was excellent (mean difference = 0.01, range = 0.00-0.03, intraclass correlation = 0.99). CONCLUSION: The measurement of the VAT/TAT ratio is highly reproducible between observers, and a high ratio is associated with patient risk of significant coronary artery disease.