Utility of visceral fat rating, measured using bioelectrical impedance analysis, for screening metabolic syndrome in patients diagnosed with obesity in Vietnam

Metabolic syndrome (MetS) is associated with increased risk for cardiovascular morbidity and mortality, particularly among patients with obesity. This study aimed to establish diagnostic visceral fat rating (VFR) cut-off values using non-invasive bioelectrical impedance analysis (BIA) to screen for MetS in patients with obesity in Vietnam. This multicenter, cross-sectional study recruited patients with obesity (body mass index ≥25 kg/m 2 ) ≥18 years of age from outpatient clinics at the University Medical Center Ho Chi Minh City and My Duc General Hospital (Ho Chi Minh, Vietnam) between July 2023 and January 2024. MetS was diagnosed based on joint consensus criteria from the International Diabetes Federation, American Heart Association, and the National Heart, Lung, and Blood Institute. In total, 502 patients with obesity (86 % diagnosed with MetS), were included. VFR was significantly higher in obese patients with MetS ( p < 0.001). The optimal VFR cut-off for predicting MetS in patients with obesity was 10, with an area under the curve (AUC) of 0.7 (95 % confidence interval CI 0.61–0.80) for males and 0.74 (95 % CI 0.64–0.84) for females. Stratified analysis according to sex and obesity class revealed that VFR demonstrated the highest predictive utility for MetS in females (AUC 0.83) and males (AUC 0.76) with class I obesity. VFR was a useful screening tool for MetS, particularly among females with class I obesity. Assessing VFR using BIA may facilitate early detection and prompt intervention to reduce risk for the development of cardiometabolic diseases before further invasive diagnostic procedures are considered. • Measuring visceral fat is important for early detection metabolism syndrome, especially among individuals with obesity. • MRI and CT are regarded to be the gold-standard modalities for the precise determination of the distribution of visceral fat, however, both methods are expensive, time-consuming, nonportable, and expose patients to radiation. • Multi-frequency bioelectrical impedance analysis is an alternative technique for measuring abdominal visceral fat (as “visceral fat rating” index), which eliminates radiation exposure and is noninvasive, cost-effective, time-efficient, and portable. • There were no established visceral fat rating thresholds for screening metabolic in the obese population in Vietnam. • Our research contributes to this gap by establishing visceral fat rating-based metabolic syndrome screening thresholds, stratified according to sex and obesity status, specifically for the Vietnamese demographic.