Arterial stiffness, high fasting glucose, and fatty liver as predictors for visceral obesity in middle-aged Chinese individuals: a cross-sectional study

Background The prevalence of obesity is increasing rapidly worldwide, including in Asia. Visceral obesity, i.e., intra-abdominal fat accumulation, precedes the development of obesity-related metabolic syndrome, based on the cluster of hyperglycemia, dyslipidemia, and hypertension, leading to atherosclerosis and cardiovascular disease. Visceral fat area (VFA) ≥ 100 cm 2 has been defined as an appropriate threshold for assessing the prevalence of obesity-related metabolic syndrome; however, there information regarding the predictors for VFA ≥ 100 cm 2 in middle-aged Chinese individuals in the general population is lacking. Methods We investigated the predictors for VFA ≥ 100 cm 2 in middle-aged Chinese individuals (n = 148; 49.3 ± 10.8 years; 54% male) who underwent health check-ups. VFA and subcutaneous fat area were determined by computed tomography, and arterial stiffness and fatty liver were diagnosed by brachial-ankle pulse wave velocity (baPWV) and abdominal ultrasonography, respectively. We compared parameters between individuals with VFA ≥ 100 cm 2 and < 100 cm 2 using unpaired t -tests and Mann-Whitney U tests and identified predictors by binary regression analysis. Results Single regression analysis identified body mass index > 25 kg/dL, waist circumference (WC) > 85 cm, red blood cells > 470×10 4 /µL, hemoglobin > 14.2 g/dL, alanine aminotransferase > 29 U/L, uric acid > 5.7 mg/dL, triglycerides > 150 mg/dL, fasting blood glucose (FBG) > 100 mg/dL, baPWV > 1,400 cm/s, male, and fatty liver as significant predictors for VFA ≥ 100 cm 2 . Multiple regression analysis also identified baPWV > 1,400 cm/s (odds ratio [OR] = 5.82, P = 0.008), WC > 85 cm (OR = 6.37, P = 0.013), FBG > 100 mg/dL (OR = 6.73, P = 0.025), male (OR = 10.54, P = 0.025), and fatty liver (OR = 4.11, P = 0.034) as independent predictors for VFA ≥ 100 cm 2 . The strongest predictor of VFA ≥ 100 cm 2 was baPWV > 1,400 cm/s, with a significant positive correlation (γ = 0.365, P < 0.001). Conclusions High baPWV, high FBG, high WC, fatty liver, and male sex are independent predictors for VFA ≥ 100 cm 2 in middle-aged Chinese individuals. High baPWV, as a measure of arterial stiffness, was the strongest predictor of VFA ≥ 100 cm 2 , indicating the importance of visceral obesity for arterial stiffness. Visceral obesity is thus a central target for interventions in metabolic syndrome, metabolic dysfunction-associated fatty liver, and cardiovascular disease, especially in males.