Abdominal wall fat index, estimated by ultrasonography, for assessment of the ratio of visceral fat to subcutaneous fat in the abdomen

doi:10.1016/0002-9343(93)90284-V

The American Journal of Medicine

Volume 95, Issue 3, September 1993, Pages 309-314

https://doi.org/10.1016/0002-9343(93)90284-V Get rights and content

Abstract

purpose: To establish a new index of regional fat distribution using ultrasonography for assessment of the ratio of the visceral fat area (V) to the subcutaneous fat area (S) (V/S ratio).

subjects and methods: The subjects examined were 62 patients (23 males and 39 females); 51 patients had hyperlipidemia and 11 patients had glucose intolerance. The mean body mass indices ranged from 20.3 to 42.9. The mean age of the patients was 44 ± 13 years. The thicknesses of the preperitoneal fat layer (P) and subcutaneous fat layer (S) in the abdomen were measured by ultrasonography and the P/S ratio was calculated. The V/S ratio was obtained with radiographic computed tomography.

results: Of the various P/S ratios examined, the ratio of the maximum thickness of preperitoneal fat to the minimum thickness of subcutaneous fat was most closely correlated with the V/S ratio (r = 0.746, p <0.0001). This ratio was termed the abdominal wall fat index (AFI). AFI was positively correlated with serum triglyceride levels and negatively correlated with high-density lipoprotein cholesterol (r = −0.312, p <0.05), whereas the V/S ratio was correlated with triglyceride levels. AFI was positively correlated with basal insulin levels in both men and women.

conclusion: These results suggest that AFI measured by ultrasonography may be a new indicator of visceral fat deposition, and may reflect metabolic disorders such as lipid metabolism and glucose metabolism disorders.

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To compare the performance of maternal body fat index (BFI) assessed during the first 20 + 6 weeks among 138 pregnant women in an ultrasound outpatient clinic as a predictor of gestational diabetes mellitus (GDM) later in pregnancy.
Maternal visceral and subcutaneous fat was measured with a convex ultrasound probe placed in two locations on the maternal abdominal surface: the first in the mid-sagittal epigastric region, visualising epigastric fat, and the second 2 cm above the maternal umbilical scar, visualising periumbilical fat. Ultrasound callipers measured the distance from dermal edge to the linea alba and after from the linea alba to the anterior hepatic surface (epigastric fat). Periumbilical fat was measured from the dermal edge to the linea alba and after from the linea alba to the anterior aortic surface. The BFI formula was [visceral adipose tissue (mm) × subcutaneous adipose tissue (mm)]/maternal height (cm).
The best thresholds for predicting GDM outcome for epigastric and periumbilical BFI were 1.2 and 4.8, respectively. Odds ratio, sensitivity and specificity were 5.88 (95% CI 1.86–18.6), 80.9%, 58.0% for the epigastric site and 6.31 (95% CI 1.73–22.94), 84.2%, 54.2% for the periumbilical site. Pre-pregnancy body mass index compatible with adult obesity shows inadequate predictive performance for GDM outcome. Only epigastric BFI above 1.2 maintained statistical significance for GDM in the logistic regression analysis, when compared to periumbilical BFI above 4.8.
Epigastric BFI above 1.2 during the first half of pregnancy may help identify women at risk of developing GDM later in pregnancy.
Comparar el desempeño del índice de grasa corporal materno (BFI) evaluado durante las primeras 20 + 6 semanas entre 138 mujeres embarazadas en una clínica ambulatoria de ultrasonido como predictor de la diabetes mellitus gestacional (DMG) más adelante en el embarazo.
La grasa visceral y subcutánea materna se midió con una sonda de ultrasonido convexa colocada en 2 lugares de la superficie abdominal materna: el primero en la región epigástrica sagital media, llamada grasa epigástrica, y el segundo 2 cm por encima de la cicatriz umbilical materna, llamada grasa periumbilical. Las sondas de ultrasonido midieron la distancia desde el borde dérmico hasta la línea alba y luego desde la línea alba hasta la superficie hepática anterior (grasa epigástrica). La grasa periumbilical se midió desde el borde dérmico hasta la línea alba y luego desde la línea alba hasta la superficie aórtica anterior. La fórmula del BFI fue (tejido adiposo visceral [mm] × tejido adiposo subcutáneo [mm])/altura materna [cm]).
El mejor umbral para predecir el resultado de la DMG entre el BFI epigástrico y periumbilical fue de 1,2 y 4,8, respectivamente. El odds ratio, la sensibilidad y la especificidad fueron 5,88 (IC del 95%: 1,86-18,6), 80,9, 58,0% para el sitio epigástrico materno y 6,31 (IC del 95%: 1,73-22,94), 84,2, 54,2% para el sitio periumbilical, respectivamente. El índice de masa corporal previo al embarazo compatible con la obesidad en adultos muestra un rendimiento predictivo inadecuado para el resultado de la DMG. Solo el BFI epigástrico por encima de 1,2 mantuvo la significación estadística para la DMG en el análisis de regresión logística, en comparación con el BFI periumbilical por encima de 4,8.
Un BFI epigástrico superior a 1,2 durante la primera mitad del embarazo puede ayudar a identificar a las mujeres en riesgo de desarrollar DMG más adelante en el embarazo.
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Observamos una correlación de las mediciones ecográficas con la duración de la hospitalización (grasa preperitoneal máxima: −0,585, grosor del recto femoral [RF]: −0,539, área del RF: −0,540), la fragilidad (RF: −0,599) y la dependencia (RF: 0,628). La capacidad de contracción del RF se correlacionó con el ejercicio semanal reportado (0,642).
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Malnutrition and sarcopenia are associated with increased risk of adverse events and worse outcome in hospitalised patients. Ultrasonography is a useful tool in the assessment of body composition.
Twenty-three patients admitted to a hospital ward were recruited. Ultrasonographic variables of muscle tissue and adipose tissue were collected, as well as their variation during admission. These were correlated with anthropometric, clinical and analytical data.
We observed a correlation of ultrasound measurements with length of hospitalisation (maximum preperitoneal fat −0.585, rectus femoris thickness [RF] −0.539, RF area −0.540), frailty (RF −0.599) and dependency (RF 0.628). RF contractile capacity correlated with reported weekly exercise (0.642).
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Abdominal wall fat index, estimated by ultrasonography, for assessment of the ratio of visceral fat to subcutaneous fat in the abdomen

Abstract

Prev Med

Metabolism

Metabolism

Metabolism

The degree of masculine differentiation of obesities: a factor determining predisposition to diabetes, atherosclerosis, gout, and uric calculous disease

Am J Clin Nutr

Relationship of body fat distribution to glucose tolerance and clinical diabetes in obese women [abstract]

Clin Res

Relation of body fat distribution to metabolic complications of obesity

J Clin Endocrinol Metab

Relationship of body fat distribution to blood pressure, carbohydrate tolerance, and plasma lipids in healthy obese women

J Lab Clin Med

Abdominal adipose tissue distribution, obesity, and risk of cardiovascular disease and death: 13 year follow up of participants in the study of men born in 1913

Br Med J

Distribution of adipose tissue and risk of cardiovascular disease and death: a 12 year follow up of participants in the population study of women in Gothenburg, Sweden

Br Med J

Relationship of fat distribution to glucose tolerance

Abdominal body fat distribution detected by computed tomography in diabetic men

Invest Radiol