Quantitative Assessment of Visceral and Subcutaneous Fat with Hepatosteatosis by Computed Tomography in Metabolic Syndrome

Purpose: We aimed to evaluate visceral and subcutaneous fat tissue and its association with hepatosteatosis on computed tomography (CT) scans to determine cut-off criteria for metabolic syndrome, measure abdominal obesity directly based on the visceral fat tissue area (VFTA) rather than indirectly based on waist circumference and obtain supportive findings by density measurements in addition to the VFTA measurements.Materials and Methods: The Hounsfield unit (HU) values, visceral, subcutaneous fat areas and HU values of 108 patients diagnosed with metabolic syndrome (MS) were determined according to the National Cholesterol Education Program Adult Treatment Panel III 2001 Criteria by retrospectively analyzing their abdominal CT images taken for various reasons. The relationships of the obtained values with each other and to MS were evaluated.Results: The strongest predictor of MS was VFTA, and 156.47 cm² was the most significant value with 74.1% sensitivity and 58.6% specificity. An HU value of -102.99 for visceral fat tissue density (VFTD) was found as the second most significant finding with 75% sensitivity and 57.6% specificity. The VFTA values of the patients with hepatosteatosis were higher, and increased VFTA values were associated with lower VFTD values.Conclusion: The most important supportive finding was the demonstration of the possibility of measuring abdominal obesity, which has an important place among criteria, directly by measuring VFTA, rather than indirectly based on waist circumference.