Relationships between the visceral fat area on CT and coronary risk factor markers.

OBJECTIVE The visceral fat area (VFA) was measured, and the relationships between the VFA and the body mass index (BMI), waist circumference, blood pressure, and indices of lipid and sugar metabolism were evaluated. METHODS The subjects included 607 consecutive patients who underwent VFA examinations using computed tomography (CT) scans. In addition to the routine examination parameters, the levels of adiponectin and homeostasis model assessment as an index of insulin resistance (HOMA-IR) were measured in all subjects, and the levels of malondialdehyde-modified low-density lipoprotein (MDA-LDL), remnant-like particles (RLP), lipoprotein (a) (Lp(a)), apolipoprotein (Apo) AI, ApoB and ApoE were measured in 270 subjects. RESULTS In both men and women, the VFA showed significant positive correlations with the age, BMI, waist circumference, subcutaneous fat area, visceral fat area/subcutaneous fat area (v/s) ratio, systolic blood pressure, diastolic blood pressure, the fasting blood sugar (FBS), the hemoglobin A1c (HbA1c), high-density lipoprotein cholesterol (HDLC), triglyceride (TG), uric acid, HOMA-IR and ApoB and the ApoB/LDLC ratio and significant negative correlations with the levels of HDLC and adiponectin. The levels of the total cholesterol (TC), low-density lipoprotein cholesterol (LDLC), non-HDLC, MDA-LDL and Lp(a) and the ApoB/ApoAI ratio were not correlated with the VFA in either men or women. The RLP exhibited a significant positive correlation with the VFA in women. CONCLUSION The VFA exhibited high positive correlations with the waist circumference, blood pressure and TG level and a negative correlation with the HDLC level, regardless of gender, supporting the validity of the present diagnostic method for evaluating metabolic syndrome (MS). Although the LDLC level is not included in the diagnostic criteria for MS, the positive correlations between the VFA and the ApoB level and ApoB/LDLC ratio observed in both men and women indicate qualitative abnormalities of lipoproteins, such as an increase in the amount of small dense LDL. Measuring the levels of apolipoproteins in addition to lipoproteins during health screening is therefore useful for evaluating of atherogenicity.