Introduction
Methods
Participants
Protocol
Measurements
DXA image analysis
Calculation of abdominal fat variables
Blood biochemistry and metabolic syndrome
Statistical analysis
Results
Characteristic | Males (n = 82) | Females (n = 86) | ||
---|---|---|---|---|
Number of non-WC MetS risk factorsb | Number of non-WC MetS risk factorsb | |||
< 2 (n = 37) | ≥ 2 (n = 45) | < 2 (n = 57) | ≥ 2 (n = 29) | |
Age (years) | 44.1 ± 14.3 | 46.0 ± 11.8 | 42.4 ± 13.9 | 45.8 ± 11.6 |
Waist circumference (cm) | 89.3 ± 7.7 | 95.6 ± 10.8* | 84.0 ± 10.1 | 88.9 ± 9.1* |
Large WC [n (%)]c | 19 (51.4) | 33 (73.3)* | 38 (66.7) | 25 (86.2)* |
Waist:height ratio | 0.53 ± 0.05 | 0.56 ± 0.07* | 0.54 ± 0.07 | 0.57 ± 0.06* |
Waist:hip ratio | 0.93 ± 0.06 | 0.95 ± 0.06 | 0.83 ± 0.07 | 0.85 ± 0.08 |
Conicity index | 1.28 ± 0.08 | 1.31 ± 0.07 | 1.23 ± 0.09 | 1.23 ± 0.09 |
Body mass index (kg/m2) | 24.2 ± 2.9 | 26.3 ± 4.1* | 25.3 ± 4.3 | 28.2 ± 4.8* |
Body adiposity index (%) | 25.8 ± 3.1 | 27.5 ± 4.7 | 33.4 ± 5.2 | 36.1 ± 6.2* |
Suprailiac SFT (mm) | 24.6 ± 11.6 | 31.8 ± 12.3* | 28.6 ± 10.6 | 34.9 ± 10.2* |
Thoracic height (cm) | 21.6 ± 2.0 | 22.5 ± 2.8 | 20.8 ± 2.0 | 21.7 ± 1.7* |
SD, anthropometric (cm) | 21.6 ± 1.6 | 22.7 ± 2.5 | 20.6 ± 2.7 | 22.6 ± 2.8* |
SD, DXA (cm)d | 22.1 ± 2.3 | 24.0 ± 2.6 | 19.4 ± 2.5 | 21.3 ± 2.6* |
Abdominal FM (g) | 210.3 ± 74.7 | 280.9 ± 90.2* | 241.2 ± 90.0 | 287.6 ± 87.6* |
Visceral FM (g) | 118.0 ± 47.3 | 156.7 ± 45.6* | 98.5 ± 37.8 | 121.6 ± 36.0* |
Subcutaneous FM (g) | 92.3 ± 42.1 | 124.2 ± 55.1* | 142.6 ± 61.9 | 166.0 ± 63.1 |
VATA/SATA ratio | 1.15 ± 0.53 | 1.11 ± 0.37 | 0.59 ± 0.23 | 0.64 ± 0.23 |
Fasting glucose (mmol/L) | 5.1 ± 0.4 | 5.4 ± 0.5* | 5.0 ± 0.4 | 5.4 ± 0.6* |
Insulin (pmol/L) | 70.3 (43.1–90.4) | 78.9 (64.6–110.5)* | 64.6 (47.4–86.1) | 91.8 (71.8–128.4)* |
Total cholesterol (mmol/L) | 5.2 ± 0.9 | 5.6 ± 1.0 | 5.2 ± 1.0 | 5.5 ± 1.0* |
LDL cholesterol (mmol/L) | 3.4 ± 0.9 | 3.7 ± 1.1 | 3.2 ± 0.9 | 3.5 ± 0.9 |
HDL cholesterol (mmol/L) | 1.3 ± 0.3 | 1.0 ± 0.2* | 1.4 ± 0.3 | 1.1 ± 0.3* |
Total: HDL cholesterol ratio | 4.23 ± 0.91 | 5.96 ± 1.38* | 3.72 ± 0.98 | 5.14 ± 1.17* |
Triglycerides (mmol/L) | 1.0 (0.9–1.3) | 2.4 (1.8–2.9)* | 1.0 (0.8–1.3) | 1.9 (1.4–2.3)* |
HOMA2-IR | 1.32 (0.82–1.68) | 1.53 (1.23–2.07)* | 1.21 (0.89–1.52) | 1.64 (1.38–2.35)* |
HOMA2-%B | 105.9 (84.3–130.6) | 112.3 (89.5–138.9) | 111.6 (80.8–130.5) | 130.5 (85.3–166.0) |
Systolic BP (mmHg) | 114.7 ± 17.4 | 124.2 ± 18.3* | 112.4 ± 20.3 | 117.6 ± 19.7 |
Diastolic BP (mmHg) | 73.5 ± 8.8 | 77.9 ± 8.5* | 71.1 ± 9.0 | 75.3 ± 8.7* |
Antihypertensive drugs | 0 (0) | 2 (4.4) | 0 (0) | 0 (0) |
Metabolic syndromee | 0 (0) | 33 (73.3)* | 0 (0) | 25 (86.2)* |
Associations between abdominal fat variables and metabolic risk factors
Dependent variable | Number of abdominal fat variables in model | ||||
---|---|---|---|---|---|
Oneb | Twoc | ||||
VFM | SFM | Waist | VFM | SFM | |
Fasting glucose | 0.138 | 0.154 | 0.102 | 0.059 | 0.121 |
log10(insulin) | 0.548‡ | 0.477‡ | 0.533‡ | 0.373‡ | 0.266† |
Total cholesterol | 0.056 | 0.102 | 0.006 | − 0.017 | 0.111 |
LDL cholesterol | 0.118 | 0.107 | 0.048 | 0.076 | 0.065 |
HDL cholesterol | − 0.313‡ | − 0.177* | − 0.250† | − 0.312† | − 0.001 |
Total/HDL cholesterol | 0.299‡ | 0.192* | 0.208† | 0.275† | 0.037 |
log10(triglycerides) | 0.306‡ | 0.195* | 0.238† | 0.282† | 0.036 |
log10(HOMA2-IR) | 0.550‡ | 0.480‡ | 0.532‡ | 0.372‡ | 0.270† |
log10(HOMA2-%B) | 0.451‡ | 0.376‡ | 0.460‡ | 0.323‡ | 0.194* |
Systolic blood pressure | 0.155* | 0.194† | 0.281‡ | 0.042 | 0.171 |
Diastolic blood pressure | 0.344‡ | 0.369‡ | 0.412‡ | 0.162 | 0.278† |
Prediction of metabolic risk factor groups
AUC (95% CI) | P-value vs. waist | Threshold-specific metric | ||||||
---|---|---|---|---|---|---|---|---|
Cut-pointb | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | Accuracy (%) | |||
Waist | 0.67 (0.55–0.79) | – | 92 cm | 60 | 68 | 69 | 58 | 63 |
Waist:height ratio | 0.64 (0.52–0.76) | 0.34 | 0.55 | 58 | 65 | 67 | 56 | 61 |
Waist:hip ratio | 0.59 (0.46–0.72) | 0.11 | 0.92 | 76 | 46 | 63 | 61 | 62 |
Conicity index | 0.63 (0.51–0.76) | 0.45 | 1.26 | 84 | 41 | 63 | 68 | 65 |
SD, DXA | 0.70 (0.59–0.81) | 0.40 | 23 cm | 64 | 65 | 69 | 60 | 65 |
SD, anthropometricc | 0.60 (0.45–0.75) | 0.47 | 23.8 cm | 32 | 93 | 82 | 59 | 63 |
Suprailiac SFT | 0.68 (0.56–0.80) | 0.86 | 30 mm | 51 | 84 | 79 | 58 | 66 |
BMI | 0.67 (0.55–0.78) | 0.94 | 24 kg/m2 | 76 | 51 | 65 | 63 | 65 |
Body adiposity index | 0.59 (0.47–0.72) | 0.23 | 27.5% | 44 | 78 | 71 | 54 | 60 |
VFM, DXA | 0.73 (0.62–0.84) | 0.25 | 125 g | 76 | 76 | 69 | 67 | 68 |
VFM, predictedd | 0.67 (0.55–0.79) | 0.95 | 143 g | 53 | 78 | 75 | 58 | 65 |
AUC (95% CI) | P-value vs. waist | Threshold-specific metric | ||||||
---|---|---|---|---|---|---|---|---|
Cut-pointb | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | Accuracy (%) | |||
Waist | 0.65 (0.53–0.77) | – | 79 cm | 97 | 32 | 42 | 32 | 53 |
Waist:height ratio | 0.66 (0.54–0.78) | 0.59 | 0.50 | 93 | 33 | 42 | 90 | 53 |
Waist:hip ratio | 0.56 (0.42–0.69) | 0.11 | 0.90 | 24 | 88 | 50 | 69 | 66 |
Conicity index | 0.53 (0.41–0.66) | 0.02 | 1.22 | 55 | 56 | 39 | 71 | 56 |
SD, DXA | 0.70 (0.59–0.82) | 0.13 | 19 cm | 62 | 72 | 53 | 79 | 69 |
SD, anthropometricc | 0.68 (0.54–0.82) | 0.44 | 21.8 cm | 67 | 69 | 54 | 79 | 68 |
Suprailiac SFT | 0.69 (0.58–0.81) | 0.51 | 29 mm | 69 | 63 | 49 | 80 | 65 |
BMI | 0.69 (0.57–0.80) | 0.40 | 24.5 kg/m2 | 83 | 51 | 46 | 85 | 62 |
Body adiposity index | 0.62 (0.50–0.75) | 0.66 | 32% | 83 | 46 | 44 | 84 | 58 |
VFM, DXA | 0.68 (0.57–0.80) | 0.16 | 112 g | 62 | 72 | 53 | 79 | 69 |
VFM, predictedd | 0.69 (0.57–0.80) | 0.48 | 95 g | 86 | 49 | 46 | 88 | 62 |
Parameter | Cut-point | Threshold-specific metric | ||||||
---|---|---|---|---|---|---|---|---|
Parameter | WC (cm) | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | Accuracy (%) | F1 score (%) | |
Males | ||||||||
SD, DXA | 21 cm | 87 | 84 | 46 | 66 | 71 | 67 | 74 |
Suprailiac SFT | 25 mm | 87 | 62 | 70 | 72 | 60 | 66 | 67 |
BMI | 24 kg/m2 | 90 | 67 | 70 | 73 | 63 | 68 | 70 |
VFM, DXA | 107 g | 78 | 91 | 43 | 66 | 80 | 70 | 77 |
Females | ||||||||
SD, DXA | 19 cm | 84 | 76 | 61 | 50 | 83 | 66 | 60 |
Suprailiac SFT | 29 mm | 84 | 57 | 74 | 52 | 77 | 68 | 55 |
BMI | 27.5 kg/m2 | 84 | 45 | 81 | 54 | 74 | 69 | 49 |
VFM, DXA | 112 g | 77 | 62 | 74 | 55 | 79 | 70 | 58 |