Age and gender specific estimation of visceral adipose tissue amounts from radiological images in morbidly obese patients.

Nicolas Linder,Arne Dietrich,Ulf Retschlag,Alexander Schaudinn,Harald Busse,Thomas Kahn,Nikita Garnov,Thomas Karlas,Stefanie Lehmann,Matthias Blüher,Tatjana Schütz

doi:10.1038/srep22261

Abstract

Image-based quantifications of visceral adipose tissue (VAT) volumes from segmented VAT areas are increasingly considered for risk assessment in obese patients. The goal of this study was to determine the power of partial VAT areas to predict total VAT volume in morbidly obese patients (BMI > 40 kg/m2) as a function of gender, age and anatomical landmarks. 130 morbidly obese patients (mean BMI 46.5 kg/m2; 94 females) underwent IRB-approved MRI. Total VAT volumes were predicted from segmented VAT areas (of single or five adjacent slices) at common axial landmark levels and compared with the measured ones (VVAT-T, about 40 slices between diaphragm and pelvic floor). Standard deviations σ1 and σ5 of the respective VAT volume differences served as measures of agreement. Mean VVAT-T was 4.9 L for females and 8.1 L for males. Best predictions were found at intervertebral spaces L3-L4 for females (σ5 = 688 ml, σ1 = 832 ml) and L1-L2 for males (σ5 = 846 ml, σ1 = 992 ml), irrespective of age. In conclusion, VAT volumes in morbidly obese patients can be reliably predicted by multiplying the segmented VAT area at a gender-specific lumbar reference level with a fixed scaling factor and effective slice thickness.

Highlights

VVAT-T values in males were significantly higher compared to females (8.1 ± 3.1; range 3.6– 15.0 L compared to 4.9 ± 1.7; range 1.4–10.2 L)
A gender-specific distribution of single-slice Visceral adipose tissue (VAT) areas (AVAT-1) across the whole study population is illustrated in Fig. 3 for different axial heights href relative to the reference position at intervertebral space L3-L4
Largest median VAT areas were found at href = − 1.05, 1.05 and 2.10 cm in females and, more cranial, at href = 3.15, 4.20 and 7.35 cm in males

Summary

Introduction

VAT volumes in morbidly obese patients can be reliably predicted by multiplying the segmented VAT area at a gender-specific lumbar reference level with a fixed scaling factor and effective slice thickness. Studies using single or five slice VAT areas for VAT volume prediction have mainly focused on patients with BMI values below 40 kg/m2 and data for the morbidly obese are lacking[10,11,12,13,14,15,16]. The goal of this study was to assess the predictive power of simple VAT areas at various anatomical landmarks and to determine the potential impact of cofactors gender and age in a relatively large number of www.nature.com/scientificreports/

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Conclusion