Original article
Measurement of visceral fat by abdominal bioelectrical impedance analysis is beneficial in medical checkup

https://doi.org/10.1016/j.orcp.2008.09.001Get rights and content

Summary

Objective

In addition to the waist circumference (WC) measurement, an accurate measurement of visceral fat is very important in terms of the pathology associated with the metabolic syndrome. The only method available for an accurate measurement of a visceral fat area (VFA) is abdominal computed tomography (CT). To overcome this limitation, we estimated VFA using abdominal bioelectrical impedance analysis (BIA) with accuracy comparable to that of abdominal CT, and investigated the relationship between VFA and risk factors of the metabolic syndrome. Because abdominal BIA detects excess visceral fat accumulation that cannot be detected by a measurement of WC, the characteristics of the subjects who were identified as having excessive visceral fat using BIA, but not WC, were examined.

Methods

Abdominal BIA was used to estimate VFA in male subjects (n = 1803) (age: 48 ± 10 years, body mass index: 23.9 ± 3.0 kg/m2) who provided informed consent.

Results

The prevalence of the metabolic syndrome diagnosed based on the diagnostic criteria established by the Japanese Society of Internal Medicine was 18%. Among the risk factors of the metabolic syndrome, WC was significantly correlated with triglycerides (TG), but estimated VFA was correlated with blood pressure and HDL-cholesterol (HDL-C), in addition to TG. Abdominal BIA detected excess visceral fat accumulation in 3% of subjects for whom WC had detected none. Elevated blood pressure, TG, and fasting plasma glucose and decreased HDL-C were also noted in these subjects, and the values of these risk factors were comparable to those of subjects in whom visceral fat accumulation was detected using WC.

Conclusion

Abdominal BIA is a simple and safe method that is superior to WC for the detection of excessive visceral fat accumulation. Therefore, abdominal BIA will likely be used clinically to detect excessive accumulation of visceral fat, which is an important predictor of the metabolic syndrome.

Introduction

Obesity is a precursor to lifestyle-related diseases, including coronary artery disease, diabetes, hyperlipidemia, and hypertension. The mechanisms by which obesity-induced lifestyle diseases develop have not been fully identified, but abnormal distribution of body fat, particularly excessive accumulation of visceral fat in the peritoneal cavity, has recently attracted attention [1], [2].

The incidence and severity of endocrine disorders of metabolism are elevated in obese individuals with excess accumulation of visceral fat compared to individuals with subcutaneous fat accumulation [3], [4], [5]. In addition, secretion of adipocytokines reportedly is associated with accumulation of visceral fat. Adipocytokines, such as adiponectin, plasminogen activator inhibitor type-1 (PAI-1) and tumor necrosis factor-α (TNF-α) are proteins secreted by adipocytes, and the level of production of adipocytokines, such as PAI-1 and TNF-α, in visceral fat is greater than in subcutaneous fat [6], [7].

Accumulation of visceral fat plays a major role in the metabolic syndrome. Carr et al. reported insulin sensitivity was lower and the amounts of intra-abdominal and subcutaneous fat were higher in subjects diagnosed with the metabolic syndrome, based on the National Cholesterol Education Program (NCEP) diagnostic criteria, than in subjects without the metabolic syndrome. Regarding the relationship between various risk factors for the metabolic syndrome and insulin sensitivity, intra-abdominal fat, and subcutaneous fat, only intra-abdominal fat was correlated with the risk factors for the metabolic syndrome [8].

Therefore, an accurate measurement of visceral fat is very important for the prevention of coronary artery disease. Currently, however, abdominal computed tomography (CT) is the only accurate measurement method available for the assessment of visceral fat area (VFA) [9]. Therefore, we developed a method for the measurement of visceral fat using abdominal bioelectrical impedance analysis (BIA), that allows for highly accurate estimates of VFA [10].

In this study, we estimated VFA using abdominal BIA, and examined the relationship between estimated VFA and the metabolic syndrome. Because abdominal BIA detected accumulation of excess visceral fat that was not detected using WC in some subjects, we also examined the characteristics of these subjects.

Section snippets

Subjects and methods

The subjects were males (n = 1803) who underwent a job-related medical checkup. The subjects gave written informed consent to voluntarily participate in this study after the importance of the evaluation of visceral fat levels as a risk factor for the metabolic syndrome was explained to them.

BIA was used to measure visceral fat with participants in the standing position during spontaneous exhalation. Venous blood was collected after a 12-h overnight fast. HDL-cholesterol (HDL-C), triglycerides

Results

The subject characteristics are shown in Table 1.

Discussion

Management of the amount of visceral fat is very important in the prevention of lifestyle diseases. Currently, the only method available at the medical checkup to assess visceral fat is measurement of WC. The home-based instruments currently available for measurement of body fat estimate only total body fat and cannot differentiate between visceral and subcutaneous adipose fat. Thus, an accurate method for the measurement of visceral fat has not yet been achieved [13], [14], [15].

Estimates of

Conflict of interest

This study was in part supported by Kao Corporaiton, Tokyo, Japan.

Acknowledgments

We are grateful to the subjects who participated in this study. We also thank Dr. Kazuhiko Hirobe and Dr. Yoshitsugu Tatsumi for allowing us to incorporate abdominal BIA measurements into the industry medical checkup. We also thank Mitsuhiro Katashima of Kao Corporation for adjusting the abdominal BIA apparatus.

References (18)

There are more references available in the full text version of this article.

Cited by (35)

  • Clinical usefulness of abdominal bioimpedance (ViScan) in the determination of visceral fat and its application in the diagnosis and management of obesity and its comorbidities

    2018, Clinical Nutrition
    Citation Excerpt :

    Mousa et al. [30] found also better correlation of FPG with VAT by ViScan than with WC, but worse for HDL-C and TG concentrations in a smaller sample (n = 285). On the contrary, Shoji et al. [31] found better correlations of HDL-C and TG level with VAT by ViScan than with WC in a large (n = 1803) sample of men. Our data in a larger sample (n = 2849) with individuals from both genders suggests that the estimation of VAT provided by the ViScan is a better predictor of the presence of alterations in lipid metabolism, hyperuricemia and fatty liver than anthropometry.

  • Decoding the Pot Belly

    2014, Clinical Epidemiology and Global Health
  • Comparison of obesity classification methods among college students

    2019, Obesity Research and Clinical Practice
    Citation Excerpt :

    However, BMI has also been shown to result in misclassification of weight status compared to AG [24]. Moreover, some findings suggest that BIA may offer minimal value over AG [25,26]. Research regarding the accuracy of BMI in comparison to other body composition measures and obesity classification methods of among college students is lacking, though findings indicate that BMI has high sensitivity and low specificity in college men, and low sensitivity and high specificity in college women with BF% used as the criterion variable [27].

View all citing articles on Scopus
View full text