Abstract
BACKGROUND: Whether abdominal visceral adipose tissue (VAT) has a stronger association with metabolic syndrome (MS) and cardiometabolic risk factors (CMRFs) than intrathoracic adipose tissue (IAT) is not yet known. We aimed to compare the associations between IAT at multiple levels and VAT with MS and CMRFs using quantitative computed tomography (QCT). The predictive value of IAT and VAT was compared. METHODS: A total of 256 participants who underwent chest low-dose computed tomography (LDCT) for lung cancer screening and QCT examinations for adipose tissue quantification were included. IAT at the T1/2 to T7/8 levels and VAT at the L2/3 level were measured by QCT. Correlation analysis was performed to determine the correlation of IAT and VAT with CMRFs. Logistic regression was used to calculate the odds ratio (OR) in adipose tissue for MS and the presence of two or more CMRFs, and the area under the curve (AUC) of the receiver operating characteristic (ROC) curve was used to compare the predictive performance. RESULTS: The VAT areas showed slightly stronger correlation with all CMRFs (r=-0.422 to 0.357, P<0.001) than IAT areas at different levels (r=-0.329 to 0.318, P<0.05). After adjusting for sex, age, and body mass index (BMI), the IAT areas were not associated with MS (P>0.05), but VAT areas remained associated with MS (OR =1.022, P=0.001). The VAT areas showed significantly higher predictive power (AUC =0.845) than IAT areas at T2/3 (AUC =0.725) and T6/7 (AUC =0.743) levels for predicting MS (P=0.004, P=0.021, respectively) in males. VAT areas had higher AUC values (AUC: 0.806 and 0.748) for predicting MS and the presence of two or more CMRFs than IAT areas at T2/3 (AUC: 0.707 and 0.657) and T6/7 (AUC: 0.748 and 0.636) levels without statistically significant differences (P>0.05) in females. CONCLUSIONS: Both VAT and IAT were associated with CMRFs, but VAT had a slightly stronger correlation with all CMRFs than IAT. After adjusting for sex, age, and BMI, VAT was an independent factor of MS rather than IAT. VAT may have slightly better predictive value for MS and the presence of two or more CMRFs.