Yohann Renard1,2, Anna Diaz Cives3, Nicolas Veyrie4, Jean Luc Bouillot4, Eric Bertin5, Marc Labrousse6, Reza Kianmanesh3, Claude Avisse6,3. 1. Department of Anatomy, Faculté de Médecine de Reims, Université de Reims Champagne-Ardenne, 51, rue Cognacq-Jay, 51095, Reims, France. yrenard@chu-reims.fr. 2. Department of Digestive and Endocrine Surgery, Robert-Debré University Hospital, Université de Reims Champagne-Ardenne, 51, rue Cognacq-Jay, 51095, Reims, France. yrenard@chu-reims.fr. 3. Department of Digestive and Endocrine Surgery, Robert-Debré University Hospital, Université de Reims Champagne-Ardenne, 51, rue Cognacq-Jay, 51095, Reims, France. 4. Department of General, Digestive and Metabolic Surgery, Ambroise Pare University Hospital, Université Versailles Saint-Quentin, Assistance Publique-Hôpitaux de Paris, 9, Avenue Charles de Gaulle, 92100, Boulogne, France. 5. Department of Diabetology, Nutrition, and Metabolism, Robert-Debré University Hospital, Université de Reims Champagne-Ardenne, 51, rue Cognacq-Jay, 51095, Reims, France. 6. Department of Anatomy, Faculté de Médecine de Reims, Université de Reims Champagne-Ardenne, 51, rue Cognacq-Jay, 51095, Reims, France.
Abstract
PURPOSE: The importance and proportion of visceral adipose tissue (VAT) represent the best criterion to define obesity. Because VAT value is difficult to obtain in clinical practice, the indication for bariatric surgery is still based at present on Body Mass index (BMI), even though BMI is a poor predictor of obesity-related morbid complications. This correlation study aimed at determining a simple and accurate computed tomography (CT) anatomic marker, which can be easily used clinically, well correlated with the volume of VAT and consequently with morbid complications. METHODS: We studied 108 CT scans of patients presenting with morbid obesity. Several simplified measures (external and internal abdominal diameters and circumferences) were conducted on CT scan view, going through the fourth lumbar vertebra (L4), in addition to various vertebral measurements (area of the vertebra, sagittal and transversal diameters), VAT and subcutaneous adipose tissue (SAT). Then, we reported the simplified measures values on the vertebral areas, and we calculated the Bertin index. Finally, we conducted a correlation study between all variables to obtain accurate VAT measurements. RESULTS: The internal abdominal circumference and the Bertin index showed the best correlations with VAT in morbidly obese patients (r = 0.84 and 0.85, respectively). BMI and anthropometric measures were not correlated with VAT. CONCLUSION: CT scan study allows to simply approximate VAT value in morbidly obese patients. An abdominal CT scan could be part of the tests used in the evaluation of obese patients to base therapeutic strategies on VAT values and not on BMI as it is the case today.
PURPOSE: The importance and proportion of visceral adipose tissue (VAT) represent the best criterion to define obesity. Because VAT value is difficult to obtain in clinical practice, the indication for bariatric surgery is still based at present on Body Mass index (BMI), even though BMI is a poor predictor of obesity-related morbid complications. This correlation study aimed at determining a simple and accurate computed tomography (CT) anatomic marker, which can be easily used clinically, well correlated with the volume of VAT and consequently with morbid complications. METHODS: We studied 108 CT scans of patients presenting with morbid obesity. Several simplified measures (external and internal abdominal diameters and circumferences) were conducted on CT scan view, going through the fourth lumbar vertebra (L4), in addition to various vertebral measurements (area of the vertebra, sagittal and transversal diameters), VAT and subcutaneous adipose tissue (SAT). Then, we reported the simplified measures values on the vertebral areas, and we calculated the Bertin index. Finally, we conducted a correlation study between all variables to obtain accurate VAT measurements. RESULTS: The internal abdominal circumference and the Bertin index showed the best correlations with VAT in morbidly obesepatients (r = 0.84 and 0.85, respectively). BMI and anthropometric measures were not correlated with VAT. CONCLUSION: CT scan study allows to simply approximate VAT value in morbidly obesepatients. An abdominal CT scan could be part of the tests used in the evaluation of obesepatients to base therapeutic strategies on VAT values and not on BMI as it is the case today.
Entities:
Keywords:
Body fat distribution; Body mass index; Cross-sectional studies; Intra-abdominal fat; Obesity; Tomography, X-ray computed
Authors: M Zamboni; E Turcato; F Armellini; H S Kahn; A Zivelonghi; H Santana; I A Bergamo-Andreis; O Bosello Journal: Int J Obes Relat Metab Disord Date: 1998-07
Authors: Joan F Carroll; Ana L Chiapa; Mayra Rodriquez; David R Phelps; Kathryn M Cardarelli; Jamboor K Vishwanatha; Sejong Bae; Roberto Cardarelli Journal: Obesity (Silver Spring) Date: 2008-01-17 Impact factor: 5.002