Omar Yaxmehen Bello-Chavolla1, Neftali Eduardo Antonio-Villa1, Arsenio Vargas-Vázquez1, Tannia Leticia Viveros-Ruiz2, Paloma Almeda-Valdes3, Donaji Gomez-Velasco2, Roopa Mehta3, Daniel Elias-López3, Ivette Cruz-Bautista2, Ernesto Roldán-Valadez4, Alexandro J Martagón5, Carlos A Aguilar-Salinas6. 1. Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico; MD/PhD (PECEM) Program, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico. 2. Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico. 3. Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico; Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico. 4. Directorate of Research, Hospital General de Mexico "Dr Eduardo Liceaga", Mexico; I.M. Sechenov First Moscow State Medical University (Sechenov University), Department of Radiology, Russia. 5. Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico. 6. Unidad de Investigación de Enfermedades Metabólicas, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico; Department of Endocrinology and Metabolism, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico; Tecnologico de Monterrey, Escuela de Medicina y Ciencias de la Salud, Mexico. Electronic address: caguilarsalinas@yahoo.com.
Abstract
BACKGROUND & AIMS: Intra-abdominal and visceral fat (VAT) are risk factors for the development of cardio-metabolic comorbidities; however its clinical assessment is limited by technology and required expertise for its assessment. We aimed to develop a novel score (METS-VF) to estimate VAT by combining the non-insulin-based METS-IR index, waist-height ratio (WHtr), age and sex. METHODS: We developed METS-VF in a sample of 366 individuals with Dual X-ray absorptiometry (DXA). METS-VF was modeled using non-linear regression and validated in two replication cohorts with DXA (n = 184, with n = 118 who also had MRI) and bio-electrical impedance (n = 991). We also assessed METS-VF to predict incident type 2 diabetes (T2D) and arterial hypertension independent of body-mass index (BMI) in our Metabolic Syndrome Cohort (n = 6144). RESULTS: We defined METS-VF as: 4.466 + 0.011*(Ln(METS-IR))3 + 3.239*(Ln(WHtr))3 + 0.319*(Sex) + 0.594*(Ln(Age)). METS-VF showed better performance compared to other VAT surrogates using either DXA (AUC 0.896 95% CI 0.847-0.945) or MRI (AUC 0.842 95% CI 0.771-0.913) as gold standards. We identified a METS-VF cut-off point >7.18 in healthy patients which has 100% sensitivity (95% CI 76.8-100) and 87.2% specificity (95% CI 79.1-93.0) to identify increased VAT (>100 cm2). METS-VF also had adequate performance in subjects with metabolically-healthy obesity. Finally, in our metabolic syndrome cohort, subjects in the upper quintiles of METS-VF (>7.2) had 3.8 and 2.0-fold higher risk of incident T2D and hypertension, respectively (p < 0.001). This effect was independent of BMI for both outcomes. CONCLUSION: METS-VF is a novel surrogate to estimate VAT, which has better performance compared to other surrogate VAT indexes and is predictive of incident T2D and hypertension. METS-VF could be a useful tool to assess cardio-metabolic risk in primary care practice and research settings.
BACKGROUND & AIMS: Intra-abdominal and visceral fat (VAT) are risk factors for the development of cardio-metabolic comorbidities; however its clinical assessment is limited by technology and required expertise for its assessment. We aimed to develop a novel score (METS-VF) to estimate VAT by combining the non-insulin-based METS-IR index, waist-height ratio (WHtr), age and sex. METHODS: We developed METS-VF in a sample of 366 individuals with Dual X-ray absorptiometry (DXA). METS-VF was modeled using non-linear regression and validated in two replication cohorts with DXA (n = 184, with n = 118 who also had MRI) and bio-electrical impedance (n = 991). We also assessed METS-VF to predict incident type 2 diabetes (T2D) and arterial hypertension independent of body-mass index (BMI) in our Metabolic Syndrome Cohort (n = 6144). RESULTS: We defined METS-VF as: 4.466 + 0.011*(Ln(METS-IR))3 + 3.239*(Ln(WHtr))3 + 0.319*(Sex) + 0.594*(Ln(Age)). METS-VF showed better performance compared to other VAT surrogates using either DXA (AUC 0.896 95% CI 0.847-0.945) or MRI (AUC 0.842 95% CI 0.771-0.913) as gold standards. We identified a METS-VF cut-off point >7.18 in healthy patients which has 100% sensitivity (95% CI 76.8-100) and 87.2% specificity (95% CI 79.1-93.0) to identify increased VAT (>100 cm2). METS-VF also had adequate performance in subjects with metabolically-healthy obesity. Finally, in our metabolic syndrome cohort, subjects in the upper quintiles of METS-VF (>7.2) had 3.8 and 2.0-fold higher risk of incident T2D and hypertension, respectively (p < 0.001). This effect was independent of BMI for both outcomes. CONCLUSION: METS-VF is a novel surrogate to estimate VAT, which has better performance compared to other surrogate VAT indexes and is predictive of incident T2D and hypertension. METS-VF could be a useful tool to assess cardio-metabolic risk in primary care practice and research settings.
Authors: Nitin Kapoor; Stephen A Jiwanmall; Munaf B Nandyal; Dheeraj Kattula; Sandhiya Paravathareddy; Thomas V Paul; John Furler; Brian Oldenburg; Nihal Thomas Journal: Diabetes Metab Syndr Obes Date: 2020-09-16 Impact factor: 3.168
Authors: A A López-González; A Martínez Jover; C Silveira Martínez; P Martínez Artal; S Arroyo Bote; Bárbara Altisench Jané; J I Ramírez-Manent Journal: Sci Rep Date: 2022-09-15 Impact factor: 4.996