Is Metabolic Score for Visceral Fat (METS-VF) a Better Index Than Other Adiposity Indices for the Prediction of Visceral Adiposity

Abstract

Background: Visceral adiposity is an important risk factor for cardiometabolic diseases.

Objective: To determine whether the Metabolic Score for Visceral Fat (METS-VF) is more effective than other adiposity indices in predicting visceral fat area (VFA).

Methods: In this single-center and cross-sectional study, we included patients aged 20-50 years, without diabetes and coronary artery disease, who underwent computed tomography (CT) including the third lumbar vertebra. Age, blood pressure, waist circumference (WC), hip circumference, fasting lipids, and glucose were assessed. VFA was measured by cross-sectional examination of CT. The correlation of WC, body mass index (BMI), waist-hip ratio (WHR), lipid accumulation product (LAP), visceral adiposity index (VAI), a body shape index (ABSI), body roundness index (BRI), and METS-VF with VFA was analyzed by correlation analysis. The cut-off values and area under the curve (AUC) for identifying increased VFA (>130 cm²) were determined.

Results: We included 185 individuals with mean age 38.2 ± 8 and female predominance (58.4%). There was a significant positive correlation between all indices and VFA (p<0.001). ROC analysis revealed that METS-VF and WC demonstrated the highest predictive value for identifying increased VFA. In both men (p=0.001) and women (p<0.001), METS-VF (AUC 0.922 and 0.939, respectively) showed a significant superiority over ABSI (AUC 0.702 and 0.658, respectively), and VAI (AUC 0.731 and 0.725, respectively). Additionally, in women, its superiority over WHR (AUC 0.807) was also statistically significant (p=0.003). We identified a METS-VF cut-off point >6.4 in males >6.5 in females and WC cut-off point >88 cm in males (AUC 0.922), >90.5 cm in females (AUC 0.938).

Conclusion: METS-VF is strongly associated with visceral adiposity and better to predict increased VFA. However, its superiority over WC, BMI, BRI, and LAP was not significant. The results emphasize that WC is more appealing as screening indicator for visceral adiposity considering its easy use.

Clinical trial registry name: Clinicaltrials.gov (http://www.clinicaltrials.gov).

Clinical trial registry url: https://clinicaltrials.gov/ct2/show/NCT05648409.

Clinical trial registry number: NCT05648409.

Keywords: anthropometric measurements; body shape; cardiometabolic risk; hypertriglyceridemic waist; obesity.

Figure 1

Flow diagram for inclusion and exclusion.

Figure 2

Fat-measurement technique in CT. After manual contour (yellow line) was placed on the abdominal wall skeletal muscles, automatic measurements of visceral adipose tissue (A, red area) and subcutaneous adipose tissue (B, red area) areas were performed with threshold values.