Visceral Adipose Tissue Volume Estimated at Imaging Sites 5-6 cm Above L4-L5 Is Optimal for Predicting Cardiovascular Risk Factors in Obese Japanese Men

Abstract

The association between visceral adipose tissue (VAT) with cardiovascular disease (CVD) has been clearly demonstrated. Although typical VAT area at 4th and 5th lumbar vertebrae (L4-L5) is used to approximate VAT volume, growing evidence has suggested that this measurement site may not be ideal. However, these findings for Asian people remain unclear. Thus, we searched for the better VAT measurement sites associated with CVD risk factors in obese, Japanese men. Eighty-two obese men were included in a cross-sectional study. Among these participants, 37 men completed the 12-week intervention (90 min and 3 d/week) were used for addressing longitudinal association between the VAT measurement sites and CVD risk factors. Consecutive MRI images (from 3 cm below L4-L5 to 20 cm above L4-L5) were used to explore the relationship between each VAT area and CVD risk factors (total cholesterol, HDL cholesterol, triglycerides, glucose, insulin and blood pressure). The images located only 5-9 cm above L4-L5 had significant correlations with HDL cholesterol and triglycerides, but L4-L5 site did not in the cross-sectional analysis. In response to exercise, the image located 5 cm above L4-L5 showed the highest correlations with changes in total cholesterol (r = 0.46) and glucose (r = 0.36). Also, the image located 6 cm above L4-L5 showed highest correlations with changes in triglycerides (r = 0.37) and insulin (r = 0.37). Thus, the range of VAT images located 5-6 cm above L4-L5 may be optimal for identifying CVD risk factors compared to a typical site of L4-L5.

Multiple-slice magnetic resonance imaging can detect visceral adipose tissue reduction more accurately than single-slice imaging

“…For this study, we chose the single-slice image located 5 cm above L4-L5 to compare to the single-slice image at the level of L4-L5, which is the traditional site of origin, because our previous studies showed the þ 5 cm site to be most closely associated with VAT volume. 10,11 Furthermore, results from our previous studies for the areas 6 and 5 cm above L4-L5 were almost identical (data not shown).…”

“…Furthermore, our ongoing research evaluates the relationship between single-slice imaging and total VAT and subcutaneous adipose tissue (SAT) volume. 10,11 We concluded that the area 5-6 cm above L4-L5 is a better predictor of VAT volume than the cross-sectional L4-L5 image, and it changes with diet and exercise. This is similar to the results of previous studies.…”

Identification of Obesity and Cardiovascular Risk in Ethnically and Racially Diverse Populations

“…97 It is not clear, however, exactly which sagittal slice best correlates with total VAT volume and CVD risk factors. Commonly, a sagittal slice obtained at the L4-L5 level is used to approximate VAT volume 98 ; however, Shen et al 99 studied an ethnically and racially diverse group of people and found that different abdominal levels are more predictive of VAT volume than the L4-L5 level. Among men, a single slice at 10 cm above L4-L5 was most predictive of VAT volume; among women, 5 cm above L4-L5 was most predictive.…”

The methods for the characteristic of adipose tissue in the organism and their clinical significance

“…Ис-следования ВЖТ на данном уровне показывают максимальную воспроизводимость и высокую точ-ность измерений. В ряде работ [29,30] показано, что оценка ВЖТ на 5-6 см выше L4-L5 является более точной при проведении МРТ и КТ в динамике.…”