Is visceral fat really a coronary risk factor? A multi-detector computed tomography study

Metabolic syndrome (MS) is currently considered to be a risk factor for arteriosclerotic disease. The accumulation of visceral fat leads to arteriosclerotic disease after other risk factors have developed and either direct or mutual effects occur. The aim of this study was to verify whether visceral fat serves as an independent coronary risk factor. A total of 3157 patients who had undergone multi-detector computed tomography (MDCT) were analyzed via computed tomographic angiography and the measurement of their visceral fat area. Coronary arteries with > 70% stenosis were considered to be significant. The visceral fat area was measured at the umbilical level, and an area of 100 cm2 or more was defined as visceral obesity. Coronary risk factors (ie, hypertension, dyslipidemia, diabetes mellitus, family history, and smoking) were obtained from the patient medical records. The patients were divided into two groups: a visceral obesity group, 1130 patients (137.0 ± 31.1 cm2) and a nonvisceral obesity group, 2027 patients (57.3 ± 25.8 cm2). A significant difference in the incidence of coronary stenosis between the two groups was observed. According to multivariable analysis, the factors affecting coronary stenosis were age, gender, dyslipidemia, diabetes mellitus, and the ratio of visceral to subcutaneous fat. Visceral obesity was not found to be an independent coronary risk factor. Visceral obesity demonstrated the predominant presence of coronary risk factors.