Objective: We investigated which anthropometric variables or imaging techniques, dual-energy x-ray absorptiometric densitometry (DXA) or bioelectric impedance analysis (BIA), are the most important determinants of the metabolic syndrome. We also evaluated the correlation between anthropometric parameters and DXA and computed axial tomography (CAT) in predicting visceral fat.
Methods: In a series of 399 overweight or obese patients (29.8% male and 70.2% female), anthropometric variables and imaging techniques (DXA or BIA) were measured and correlated with each component of the metabolic syndrome (diagnosed according to the criteria of the Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults of the National Cholesterol Education Program [Adult Treatment Panel III], with the exception of waist circumference). In a subpopulation of 109 patients, CAT was used to assess visceral fat and its correlation with the anthropometric variables and DXA.
Results: Applying receiver operating characteristic curves, the waist/height ratio was the best determinant of the metabolic syndrome (0.758, 95% confidence interval 0.634-0.882). The intra-abdominal diameter determined by DXA (r = 0.657, P < 0.001) and the waist/hip ratio (r = 0.603, P < 0.001) had the best correlation with visceral fat as measured by CAT.
Conclusion: The prediction of visceral fat in overweight and obese patients, as assessed by anthropometric tests and DXA, offers a good alternative to CAT, without significant differences between them.