Visceral And Subcutaneous Fat as Predictors of Diabetes Mellitus: A Computed Tomography Scan-Based Study in Southern Indian Rural Population

Introduction Type 2 diabetes mellitus is constantly increasing globally, and obesity is deemed a "high-risk factor" for it. Visceral fat plays a significant role in the development and progression of metabolic syndrome. However, the effect of subcutaneous fat accumulation (SFA) remains unclear and warrants further investigation. Although imaging modalities such as magnetic resonance imaging, computed tomography (CT), and dual-energy X-ray absorptiometry are commonly employed to evaluate visceral fat, their high cost and limited accessibility restrict their routine clinical use. This highlights the urgent need for simple, cost-effective, reliable, and widely accessible diagnostic tools. Material & Methods A retrospective study was conducted on 240 individuals (120 patients with diabetes and 120 without diabetes) aged 18-75 years. Patients who underwent plain CT scans of the abdomen, pelvis, kidney, ureter, and bladder at the L3 vertebral level were considered for this study. The study was performed using a Siemens 128-slice SOMATOM Go-top CT machine. Data were obtained using the SYNAPSE software. Visceral and subcutaneous fat volumes were measured using a fat analyzer by adjusting the measurement plane to the level of the umbilicus. Results The mean ages were recorded as 46.47 and 42.60 years in patients with diabetes and without diabetes, respectively, with male predominance (53.33%) among patients with diabetes and female predominance (51.67%) among patients without diabetes. The mean HbA1c and BMI values were 6.57% and 25.63% in patients with diabetes and 5.38 kg/m² and 23.62 kg/m² in patients without diabetes, respectively. The mean visceral fat accumulation (VFA) was recorded to be 3075.72 cm³ and 2042.54 cm³ in patients with and without diabetes, whereas the mean SFA was recorded to be 3309.39 cm³ and 1795.75 cm³ in patients with and without diabetes, respectively; and this was found to be statistically significant. Conclusion We recorded significant differences in VFA and SFA between individuals with and without diabetes, illustrating the alterations that patients with diabetes undergo. Over the years, extensive research on the assessment of VFA has been conducted and it has proven to be a reliable marker. However, there is a lack of similar evidence for SFA. Therefore, we recommend using it as an adjunct to VFA.