Validation of EASO criteria and development of a new diagnostic tool for visceral obesity in Chinese adults

Aim: This study aimed to explore the relationship between visceral fat and obesity-related metabolic diseases, validate the obesity criteria from the European Association for the Study of Obesity (EASO) in the Chinese population, and propose new standards for identifying visceral fat using simple anthropometric indicators. Methods: This cross-sectional study involved 3,371 participants aged 26-76 years in Pinggu District, Beijing. Anthropometric measurements and metabolic indicators were assessed, and visceral fat area (VFA) was calculated from non-contrast abdominal computed tomography scans. The McNemar test was used to compare the diagnostic accuracy of the EASO criteria and body mass index (BMI) for identifying visceral obesity. The correlation between anthropometric indicators and VFA was analysed using Spearman’s correlation coefficient. Receiver operating characteristic curves were used to compare the diagnostic efficacy and thresholds of anthropometric indicators with the EASO criteria. Results: Among 3,371 participants, 61.2% were diagnosed with visceral obesity. Metabolic disease prevalence was higher in individuals with visceral obesity, suggesting that visceral fat accumulation is a sensitive marker for identifying metabolic diseases. The EASO criteria showed higher sensitivity and lower specificity than BMI alone for diagnosing visceral obesity. Waist circumference (WC) and waist-to-height ratio correlated strongly with VFA. BMI combined with WC was the most effective tool for diagnosing visceral obesity in the Chinese population. Conclusion: Visceral fat accumulation is associated with metabolic diseases, and the EASO criteria are superior to BMI in identifying visceral obesity. BMI combined with WC is effective for diagnosing visceral obesity in the Chinese population.