Role of CT in Obesity: Scanning the Scene for Metabolic Syndrome Clues

Objective: This study aims to evaluate the relationship between visceral fat volume (VFV), subcutaneous fat volume (SVF), and total abdominal fat volume with metabolic syndrome, using CT and contrast-enhanced CT (CECT) of the abdomen and pelvis. Methods: A retrospective study was conducted, including 112 patients referred for abdominal CT scans between January 2023 and May 2024. Patients were categorized into two groups: Group 1, with metabolic syndrome, and Group 2, without. Inclusion criteria included individuals with hyperinsulinemia or hyperglycemia and at least two additional metabolic risk factors. Abdominal fat volumes were measured at the L4-L5 intervertebral disc level using a 128-slice MDCT scanner and a segmentation algorithm to distinguish visceral and subcutaneous fat volumes. Statistical analysis was performed using independent sample t-tests and Pearson’s correlation tests. Results: Group 1 had significantly higher VFV, SVF, and total fat volume compared to Group 2 (p = 0.001). A notable male predominance (61.6%) was observed, with significant gender-specific differences in fat volume distributions. Group 1 exhibited larger VFV, SFV, and total fat volumes in both males and females, with higher VFV particularly in females. No correlation was found between BMI and VFV, SVF, or total fat volume. VFV in females showed a strong association with metabolic syndrome. Conclusions: Abdominal CT is an effective tool for assessing metabolic syndrome risk through quantification of VFV, SVF, and total fat volume, providing a more reliable assessment than BMI. These findings suggest that CT imaging may play a vital role in early detection and intervention for metabolic syndrome, allowing for improved clinical outcomes.