title: Methods of estimation of visceral fat: advantages of ultrasonography.
abstract: OBJECTIVE
  To compare methods for the assessment of visceral fat with computed tomography (CT) and establish cutoffs to define visceral obesity based on such alternative methods.
  
  
  METHODS
  One hundred women (50.4 +/- 7.7 years; BMI 39.2 +/- 5.4 kg/m2 underwent anthropometric evaluation, bioelectrical impedance, DXA, abdominal ultrasonography (US), and CT scan.
  
  
  RESULTS
  Waist circumference, waist-to-hip ratio (WHR), and US-determined visceral fat values showed the best correlation coefficients with visceral fat determined by CT (r = 0.55, 0.54, and 0.71, respectively; p < 0.01). Fat mass determined by DXA was inversely correlated with visceral-to-subcutaneous-fat ratio (r = -0.47, p < 0.01). Bioimpedance-determined fat mass and skinfolds were correlated with only subcutaneous abdominal fat quantified by CT. Linear regression indicated US visceral-fat distance and WHR as the main predictors of CT-determined visceral fat (adjusted r2 = 0.51, p < 0.01). A waist measurement of 107 cm (82.7% specificity, 60.6% sensitivity) and WHR of 0.97 (78.8% specificity, 63.8% sensitivity) were chosen as discriminator values corresponding with visceral obesity diagnosed by CT. A value of 6.90 cm for visceral fat US-determined diagnosed visceral obesity with a specificity of 82.8%, a sensitivity of 69.2%, and a diagnostic concordance of 74% with CT.
  
  
  CONCLUSIONS
  US seemed to be the best alternative method for the assessment of intra-abdominal fat in obese women. Its diagnostic value could be optimized by an anthropometric measurement. Prospective studies are needed to establish CT and US cutoffs for defining visceral-fat levels related to elevated cardiovascular risk.
authors.affiliation: Department of Internal Medicine, Endocrinology Division, Federal University of Sao Paulo, Brazil. fflexa@uol.com.br
authors.forename: Fernando F
authors.initials: FF
authors.lastname: Ribeiro-Filho
authors.forename: Alessandra N
authors.initials: AN
authors.lastname: Faria
authors.forename: Sergio
authors.initials: S
authors.lastname: Azjen
authors.forename: Maria-Teresa
authors.initials: MT
authors.lastname: Zanella
authors.forename: Sandra R G
authors.initials: SR
authors.lastname: Ferreira
mesh_terms: D000005:Abdomen / Q000000981:diagnostic imaging* / Q000502:physiology; D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000000981:diagnostic imaging* / Q000502:physiology; D000328:Adult; D000368:Aged; D000886:Anthropometry / Q000295:instrumentation / Q000379:methods*; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000000981:diagnostic imaging* / Q000473:pathology; D012372:ROC Curve; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography