title: Visceral fat quantification in asymptomatic  adults using abdominal CT: is it predictive  of future cardiac events?
abstract: OBJECTIVE
  The purpose of this study was to determine if quantifying visceral adipose tissue (VAT) at CT in asymptomatic adults can predict the likelihood of future cardiac events.
  
  
  METHODS
  Subcutaneous and visceral fat volumes were obtained from abdominal CT utilizing a validated semi-automated software tool in 663 asymptomatic adults (mean age 57.3 years, 379F/284M) undergoing colorectal screening. Patients were followed for subsequent cardiac events, defined as myocardial infarction or coronary intervention for a mean follow-up interval of 7.0 ± 1.4 years. Relevant clinical data including Framingham risk score (FRS) were also collected. Statistical analysis included logistic regression, Pearson correlation coefficients, and Welch and Wilcoxon rank sum tests.
  
  
  RESULTS
  Cardiac events were documented in 32 subjects (4.8%) an average 3.0 years after index CT. FRS was predictive of future cardiac events, signified by a higher score (mean score 11.9 vs. 7.4; p < 0.001). HDL levels were significantly lower in the cardiac event cohort (mean 52.2 vs. 61.0; p < 0.01). None of the other clinical variables were predictive and none of the CT-based fat measurements (visceral, subcutaneous, and total adipose tissue; visceral fat %) correlated with future cardiac events (p = 0.561–0.886). Mean visceral fat % in the cardiac event cohort was 38.1% vs. 39.1% for the non-event group.
  
  
  CONCLUSIONS
  Quantification of VAT at abdominal CT was not predictive of future cardiac events in this asymptomatic cohort, whereas HDL levels and FRSs correlated well with risk.
authors.forename: Eva M
authors.initials: EM
authors.lastname: Ryckman
authors.forename: Ronald M
authors.initials: RM
authors.lastname: Summers
authors.forename: Jiamin
authors.initials: J
authors.lastname: Liu
authors.forename: Alejandro
authors.initials: A
authors.lastname: Munoz del Rio
authors.forename: Perry J
authors.initials: PJ
authors.lastname: Pickhardt
mesh_terms: D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000175:diagnosis*; D006801:Humans; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011860:Radiography, Abdominal / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed / Q000379:methods*