Measurement of visceral fat: should we include retroperitoneal fat?
OBJECTIVE
Whether retroperitoneal fat should be included in the measurement of visceral fat remains controversial. We compared the relationships of fat areas in peritoneal, retroperitoneal, and subcutaneous compartments to metabolic syndrome, adipokines, and incident hypertension and diabetes.


METHODS
We enrolled 432 adult participants (153 men and 279 women) in a community-based cohort study. Computed tomography at the umbilicus level was used to measure the fat areas.


RESULTS
Retroperitoneal fat correlated significantly with metabolic syndrome (adjusted odds ratio (OR), 5.651, p<0.05) and the number of metabolic abnormalities (p<0.05). Retroperitoneal fat area was significantly associated with blood pressure, plasma glycemic indices, lipid profile, C-reactive protein, adiponectin (r =  -0.244, P<0.05), and leptin (r = 0.323, p<0.05), but not plasma renin or aldosterone concentrations. During the 2.94 ± 0.84 years of follow-up, 32 participants developed incident hypertension. Retroperitoneal fat area (hazard ration (HR) 1.62, p = 0.003) and peritoneal fat area (HR 1.62, p = 0.009), but not subcutaneous fat area (p = 0.14) were associated with incident hypertension. Neither retroperitoneal fat area, peritoneal fat area, nor subcutaneous fat areas was associated with incident diabetes after adjustment.


CONCLUSIONS
Retroperitoneal fat is similar to peritoneal fat, but differs from subcutaneous fat, in terms of its relationship with metabolic syndrome and incident hypertension. Retroperitoneal fat area should be included in the measurement of visceral fat for cardio-metabolic studies in human.
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Chi-Sheng
CS
Hung
Department of Clinical Pathology, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Jen-Kuang
JK
Lee
Department of Medical Imaging, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.
Chung-Yi
CY
Yang
Department of Radiology, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
Hung-Ren
HR
Hsieh
Division of Endocrinology, Department of Internal Medicine, Cardinal Tien Hospital, Xindian, Taiwan.
Wen-Ya
WY
Ma
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Mao-Shin
MS
Lin
Clinical Informatics and Medical Statistics Research Center, Chang Gung University, Gueishan, Taiwan.
Pi-Hua
PH
Liu
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Shyang-Rong
SR
Shih
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Jyh-Ming
JM
Liou
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Lee-Ming
LM
Chuang
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Ming-Fong
MF
Chen
Department of Internal Medicine, National Taiwan University Hospital Yun-Lin Branch, Yun-Lin, Taiwan.
Jou-Wei
JW
Lin
Chia Nan University of Pharmacy and Science, Tainan, Taiwan.
Jung-Nan
JN
Wei
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Hung-Yuan
HY
Li
D050153:Abdominal Fat / Q000033:anatomy & histology* / Q000378:metabolism / Q000473:pathology; D054392:Adipokines / Q000378:metabolism; D000328:Adult; D000368:Aged; D001837:Body Weights and Measures; D015897:Comorbidity; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000209:etiology; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D009929:Organ Size; D062486:Public Health Surveillance; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
D054392:Adipokines