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To investigate the association between the Metabolic Score for Visceral Fat (METS-VF) and risk of type 2 diabetes mellitus (T2DM) and compare the predictive value of the METS-VF for T2DM incidence with other obesity indices in Chinese people. A total of 12 237 non-T2DM participants aged over 18 years from the Rural Chinese Cohort Study of 2007–2008 were included at baseline and followed up during 2013–2014. The cox proportional hazards regression was used to calculate hazard ratios (HR) and 95 % CI for the association between baseline METS-VF and T2DM risk. Restricted cubic splines were used to model the association between METS-VF and T2DM risk. Area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the ability of METS-VF to predict T2DM incidence. During a median follow-up of 6·01 (95 % CI 5·09, 6·06) years, 837 cases developed T2DM. After adjusting for potential confounding factors, the adjusted HR for the highest v. lowest METS-VF quartile was 5·97 (95 % CI 4·28, 8·32), with a per 1-sd increase in METS-VF positively associated with T2DM risk. Positive associations were also found in the sensitivity and subgroup analyses, respectively. A significant nonlinear dose–response association was observed between METS-VF and T2DM risk for all participants (P nonlinearity = 0·0347). Finally, the AUC value of METS-VF for predicting T2DM was largest among six indices. The METS-VF may be a reliable and applicable predictor of T2DM incidence in Chinese people regardless of sex, age or BMI.

•The Metabolic Score for Visceral Fat was positively associated with hypertension risk in this rural Chinese population.•The incidence of hypertension increased with increasing quartiles of the Metabolic Score for Visceral Fat.•The Metabolic Score for Visceral Fat might be a useful index for predicting incident hypertension. The aim of this study was to investigate the association of the Metabolic Score for Visceral Fat (METS-VF) with the risk for hypertension and to compare the ability of the METS-VF, the metabolic score for insulin resistance, visceral adiposity index, waist-to-height ratio, waist circumference, and body mass index to predict hypertension incidence based on a large prospective study of rural Chinese individuals. In all, 10 297 non-hypertensive adults (≥18 y of age) from a rural Chinese cohort study in 2007 and 2008 were included at baseline and followed up in 2013 and 2014. Multivariable logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs) for the association between baseline METS-VF and hypertension risk. Area under the receiver operating characteristic curve (AUC) analysis was used to evaluate the ability of METS-VF to predict hypertension incidence. We identified 2071 hypertension cases during follow-up. After adjusting for multivariable confounding factors, the adjusted ORs (95% CIs) for the highest versus lowest METS-VF quartile overall and for men and women were 3.84 (3.23–4.56), 3.25 (2.48–4.24), and 4.14 (3.30–5.20), respectively. Also, per-SD increase in METS-VF was positively associated with hypertension risk overall and for men and women. Similar results were found in the sensitivity and subgroup analyses. Finally, the AUC value for hypertension was higher for METS-VF than the other five indices overall and for men and women. The present study indicated that METS-VF was positively associated with hypertension incidence and performed better in predicting hypertension risk than five other indices, which suggests that METS-VF is a reliable predictor of hypertension in the Chinese population.

The presence of abdominal obesity, characterized by an accumulation of visceral fat area (VFA), has been identified as a significant risk factor for the development of type 2 diabetes mellitus (T2DM) and its associated complications. Substantial evidence has proven that it's strongly associated with lipid metabolism. The atherogenic combined index (ACI) is a novel non-traditional lipid index, but there is no clear evidence to explore the relationship with visceral fat obesity (VFO). Our study aimed to interpret this relationship in T2DM. In accordance with the research objective, this cross-sectional study retrospectively included 2,323 patients with T2DM from February 2020 to March 2023. The clinical and biochemical data were measured. VFA measurement was conducted at the umbilicus level using a dual bioelectrical impedance analysis. VFO was redefined as VFA ≥ 100 cm . The formula of ACI was based on triglyceride, non-high-density lipoprotein cholesterol and high-density lipoprotein cholesterol. Patients were categorized into the VFO group and the non-VFO group, which were then further divided according to gender. The incidence of VFO was found to be higher among males than females. Among participants of both genders, the level of ACI was found to be significantly increased in the VFO group compared with the non-VFO group (both p < 0.001). As the ACI increased, the incidence of VFO increased concomitantly. Univariate correlation analysis revealed a positive correlation between ACI and VFO (correlation coefficient: 0.223, p < 0.001 in females; correlation coefficient: 0.302, p < 0.001 in males). Logistic regression analysis indicated that ACI was associated with VFO independently (OR: 1.797, p = 0.029 in females; OR: 2.501, p < 0.001 in males). The ACI had been found to be independently correlated with VFO in patients with T2DM in both genders. This finding had the potential to facilitate the monitoring and management of VFO in T2DM.

The components of roasted or green coffee beans that promote abdominal fat reduction are not clear. We investigated the effects of daily consumption of coffee enriched in chlorogenic acids (CGA) on abdominal fat area in a randomized, double-blind, parallel controlled trial. Healthy, overweight men and women (n = 150, body mass index (BMI) ≥25 to <30 kg/m2) were randomly allocated to high-CGA (369 mg CGA/serving) or control (35 mg CGA/serving) coffee groups. Instant coffee was consumed once daily for 12 weeks, with four-week pre- and post-observation periods. Abdominal fat area and anthropometric measurements were analyzed at baseline and at four, eight, and 12 weeks, and 142 subjects completed the trial. Visceral fat area (VFA), total abdominal fat area (TFA), body weight, and waist circumference significantly decreased in the CGA group compared with the control group, with a group × time interaction (p < 0.001, p = 0.001, p = 0.025, and p = 0.001, respectively). Changes in VFA and TFA from baseline to 12 weeks were significantly greater in the CGA group than in the control group (−9.0 ± 13.9 cm2 vs. −1.0 ± 14.3 cm2, p < 0.001; −13.8 ± 22.9 cm2 vs. −2.0 ± 16.2 cm2, p < 0.001). No severe adverse events occurred. Consumption of high-CGA coffee for 12 weeks by overweight adults might lower VFA, TFA, BMI, and waist circumference.

•Patients with higher body mass index, visceral fat index, and subcutaneous fat index may have better overall survival.•Patients with higher visceral adipose tissue and visceral fat index were prone to postoperative anastomotic leakage.•Patients with higher visceral adipose tissue and visceral fat index were more difficult to heal from anastomotic leakage. Body composition was reported to be related to the prognosis of patients with cancer. This study aimed to investigate the influence of preoperative body composition on anastomotic leakage and overall survival in patients with esophageal cancer. In this retrospective study, 93 patients with esophageal cancers were evaluated. Skeletal muscle area, intermuscular adipose tissue, visceral adipose tissue (VAT), and subcutaneous adipose tissue were measured on computed tomography images at the level of the third lumbar vertebra. Subsequently, each body composition index was also calculated by dividing the body composition by the square of the height. The cut-off values of body compositions were defined using X-tile software (version 3.6.1; Yale University, New Haven, CTA). Univariate and multivariate analyses were performed to evaluate the risk factors of anastomotic leakage. Kaplan-Meier method and Cox regression analysis were used to evaluate the risk factors of overall survival. VAT and visceral fat index (VFI) were higher in patients with anastomotic fistula than in those without anastomotic fistula, but none of them were independent risk factors. Patients with higher body mass index (BMI), higher VFI, and higher subcutaneous fat index (SFI) had better overall survival. By multivariate analysis, SFI >27.6 cm2/m2 was still significantly associated with overall survival. Patients with higher VAT and VFI were prone to have an anastomotic leakage. Lower BMI, VFI, and SFI were associated with a reduction in overall survival.

Although an increased body mass index is associated with lower mortality in patients undergoing hemodialysis (HD), known as the “obesity paradox,” the relationship of abdominal fat levels with all-cause mortality has rarely been studied. We investigated the impact of computed-tomography-measured abdominal fat levels (visceral fat area (VFA) and subcutaneous fat area (SFA)) on all-cause mortality in this population. A total of 201 patients undergoing HD were enrolled and cross-classified by VFA and SFA levels according to each cutoff point, VFA of 78.7 cm2 and SFA of 93.2 cm2, based on the receiver operator characteristic (ROC) curve as following; group 1 (G1): lower VFA and lower SFA, G2: higher VFA and lower SFA, G3: lower VFA and higher SFA, G4: higher VFA and higher SFA. During a median follow-up of 4.3 years, 67 patients died. Kaplan–Meier analysis revealed 10-year survival rates of 29.0%, 50.0%, 62.6%, and 72.4% in G1, G2, G3, and G4 (p < 0.0001), respectively. The adjusted hazard ratio was 0.30 (95% confidence interval [CI] 0.05–1.09, p = 0.070) for G2 vs. G1, 0.37 (95% CI 0.18–0.76, p = 0.0065) for G3 vs. G1, and 0.21 (95% CI 0.07–0.62, p = 0.0035) for G4 vs. G1, respectively. In conclusion, combined SFA and VFA levels were negatively associated with risks for all-cause mortality in patients undergoing HD. These results are a manifestation of the “obesity paradox.”

We investigated the impact of the difference in fat distribution between men and women on long-term prognosis after gastrectomy in patients with advanced gastric cancer. Patients with advanced gastric cancer deeper than p-T2 who underwent gastrectomy between April 2008 and June 2018 were included. Visceral fat mass index (VFI) and subcutaneous fat mass index (SFI) were calculated by dividing the cross-sectional area at the umbilical level by the height squared. The medians of VFI and SFI by sex were defined as cut-off values, below which values were defined as low VFI and low SFI. Of the 485 patients, 323 (66.6%) were men and 162 (33.4%) were women. Men with a low VFI had a significantly worse overall survival (OS) (p = 0.004) and women with a low SFI had a significantly worse OS (p = 0.007). Patients with a low VFI and low SFI had the worst prognosis. Multivariate analysis showed that a low VFI was an independent poor prognostic factor in men, while a low SFI was an independent poor prognostic factor in women. In conclusion, a low visceral fat mass in men and a low subcutaneous fat mass in women were independent poor prognostic factors after radical gastrectomy for advanced gastric cancer.

Purpose To research the correlation between abdominal visceral fat and laryngopharyngeal reflux (LPR) in patients with obstructive sleep apnea (OSA). Methods This study included 72 OSA patients, and the correlation between abdominal visceral fat and the severity of LPR was analyzed after abdominal visceral fat area (VFA) was measured according to body composition analysis and reflux symptom index (RSI) score was completed. Finally, in order to further clarify the effect of VFA on LPR, multiple linear regression analysis was performed on the collected related parameters. Results Partial correlation analysis showed that the VFA was positively correlated with the RSI score ( r  = 0.502, p  < 0.001) after controlling for apnea-hypopnea index (AHI), body mass index (BMI), lowest oxygen saturation (LSO₂), age, and sex. The multiple linear regression analysis indicated that VFA and AHI were the factors influencing LPR ( t  = 4.678, p  < 0.001; t  = 3.164, p  = 0.002). Conclusion Our study found that VFA was associated with RSI score in OSA patients, but BMI didn’t show an independent correlation with RSI score. This indicated that we should pay attention to the effect of abdominal visceral fat on LPR in OSA patients, and more experiments are needed in the future to clarify the relationship between the two.

Sarcopenic obesity is regarded as a risk factor for the progression and development of non-alcoholic fatty liver disease (NAFLD). Since male sex is a risk factor for NAFLD and skeletal muscle mass markedly varies between the sexes, we examined whether sex influences the association between appendicular skeletal muscle mass to visceral fat area ratio (SVR), that is, an index of skeletal muscle mass combined with abdominal obesity, and the histological severity of NAFLD. The SVR was measured by bioelectrical impedance in a cohort of 613 (M/F = 443/170) Chinese middle-aged individuals with biopsy-proven NAFLD. Multivariable logistic regression and subgroup analyses were used to test the association between SVR and the severity of NAFLD (i.e. non-alcoholic steatohepatitis (NASH) or NASH with the presence of any stage of liver fibrosis). NASH was identified by a NAFLD activity score ≥5, with a minimum score of 1 for each of its categories. The presence of fibrosis was classified as having a histological stage ≥1. The SVR was inversely associated with NASH in men (adjusted OR 0·62; 95 % CI 0·42, 0·92, P = 0·017 for NASH, adjusted OR 0·65; 95 % CI 0·43, 0·99, P = 0·043 for NASH with the presence of fibrosis), but not in women (1·47 (95 % CI 0·76, 2·83), P = 0·25 for NASH, and 1·45 (95 % CI 0·74, 2·83), P = 0·28 for NASH with the presence of fibrosis). There was a significant interaction for sex and SVR (P interaction = 0·017 for NASH and P interaction = 0·033 for NASH with the presence of fibrosis). Our findings show that lower skeletal muscle mass combined with abdominal obesity is strongly associated with the presence of NASH only in men.

Visceral obesity has been recognized as a predictor of metabolic risk factors. However, few studies have evaluated the metabolic risks in subjects with normal waist circumference (WC). We aimed to examine if the visceral-to-subcutaneous fat ratio (VSR) has diagnostic value to identify multiple metabolic risk factors in subjects with normal WC, compared with visceral fat area (VFA) and subcutaneous fat area (SFA). This is a cross-sectional study in which we have compared mean VFA, SFA, and VSR according to each metabolic risk factor. We performed a receiver operating characteristic (ROC) curve analysis for VFA, SFA, and VSR to assess their accuracy in picking out two or more non-adipose factors for metabolic syndrome. For each metabolic risk factor, mean VSRs were significantly different between groups (risk-absent group vs risk-present group) in men and women, except for men with low high-density lipoprotein. However, mean VFAs and SFAs showed no significant differences between groups. VSR showed superior diagnostic values in predicting at least two non-adipose metabolic risk factors in men and similar diagnostic value in women. Areas under ROC curves for VSR and VFA were 0.705 and 0.649 in men ( =0.028) and 0.798 and 0.785 in women ( =0.321). For men with a normal WC, VSR appeared to effectively predict the presence of multiple metabolic risk factors. Thus, VSR may serve as an indicator for identifying men who have a normal WC and multiple metabolic risk factors.