Abstract

CARDIOMETABOLIC RISK: INDEPENDENT ROLE OF VISCERAL AND LIVER FAT

*Kaushal Y Pathak, Anookh Mohanan, Hemant R Jadhav, Shivani Acharya

Abstract

It is known that visceral adiposity is closely related to cardiometabolic abnormalities and visceral fat accumulation leads to drainage of free fatty acids (FFA) to liver via portal vein. This in turn leads to hepatic insulin resistance, increased intra-cellular triglyceride (TG) content, and increased synthesis and secretion of atherogenic lipoproteins. Studies have shown that only 15% of FFA delivered to the liver comes from visceral adipose tissue, while remainder comes from larger subcutaneous fat depot. It is also reported that subcutaneous fat has minimal association with cardiometabolic risks. Independent association of visceral fat and liver fat with cardiometabolic risks (CMR) is not yet clear. This review summarizes all available evidences obtained in clinical studies using computed tomography (CT) and magnetic resonance imaging (MRI) indicating independent association of visceral and liver fat with CMR. Currently, MRI is considered to be the „gold standard‟ technique for determining abdominal fat measures non-invasively. Observations from the studies using two different imaging techniques yields contradictory results by far; with MRI based studies showing liver fat to be stronger predictor of CMR than visceral fat as against the results from CT based studies. Further, the review highlights on the dearth of similar evidences with respect to Indian population considering ethnic differences in abdominal fat accumulation and concludes with the gap in existing research.

Keywords: Visceral fat, subcutaneous fat, cardiometabolic risk, computed tomography, magnetic resonance imaging.