Ultrasound evaluation of visceral fat and posture: relevance for diagnosis metabolic syndrome and obesity

Introduction Meeting definition of metabolic syndrome (MetS) requires detection of central obesity (increasing waist circumference, WC) plus any two of the other four factors (hyperglycemia, dyslipidemia, cardiovascular disease, hypertension) [1]. Multiparameter ultrasound (US) can provide accurate information on every MetS sign [2]. The Aim was to evaluate the relevance of measurement of visceral fat and posture and detecting metabolic health markers using US for diagnosis MetS and stratification overweight patients. Materials and Methods We included 120 overweight subjects (age 24-76 years; 65 females), BMI > 30, waist circumference (WC) > 110. 30 healthy volunteers were controls. All patients underwent general clinical, lab tests; abdominal US using convex 2-7 MHz probes was carried out to all patients including multiparameter US of liver, bile ducts, measuring shear wave elastography (SWE). We determined fat accumulations measuring VF and subcutaneous (SF) fat thickness (cm) and areas (cm2) on US and measured postural stability parameter (abdominal wall, diaphragm and pelvic floor motility); cardia structure (GERD signs) using dynamic US. We also included to the protocol measurements of liver, spleen and pancreas size and structure, the diameters of bile ducts; visualizing colon (anti)peristalsis; detection US signs of gastritis, nephropathy when appropriate. Results SF was 33 ± 7 mm, VF was 26 ± 6 mm (p 0.85). Higher incidence of hypertension (in 62 %); hypercholesterolemia (in 45 %); hyperuricemia (in 28 %); hyperglycemia (in 32 %); nephropathy (in 37 %), portal hypertension (in 32 %) was in obese individuals (p Conclusion Multiparameter abdominal US markers including evaluation of visceral fat and posture are robust and accessible markers to measure metabolic disease in obese patients, can be more reliable vs anthropometric data to define MetS.