The Association between the Relative Visceral to Subcutaneous Abdominal Fat Distribution and the Presence of Coronary Artery Atherosclerosis

Introduction: Distribution of abdominal fat is more detrimental in the pathogenesis of coronary artery atherosclerosis (CAA) than its amount. Purpose: To detect the value of the amount of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT), and their distribution by abdominal computed tomography in the detection of CAA as assessed by multi-slice computed tomography coronary angiography (MSCT-CA). Methods: The abdominal muscular wall was traced manually to calculate SAT and VAT areas (cm²) (outside and inside abdominal muscular wall respectively) at L4-L5 in 63 consecutive patients with no risk factors for coronary artery disease (CAD) referred for evaluation of chest pain by MSCT-CA. Results: 40% of the studied patients (n=25) had CAA (Group 1), while the remaining 60%(n=38) had no CAA (Group 2). There was no statistically significant difference between both groups as regards weight, body mass index (BMI), waist circumference (WC), waist-to hip ratio (W/H ratio), VAT area, SAT area, and total fat area. Group 1 patients were predominantly males (53% vs 24%; p=0.023), with statistically significantly increased VAT/ SAT area ratio (0.40 ± 0.23 vs 0.29 ± 0.16; p=0.028), and increased age (55.7 ± 7.9 vs 44.0 ± 11.1; p<0.001) as compared to Group 2 patients. Conclusion: VAT/SAT area ratio can be used in the detection of CAA in patients with no CAD risk factors.