E1538. Assessment of Visceral Adipose Tissue vs. Subcutaneous Adipose Tissue on CT in Type II Diabetes Mellitus Patient’s Glycaemic Control
Rajarajeswari Medical College and Hospital
Type 2 Diabetes Mellitus (DM) is associated with increase in central obesity, i.e., abdominal fat. Abdominal fat includes subcutaneous adipose tissue (SAT) and Visceral adipose tissue (VAT). VAT is now recognized to have metabolic, endocrine, and immune functions and has a stronger correlation to obesity-related disorders. The aim of this study was to study to grade the VAT and SAT in type II DM patients by CT scan and to assess the outcome.
Materials and Methods:
We performed a prospective study at our centre involving patients referred to plain Computed Tomography (CT) abdomen or KUB (Kidney, ureter and bladder) with clinical diagnosis of type II diabetes mellitus. Patients were excluded if they were diagnosed as type I DM or less than 18 years. Scans were performed on 128 slice multi detector CT scanner. VAT and SAT quantification was done at the L4-L5 level and grading was done using the volume assessment software. A region of interest of the subcutaneous fat layer and visceral fat layer was defined by tracing its contour on each scan. The attenuation range for fat tissue was defined as the interval within the mean plus or minus 2 Standard Deviations (SDs) considered to be individual variation. Correlation of VAT and SAT measured by CT was compared with fasting blood glucose in diabetic patients was done using Pearson's correlation coefficient. Automatic dose reduction was done in all patients.
Among the enrolled 100 patients VAT and SAT quantification was done. Patients were grouped based on fasting blood glucose and a unique grading was devised for SAT and VAT. In our study, higher amount of VAT correlated with uncontrolled type 2 DM. Pearson's correlation coefficient for VAT was found to be 0.741, implying a strong positive correlation and p-value was found to be <0.05 showing that it is statistically significant.
Reduction in the VAT aids in significant reduction in the incidence of obesity related disorders like diabetes and also helps in good glycaemic control in diabetic patients leading to better activities of daily living. Extraordinarily beneficial clinical based grading of VAT assesses the risk for further cardiovascular events. VAT can be reduced with lifestyle modification. CT is the “gold standard” for the measurement of VAT because of better demonstration of fat attenuation.