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Keywords:

  • CT scan;
  • high-throughput risk screening;
  • non-apparent visceral obesity;
  • plasma amino acid.

What is already known about this subject

  • • 
    Asians with metabolic complications associated with obesity, a low body mass index and a low waist circumference have a greater proportion of visceral adipose tissue for a given amount of total body fat compared with Europeans.
  • • 
    Apparent obese humans and obese animal models show an elevation of branched-chain amino acid levels in plasma.
  • • 
    A multivariate logistic regression model of plasma free amino acids has been used to screen for several types of cancers in clinical settings.

What this study adds

  • • 
    A specific formula incorporating six amino acid values (Ala, Gly, Glu, Trp, Tyr and branched-chain amino acid) was developed for discrimination of subjects with high visceral fat area by multivariate logistic regression analyses.
  • • 
    The generated amino acid formula was strongly correlated with visceral fat area in both apparent and non-apparent obese subjects.
  • • 
    Measuring plasma free amino acids can be used to distinguish the non-apparent visceral obesity in clinical settings in Asian populations.

Summary

Metabolic complications associated with obesity are becoming more common among Japanese subjects. However, visceral fat accumulation is not always apparent by measuring body mass index (BMI) or waist circumference in Asian populations because of the physiological characteristics particular to those ethnicities. Excess visceral fat accumulation raises the odds ratio for developing cardiovascular disease. Thus, high-throughput determination of the amount of abdominal adipose tissue is necessary. We hypothesized that accumulating visceral fat alters the peripheral amino acid profile and that a multivariate logistic regression model of plasma free amino acids can distinguish visceral obesity. A total of 1449 Japanese subjects (985 males and 464 females) who had undergone a comprehensive health screening were enrolled in this study. The visceral fat area was determined using computed tomography imaging, and a plasma free amino acid index to identify high visceral fat areas (≥100 cm2) was developed. The sensitivity and specificity values of the generated amino acid index were 80% and 65%, respectively. In particular, the sensitivity of the generated index to identify subjects with non-apparent visceral obesity (BMI < 25 kg m−2; visceral fat area ≥ 100 cm2) was much greater than that of the waist circumference (73% vs. 46%, respectively). This index's high sensitivity and specificity may be the result of specific alterations in the patients' amino acid profiles, which were specifically correlated with the visceral fat areas and not with subcutaneous fat areas. This profile can be used as a predictor of elevated visceral obesity and a risk assessment tool for metabolic complications in Asian populations.