Ultrasound assessment of abdominal fat: Subcutaneous maximum thickness as a practical marker of metabolic risk in primary care.

AIMS: Ultrasound is a cost-effective tool for characterizing abdominal fat, with measurement accuracy comparable to advanced imaging techniques. A lack of standard operating procedures has hindered widespread adoption. Our study aimed to describe, through ultrasound, the adipose tissue layers of the abdominal wall in patients living with excess body fat.

METHODS

Cross-sectional study including 103 adults. Patients with a healthy fat mass were excluded. Fat mass was quantified through Clínica Universidad de Navarra-Body Adiposity Estimator (CUN-BAE). Ultrasound was performed at the midpoint between the xiphoid process and the navel (1-3 cm above the umbilicus) along the linea alba.

RESULTS

Mean age (SD) was 46.6 (14.4) years, and 74.8% were women. A subcutaneous adipose tissue (SAT) measurement >1.8 cm showed significantly higher adiposity indices (BMI, CUN-BAE), systolic blood pressure, and laboratory metabolic parameters (insulin, HOMA-IR, triglycerides, creatinine) than those with SAT ≤1.8 cm. SAT was associated with an increased prevalence of dysglycemia (Q4 vs. Q1, adjusted OR 6.13; 95% CI 1.38-27.28), showing strong discriminative ability (AUC = 0.79; 95% CI 0.69-0.89).

CONCLUSIONS

In a primary care setting, ultrasound characterization of abdominal fat should include measurement of the SAT maximum layer above the navel along the linea alba, as it may aid in evaluating metabolic risk.