Endocrinology and Metabolism

Original Articles

Association of Abdominal Myosteatosis and Visceral Fat Obesity with Arterial Stiffness: Min Jung Lee, Hong-Kyu Kim, Eun Hee Kim, Sung Jin Bae, Hyo-Jung Nam, Sang Hoon Lee, Chang Hee Jung, Woo Je Lee; Received October 22, 2025 Accepted January 12, 2026 Published online April 8, 2026; DOI: https://doi.org/10.3803/EnM.2025.2734 [Epub ahead of print]

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Abstract PDF Supplementary Material PubReader ePub: Background
Arterial stiffness with aging predicts cardiovascular diseases (CVDs) and target organ damage. While sarcopenia has been linked to arterial stiffness, the association of myosteatosis and visceral adiposity with arterial stiffness remains underexplored. As age-related fat redistribution, including myosteatosis and visceral obesity, often precedes the overt sarcopenia, their early evaluation may be beneficial in preventing arterial stiffness. Therefore, this cross-sectional study aimed to assess whether myosteatosis and visceral obesity are associated with increased arterial stiffness.
Methods
A total of 6,004 subjects without CVD who underwent abdominal computed tomography and brachial-ankle pulse wave velocity (baPWV) between 2012 and 2013 during health examinations were included. Visceral fat area and total abdominal muscle area (TAMA) were measured at the L3 vertebral level. Muscle quality was assessed using the normal attenuation muscle area (NAMA)/TAMA index, where a lower value indicates a reduced proportion of healthy muscle (NAMA) and a higher presence of myosteatosis.
Results
After adjusting for multiple cardiovascular risk factors, including myosteatosis, visceral obesity was significantly associated with elevated baPWV in men (odds ratio [OR]=1.32; 95% confidence interval [CI]=1.10 to 1.60; P=0.004). In contrast, in women, myosteatosis was significantly associated with elevated baPWV in a fully adjusted model that included visceral obesity (OR=3.26; 95% CI=1.13 to 9.44; P=0.029).
Conclusion
Ectopic fat infiltration, including visceral obesity and myosteatosis, was significantly associated with increased arterial stiffness. Notably, visceral obesity was significantly associated with elevated baPWV in men, while myosteatosis was significant in women after adjustment.

Diabetes, Obesity and Metabolism
Differences in Abdominal Body Composition According to Glycemic Status: An Inverse Probability Treatment Weighting Analysis: Seungbong Han, Young-Jee Jeon, Gyung-Min Park, Tae Young Lee, Soon Eun Park, Gyeongseok Yu, Byung Ju Kang; Endocrinol Metab. 2021;36(4):855-864. Published online August 11, 2021; DOI: https://doi.org/10.3803/EnM.2021.1086

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2 Web of Science
2 Crossref

Background
Several studies have reported that abdominal fat and muscle changes occur in diabetic patients. However, there are few studies about such changes among prediabetic patients. In this study, we evaluated the differences in abdominal fat and muscles based on abdominopelvic computed tomography in prediabetic and diabetic subjects compared to normal subjects.
Methods
We performed a cross-sectional study using health examination data from March 2014 to June 2019 at Ulsan University Hospital and classified subjects into normal, prediabetic, and diabetic groups. We analyzed the body mass index corrected area of intra-abdominal components among the three groups using inverse probability treatment weighting (IPTW) analysis.
Results
Overall, 8,030 subjects were enrolled; 5,137 (64.0%), 2,364 (29.4%), and 529 (6.6%) subjects were included in the normal, prediabetic, and diabetic groups, respectively. After IPTW adjustment of baseline characteristics, there were significant differences in log visceral adipose tissue index (VATI; 1.22±0.64 cm²/[kg/m²] vs. 1.30±0.63 cm²/[kg/m²] vs. 1.47±0.64 cm²/[kg/m²], P<0.001) and low-attenuation muscle index (LAMI; 1.02±0.36 cm²/[kg/m²] vs. 1.03±0.36 cm²/[kg/m²] vs. 1.09±0.36 cm²/[kg/m²], P<0.001) among the normal, prediabetic, and diabetic groups. Prediabetic subjects had higher log VATI (estimated coefficient= 0.082, P<0.001), and diabetic subjects had higher log VATI (estimated coefficient=0.248, P<0.001) and LAMI (estimated coefficient=0.078, P<0.001) compared to normal subjects.
Conclusion
Considering that VATI and LAMI represented visceral fat and lipid-rich skeletal muscle volumes, respectively, visceral obesity was identified in both prediabetic and diabetic subjects compared to normal subjects in this study. However, intra-muscular fat infiltration was observed in diabetic subjects only.

Citations

Citations to this article as recorded by

Quantitative CT histogram indices for abdominal muscles are associated with coronary artery disease severity
G. Geng, Z. Li, T. Yuan, G.-M. Quan
Clinical Radiology.2025; 83: 106840. CrossRef
Testosterone is associated with abdominal body composition derived from computed tomography: a large cross sectional study
Seungbong Han, Young-Jee Jeon, Tae Young Lee, Gyung-Min Park, Sungchan Park, Seong Cheol Kim
Scientific Reports.2022;[Epub] CrossRef

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