Table 1.

Comparison of different visceral adipose tissue (VAT) studies and pathogenesis in older adults.

Author	Title	Objective	Year	Study location	Sample	Population age (years)	Study	Comorbidities	Laboratory test associated with VAT	Results	P value
(van Roekel et al., 2017) [33]	Associations of adipose and muscle tissue parameters at colorectal cancer diagnosis with long-term health-related quality of life	Analyze the associations of body composition parameters in diagnosing colorectal cancer with long-term health-related quality of life, 2 to 10 years after diagnosis.	2017	Netherlands	104	64.3 ± 9.0	Cross-sectional	Health-related quality of life in individuals with colorectal cancer	—	There was no significant association between visceral obesity and sarcopenia with long-term health-related quality of life in colorectal cancer survivors in stages I to III.	P < 0.05
(Aoki et al., 2015) [24]	Abdominal fat accumulation, as measured by computed tomography, increases the risk of ischemic colitis: a retrospective case-control study	Evaluate the abdominal fat accumulation effect on the ischemic colitis development and related clinical outcomes.	2015	Japan	116	Cases (61.5 ± 17.3)	Retrospective case-control	Ischemic colitis	—	The abdominal fat accumulation, but not the BMI, is associated with ambulatory ischemic colitis development. Colitis clinical results did not correlate with abdominal obesity.	P < 0.05
						Controls (61.5 ± 16.9)
(Nagata et al., 2014) [30]	Predictors for cecal insertion time: the impact of abdominal visceral fat measured by computed tomography	Identify the predictors of longer cecal insertion time and evaluate the effect of BMI, VAT, and SAT on this time.	2014	Japan	899	63.7 ± 14.3	Retrospective observational	Colorectal cancer screening	—	Among the obesity indices, the high accumulation of subcutaneous fat was the best predictive factor to facilitate the colonoscope's passage, even when the body weight was normal.	P < 0.05
(Kim et al., 2012) [25]	Nonalcoholic fatty liver disease is associated with coronary artery calcification	Investigate the relationship between NAFLD and coronary artery calcification, taking into account risk factors for coronary artery disease, such as VAT, in an apparently healthy population.	2012	Seoul (South Korea)	4023	56.9 ± 9.4	Cross-sectional	Nonalcoholic fatty liver disease and coronary artery calcification	—	NAFLD individuals are at high risk of developing coronary atherosclerosis, regardless of whether they have visceral obesity or classic coronary risk factors.	P < 0.001
(Hori et al., 2018) [29]	Impact of preoperative abdominal visceral adipose tissue area and nutritional status on renal function after donor nephrectomy in Japanese living donors for renal transplantation	Evaluate the effects of preoperative abdominal fat distribution and nutritional status on renal function after nephrectomy in living donors.	2018	Japan	75	47 to 64	Cohort	Kidney function after nephrectomy	—	Preoperative VAT distribution and nutritional status can predict postoperative renal function in living donors.	P < 0.05
(Natu et al., 2017) [26]	Visceral adiposity predicts severity of acute pancreatitis	Determine the association of visceral adiposity with severe outcomes in acute pancreatitis.	2017	Cleveland (United States)	252	52.0 ± 15.9	Historical cohort	Acute pancreatitis	—	An increased VAT area is a strong indicator of severe pancreatitis, necrosis, and multisystem organ failure.	P < 0.001
(van Dijk et al., 2017) [32]	Low skeletal muscle radiation attenuation and visceral adiposity are associated with overall survival and surgical site infections in patients with pancreatic cancer	Evaluate the association of adipose tissue and other body composition characteristics with postoperative survival, postoperative complications, and surgical site infections in patients with pancreatic head cancer.	2017	Netherlands	186	61 to 79	Prospective cohort	Surgical site infection in patients with pancreatic cancer	—	The low attenuation of muscle radiation is a predictor of survival after pancreatic surgery and the high visceral adiposity associated with the surgical site's risk of infections.	P < 0.05
(Dias et al., 2016) [35]	Association of abdominal fat with serum amylase in an older cohort: the baltimore longitudinal study of aging	Investigate serum amylase associations with diabetes and body fat measurements with a focus on abdominal obesity.	2016	United States	778	66.8 ± 13.6	Cross-sectional	Diabetes	Serum glucose; serum amylase	Serum amylase tends to be low in people with diabetes and is more strongly associated with VAT than with BMI or SAT.	P < 0.05
(Ongun et al., 2015) [31]	Impact of pelvic biometric measurements, visceral and subcutaneous adipose tissue areas on trifecta outcome and surgical margin status after open radical retropubic prostatectomy	Investigate the impact of pelvic biometric measurements, VAT and SAT areas, on the functional and oncological results of retropubic radical prostatectomy.	2014	Turkey	270	62.63 ± 6.03	Retrospective single center	Trifecta result (ability to reach urinary continence, sexual potential, and cancer control) after prostatectomy	—	Pelvic biometric measurements and a more prominent VAT area impact the trifecta result after radical retropubic prostatectomy.	P < 0.05
(Sadeghi et al., 2013) [12]	Abdominal fat distribution and serum lipids in patients with and without coronary heart disease	Investigate the association between different obesity rates, fat distribution indicators, and lipid profile in patients with stable angina, with or without coronary heart disease (CHD).	2013	Iran	123	With CHD (50.5 ± 7.6)	Cross-sectional	Coronary heart disease/stable angina	Serum total cholesterol; serum triglycerides; HDL-c; LDL-c; apolipoproteins A and B	The VAT area correlates better with dyslipidemia in patients without coronary heart disease.	p ≤ 0.05
						Without CHD (53.7 ± 7.6)
(Roriz et al., 2010) [11]	Imaging assessment of visceral adipose tissue area and its correlations with metabolic alterations	Verify the VAT area influence on metabolic changes in adults and older adults.	2010	Brazil	194	Mean 72,97	Cross-sectional	—	Serum glucose level; serum total cholesterol; serum triglycerides; HDL-c; LDL-c; VLDL-c; uric acid	Most biochemical tests correlated strongly with the VAT area—considered a risk factor for metabolic changes. In older individuals, the risk of VAT area appears to be greater than in younger adults.	P ≤ 0.05
(Ohashi et al., 2010) [28]	Association between visceral adipose tissue area and coronary plaque morphology assessed by CT angiography	Investigate VAT association with noncalcified coronary plaques' presence, extent, and characteristics.	2010	Japan	427	67 ± 11	Cross-sectional	Noncalcified coronary plaques	—	An increased VAT area significantly associates with noncalcified coronary plaques' presence, extension, and vulnerable features.	P < 0.05
(Ji et al., 2018) [34]	Impact of sarcopenic obesity on 30-day mortality in critically ill patients with intra-abdominal sepsis	Investigate the association between sarcopenic obesity and 30-day mortality in patients with intra-abdominal sepsis.	2018	China	236	44 to 83	Retrospective cohort	Intra-abdominal sepsis	—	Sarcopenic obesity is an independent risk factor for 30-day mortality in critically ill patients with intra-abdominal sepsis.	P < 0.05
(Cho et al., 2019) [27]	The relationship between visceral adiposity and depressive symptoms in the general Korean population	Examine the association between clinical depressive symptoms and intra-abdominal fat.	2019	Korea	7238	Nondepressives (52.0 ± 8.7) Depressives (52.1 ± 9.8)	Cross-sectional	Depression	—	Depressive symptoms are associated with intra-abdominal fat and the proportion of total and visceral adipose areas in women.	P < 0.05

CRC: coronary heart disease (CHD); CT: computed tomography; SAT: subcutaneous adipose tissue; VAT: visceral adipose tissue; BMI: body mass index; NAFLD: nonalcoholic fatty liver disease; HDL-c: high-density lipoprotein cholesterol; LDL-c: low-density lipoprotein cholesterol; VLDL-c: very-low-density lipoprotein cholesterol.