Correlation between subcutaneous fat measurements in knee MRI and BMI: relationship to obesity and related co-morbidities.

• Type of Material: Article
• Authors: Ricardo Hernandez, Philadelphia College of Osteopathic Medicine; Yara Younan, Emory University; Michael Mulligan, University of Maryland; Adam Daniel Singer, Emory University; Gulshan B Sharma, University of Calgary; Felix Gonzalez, Emory University; Monica Umpierrez, Emory University
• Language: English
• Date: 2019-06
• Publisher: SAGE Publications (UK and US): Open Access Titles
• Publication Version: Final Published Version
• Copyright Statement: © The Foundation Acta Radiologica 2019
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1177/2058460119853541
• Title of Journal or Parent Work: Acta Radiologica Open
• ISSN: 2058-4601
• Volume: 8
• Issue: 6
• Start Page: 2058460119853541
• End Page: 2058460119853541
• Grant/Funding Information: The author(s) received no financial support for the research, authorship, and/or publication of this article.
• Keywords: osteoporosis; obesity; asthma; subcutaneous fat; Knee
• Research Categories: Health Sciences, Radiology; Health Sciences, Medicine and Surgery; Health Sciences, Nutrition

Abstract

Background: Obesity is a major public health disorder associated with multiple co-morbidities. Knee magnetic resonance imaging (MRI) permits visualization of the subcutaneous fat anatomy, which can be correlated to body mass index (BMI) and obesity-related co-morbidities. Purpose: This study intends to validate a method of correlating measurements of subcutaneous fat around the distal femur on axial MR images to BMI and obesity-related co-morbidities. Material and Methods: The most proximal axial slice of each knee MRI was divided into four quadrants. Measurements of the thickest portion of the subcutaneous fat in each quadrant were independently obtained, yielding a value which was assigned the name of the SubCut fat index. The relationship between the SubCut fat index of each quadrant and the patient's BMI was then evaluated. Receiver operating characteristic curves utilizing both the subcutaneous fat in the medial and lateral quadrants as well as BMI were performed with respect to obesity-related co-morbidities. Results: SubCut fat index measurements in all four quadrants and BMI show the strongest correlation (all four, ANOVA P < 0.0001, r = 0.6), with subcutaneous fat measurements of the anterior medial (p < 0.0001) and posterior medial quadrants (P = 0.01). Additionally, BMI and medial quadrants SubCut indices showed strong association with obesity-related co-morbidities including sleep apnea, asthma, diabetes, hypertension, gastroesophageal reflux disease, and osteoporosis. Conclusion: The SubCut fat index, a marker of distal femur subcutaneous fat on axial MRI, correlates with severity of obesity (BI) and associated obesity-related co-morbidities.