Abdominal Visceral Adipose Tissue and All-Cause Mortality: A Systematic Review.
Level 3 - non-randomized controlled study
Systematic review of observational cohort studies
PubMed 36082075 · doi:10.3389/fendo.2022.922931
What was done
Authors systematically reviewed four databases to evaluate the association between abdominal visceral adipose tissue (VAT) measurements and all-cause mortality risk (PROSPERO CRD42020205021). Screening, data abstraction, and quality assessment were performed independently in duplicate across 12 cohort studies, most of which measured abdominal VAT area via computed tomography.
What was found
In six cohorts with a mean age ≤65 years, increments in VAT area or volume showed an 11% to 98% relative risk increase for all-cause mortality; however, this association lost statistical significance after adjusting for body mass index, glycemic indices, or other fat parameters. In four cohorts with a mean age >65 years, associations with mortality were inconsistent. In two cohorts (mean age 73–77 years), higher VAT density was inversely proportional to VAT area and associated with higher mortality risk.
Why it matters
The review suggests that the mortality risk linked to visceral adiposity in adults aged 65 and younger may be mediated by metabolic complications rather than acting as an independent driver. It also indicates that the risk profile shifts or reverses in older populations.
Limits
The underlying evidence is observational, precluding causal inference. The abstract does not report pooled effect estimates, confidence intervals, or total participant numbers. Results varied substantially by age group, and associations attenuated after multivariable adjustment for metabolic covariates.