Relationship between epicardial fat and visceral adiposity index in patients with metabolic syndrome

Pavel A. Montes-Hernández, Departamento de Medicina Interna, Hospital General de Xoco, Secretaría de Salud, Ciudad de México, México
Alberto F. Rubio-Guerra, Enseñanza e Investigación, Hospital General de Ticomán, Secretaría de Salud, Ciudad de México, México
Ivonne G. Narváez-Ortiz, Facultad Mexicana de Medicina, Universidad La Salle, Ciudad de México, México
Jorge A. Ayala-San Pedro, Departamento de Medicina Interna, Hospital General de Ticomán, Secretaría de Salud, Ciudad de México, México
Jorge L. Narváez-Rivera, Departamento de Ecocardiografía, Hospital General de Ticomán, Secretaría de Salud, Ciudad de México, México
Juan A. Suárez-Cuenca, Departamento de Medicina Interna, Hospital General de Xoco, Secretaría de Salud, Ciudad de México, México
Teodoro Montes-Hernández, Departamento de Medicina Interna, Hospital General de Xoco, Secretaría de Salud, Ciudad de México, México
Dylani R. Ávila-Salcedo, Departamento de Medicina Interna, Hospital General de Ticomán, Secretaría de Salud, Ciudad de México, México
Alberto Melchor-López, Departamento de Medicina Interna, Hospital General de Xoco, Secretaría de Salud, Ciudad de México, México

Objective: To evaluate the association between the Visceral Adiposity Index (VAI) and epicardial fat thickness (EFT) in patients with metabolic syndrome. Method: Cross-sectional study including 53 patients with metabolic syndrome diagnosed according to the International Diabetes Federation criteria was conducted. VAI was calculated using anthropometric and biochemical parameters, and EFT was measured by transthoracic echocardiography. Continuous variables were summarized using measures of central tendency and dispersion. Normality was assessed with the Kolmogorov-Smirnov test. The association between VAI and EFT was evaluated using Spearman’s correlation coefficient, and multiple linear regression analysis was performed to identify independent predictors of EFT. Results: A significant positive association was observed between VAI and EFT (ρ = 0.603; p < 0.001). The multiple regression model was statistically significant (F = 5.408; p < 0.001) and explained 46.2% of the variability in EFT (R² = 0.462). VAI remained the only independent predictor of EFT (B = 0.165; p = 0.004), indicating that each one-unit increase in VAI was associated with a 0.165-mm increase in EFT. A parsimonious predictive equation was derived: EFT = 3.898 + 0.165 × VAI. No other clinical or biochemical variables were significantly associated with EFT. Conclusions: VAI is a robust independent predictor of epicardial fat thickness in patients with metabolic syndrome. The proposed equation provides a practical and non-invasive approach for estimating EFT in clinical settings without echocardiography, supporting its potential role in cardiometabolic risk stratification.

Keywords: Visceral adiposity index. Epicardial fat thickness. Cardiometabolic risk.