Mesenteric Fat Thickness Is an Independent Determinant of Metabolic Syndrome and Identifies Subjects With Increased Carotid Intima-Media Thickness Kin Hung Liu , PHD 1 , Yu Leung Chan , MD, FRCR 1 , Wing Bun Chan , MBCHB, FRCP 2 , Juliana Chung Ngor Chan , MD, FRCP 2 and Chiu Wing Winnie Chu , MBCHB, FRCR 1 1 Department of Diagnostic Radiology and Organ Imaging, The Chinese University of Hong Kong, The Prince of Wales Hospital, Shatin, Hong Kong 2 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, The Prince of Wales Hospital, Shatin, Hong Kong Address correspondence and reprint requests to Dr. Kin Hung Liu, Department of Diagnostic Radiology and Organ Imaging, Prince of Wales Hospital, Shatin, Hong Kong. E-mail: tongyc{at}netvigator.com Abstract OBJECTIVE —Mesenteric fat, a reflection of visceral adiposity, may play an important role in the pathogenesis of metabolic syndrome and cardiovascular diseases (CVD). In this study, we examined the independent relationship between mesenteric fat thickness and metabolic syndrome and defined its optimal cutoff value to identify high-risk subjects for metabolic syndrome and CVD. RESEARCH DESIGN AND METHODS —A total of 290 Chinese subjects had an ultrasound examination for measurements of thickness of mesenteric, preperitoneal, and subcutaneous fat as well as carotid intima-media thickness (IMT). Anthropometric measurements and metabolic risk profile were assessed by physical examination and blood taking. RESULTS —Twenty (6.9%) subjects had metabolic syndrome according to the National Cholesterol Education Panel Adult Treatment Panel III criteria with Asian definitions for central obesity (waist circumference >80 cm in women and >90 cm in men). Mesenteric fat thickness had significant correlations ( P < 0.05) with various metabolic variables. On multivariate regression, mesenteric fat thickness was an independent determinant of all components of metabolic syndrome after adjustment for age, sex, homeostasis model assessment of insulin resistance, and other fat deposits. The odds ratio of metabolic syndrome was increased by 1.35 (95% CI 1.10–1.66)-fold for every 1-mm increase in mesenteric fat thickness. On receiver-operating characteristic curve analysis, mesenteric fat thickness of ≥10 mm was the optimal cutoff value to identify metabolic syndrome, with sensitivity of 70% and specificity of 75%. Subjects with mesenteric fat thickness ≥10 mm had higher carotid IMT than those with thickness <10 mm (0.73 ± 0.19 vs. 0.64 ± 0.16 mm, P = 0.001). CONCLUSIONS —Mesenteric fat thickness was an independent determinant of metabolic syndrome and identified subjects with increased carotid IMT. CVD, cardiovascular disease FPG, fasting plasma glucose HOMA-IR, homeostasis model assessment of insulin resistance IMT, intima-media thickness ROC, receiver-operating characteristic curve Footnotes A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. Accepted November 16, 2005. Received August 23, 2005. DIABETES CARE