The Study: Recurrent stone-forming patients have high visceral fat ratio based on computed tomography images compared to first-time stone-forming patients

The Facts:

a.  The authors measured visceral fat area and volume, subcutaneous fat area and volume, visceral fat area ratio and visceral fat volume ratio.

b. The authors state that, “MetS [metabolic syndrome] is characterized by obesity, hypertension, diabetes mellitus, dyslipidemia and an overall proinflammatory state. Accumulation of visceral fat is known as a major cause of various features of MetS.”

 c. This was done using a CT scan as the authors note that CT measurement is more accurate than just doing a waist measurement to evaluate visceral fat.

d. Previous studies have noted that metabolic syndrome is associated with kidney stones.

e. The subjects in this study were 300 patients who had undergone kidney stone removal.

f. “We compared patient backgrounds and these fat parameters between those who recurrently formed stones and those who formed stones for the first time.”

g. 148 of these subjects were in the recurrent stone forming group.

h. Recurrent stone formers tended to be significantly younger and also had a higher “visceral fat area ratio and visceral fat volume ratio” than the first time stone group.

i.  This study “revealed that visceral fat ratio had strong correlation with recurrent stones and increasing VFVR [visceral fat volume ratio] was an independent predictor of recurrent stones.” 

Take Home:

Higher levels of visceral fat is a predictor of recurrent kidney stone formation. 

Reviewer's Comments:

So why did I review this paper. Once again in my category of “Science is to be lived not learned” (Although I should change that to “not just learned”),  I have more visceral fat than I should and also happen to have a problem with kidney stones.  Both Mark and I have been losing weight but I still have more visceral fat than I should. I wanted to have a method to evaluate this problem. DEXA appeared to be a good method for accuracy but is expensive and inconvenient. Bioelectrical Impedance Analysis (the method you see in body fat measuring scales is convenient and has repeatability but has had some criticism over accuracy. Tanita is now producing a newer dual frequency scale capable of  measuring visceral fat.

Both Dr. Payne and I have purchased the scales and are now tracking the results of our diet and exercise changes to see how they influence our visceral fat. Is this accurate? It appears to be,  but even if it’s not perfect, it can still give me useful real world information.(At least it will hopefully give me motivation. At least a placebo effect!)  Considering the ever present interest in diet, I am sure that if we are successful in losing more weight and now monitoring total body fat and visceral fat in particular, we will discuss this more in the future.  If not, then just try to forget I ever mentioned it.  

Reviewer:  Roger Coleman DC 

Editor: Mark R. Payne DC

Link to Abstract: https://pubmed.ncbi.nlm.nih.gov/29651810/

Link to Article:  https://onlinelibrary.wiley.com/doi/epdf/10.1111/iju.13564