Body mass index was calculated as weight/height2 (kg/m2), and waist circumference was measured at the midpoint between the lower border of the rib cage and the iliac crest. A whole body DXA scan was performed for each patient to measure total and regional lean mass (kg), total body fat (kg) and total body fat percentage (%) using fan-beam technology (QDR 4500; Hologic, Bedford, MA, USA). Appendicular skeletal muscle mass (kg) and skeletal muscle mass index (SMI [%] = total skeletal muscle mass [kg]/weight [kg]×100) were obtained as previously described [14] (link), [15] (link).
The abdominal adipose tissue area was quantified by CT (Somatom Plus 4; Siemens, Forchheim, Germany). Visceral fat area was calculated from a 10-mm CT slice scan image between the fourth and fifth lumbar vertebrae that was obtained during suspended respiration. VFA was quantified by delineating the intra-abdominal cavity at the internal aspect of the abdominal and oblique muscle walls surrounding the cavity and the posterior aspect of the vertebral body. Fat attenuation was determined by measuring the mean value of the pixels within a range of −190 to −30 Hounsfield units.
The abdominal adipose tissue area was quantified by CT (Somatom Plus 4; Siemens, Forchheim, Germany). Visceral fat area was calculated from a 10-mm CT slice scan image between the fourth and fifth lumbar vertebrae that was obtained during suspended respiration. VFA was quantified by delineating the intra-abdominal cavity at the internal aspect of the abdominal and oblique muscle walls surrounding the cavity and the posterior aspect of the vertebral body. Fat attenuation was determined by measuring the mean value of the pixels within a range of −190 to −30 Hounsfield units.
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