A study from URV, with participation from IISPV, compares abdominal ultrasound with magnetic resonance imaging and shows the potential of this technique to detect early risk of prediabetes and metabolic syndrome in people with abdominal obesity
The distribution of body fat, especially the fat accumulated in the abdomen, is a key factor in the risk of developing metabolic and cardiovascular diseases. However, not all abdominal fat has the same impact on health: subcutaneous fat, located under the skin, does not carry the same risks as visceral fat, which is stored deeper and can come into direct contact with vital organs. Identifying which type of fat is more predominant in a person is essential to assess metabolic risk and to guide clinical interventions. In this context, a study led by researchers from the Department of Medicine and Surgery at the Universitat Rovira i Virgili (URV), with the participation of research staff from the IISPV, analysed how useful and reliable abdominal ultrasound can be for measuring visceral fat, compared with magnetic resonance imaging, which is currently considered the reference technique.
In clinical practice, the risk associated with abdominal fat is usually assessed by measuring waist circumference. However, this simple method is limited because it cannot distinguish between subcutaneous and visceral fat. Imaging techniques such as magnetic resonance imaging or computed tomography provide this information with high accuracy, but they are expensive, require specialised equipment, and are not easily available in primary care. To explore more accessible alternatives, the research team aimed to validate the use of abdominal ultrasound to characterise fat distribution. “Ultrasound is available in most primary care centres and hospitals, and with trained health professionals it allows real-time imaging at a very low cost,” explains Claudia Jiménez-ten Hoevel, researcher at the Department of Medicine and Surgery at the URV and co-author of the article.
The key question was how similar the results of ultrasound could be to those of magnetic resonance imaging when analysing abdominal fat. To answer this, the team worked with a sample of 113 adult volunteers with abdominal obesity, living in Reus and nearby areas. All participants underwent both a magnetic resonance imaging scan and an abdominal ultrasound within a short period —between three and four days— to ensure comparable results.
A valid and accurate tool
The results of the study, published in Diabetes, Obesity and Metabolism, show that visceral fat measurements obtained through ultrasound had good agreement with those obtained through magnetic resonance imaging. However, the researchers also found some limitations of ultrasound when measuring subcutaneous fat, something that previous studies had already suggested. “The main conclusion is that ultrasound can be especially useful when the goal is to identify visceral fat, which is the type most clearly linked to metabolic risk,” says Anna Pedret, researcher from the same department. This potential adds to the fact that ultrasound is easy to use for trained staff and is available in most health centres.
Visceral fat: an indicator of metabolic risk
The analysis also allowed the researchers to explore whether the amount of visceral fat measured by ultrasound could predict future metabolic problems. The results show a relationship between high levels of visceral fat and the presence of prediabetes —a condition where blood sugar levels are high but still below the threshold for type 2 diabetes— as well as metabolic syndrome —a group of risk factors that increase the likelihood of cardiovascular disease.
More specifically, the study identifies a level of visceral fat above which the risk of associated diseases increases significantly. For example, a thickness of 7.35 centimetres or more is linked to a higher risk of prediabetes, while from 5.77 centimetres there is a relationship with the probability of metabolic syndrome. These findings highlight the potential of ultrasound as an exploratory tool: “Including abdominal ultrasound in routine clinical practice, especially in nutrition and primary care, could improve risk assessment and allow more personalised interventions,” the researchers explain.
The research group Nutrició Funcional, Oxidació i Malalties Cardiovasculars (NFOC-SALUT) from the URV and the Institut d’Investigació Sanitària Pere Virgili (IISPV) continues working to promote the use of ultrasound as an affordable, fast, and easily applicable technique in clinical practice. The team is now studying the impact of abdominal fat distribution in other population groups and its relationship with different health conditions, such as cognitive function or sarcopenia. In this context, the group is carrying out new studies using abdominal ultrasound in people aged 60 to 74, with ongoing research and open participation. Interested individuals can contact the team at estudisalimentacionfocsalut@gmail.com.
Bibliographic reference: Jiménez-Ten Hoevel C, Besora-Moreno M, Queral J, Llauradó E, Valls RM, Solà R, Pedret A. Ultrasound and MRI abdominal fat distribution and its associations with metabolic conditions in adults with abdominal obesity. Diabetes Obes Metab. 2025 Dec 17. DOI: 10.1111/dom.70390. Epub ahead of print. PMID: 41403258.
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