Clinical usefulness of abdominal bioimpedance (ViScan) in the determination of visceral fat and its application in the diagnosis and management of obesity and its comorbidities  Javier Gómez-Ambrosi, Ignacio González-Crespo, Victoria Catalán, Amaia Rodríguez, Rafael Moncada, Víctor Valentí, Sonia Romero, Beatriz Ramírez, Camilo Silva, María J. Gil, Javier Salvador, Alberto Benito, Inmaculada Colina, Gema Frühbeck  Clinical Nutrition  DOI: 10.1016/j.clnu.2017.01.010 Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism Terms and Conditions

Fig. 1 Flowchart scheme of the study. Clinical Nutrition DOI: (10.1016/j.clnu.2017.01.010) Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism Terms and Conditions

Fig. 2 Comparison of trunk fat (a) and visceral fat (b) measured with the ViScan in the lean, overweight and obese groups stratified by gender. Box represents first and third quartiles and median, with whiskers from minimum to maximum. Statistical differences between groups were analyzed by ANOVA followed by LSD tests. **P < 0.01 and ***P < 0.001 vs lean; &&P < 0.01 and &&&P < 0.001 vs overweight. (c) Correlation between visceral fat measured by the ViScan and visceral fat estimated using computed tomography (CT) including 140 subjects (73 men and 67 women). The arbitrary units of visceral fat were multiplied by 10 in order to make them comparable with the cm2 obtained in the CT determination as indicated by the provider of the device. Pearson's correlation coefficient and associated P value are shown for the whole sample. The identity and the fitted lines are shown (d) Bland–Altman plot showing the limits of agreement between visceral fat measured by the ViScan and visceral fat estimated using CT in the comparison sample of 140 subjects. The middle discontinuous line represents the mean difference between the estimated and the measured visceral fat. The thinner discontinuous lines indicate ±1.96 SDs from the mean. VAT, visceral adipose tissue. Clinical Nutrition DOI: (10.1016/j.clnu.2017.01.010) Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism Terms and Conditions

Fig. 3 Correlation plotted by gender and BMI (lean, overweight and obesity) of visceral fat measured by the ViScan with glucose (a), HDL-cholesterol (b), triglyceride (c), uric acid (d), ALT (e) circulating concentrations and the AST/ALT ratio (f) in the sample including 2849 subjects (1172 males/1677 females). Pearson's correlation coefficients and associated P values are shown for the whole sample. ALT, alanine aminotransferase; AST, aspartate aminotransferase; VAT, visceral adipose tissue. Clinical Nutrition DOI: (10.1016/j.clnu.2017.01.010) Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism Terms and Conditions

Fig. 4 Changes in body weight, BMI, body fat percentage, waist circumference, as well as trunk fat and visceral fat measured with the ViScan after weight gain or weight loss in 107 and 335 Caucasian subjects, respectively. Weight loss was achieved either by conventional dietary treatment (n = 214) or after Roux-en-Y gastric bypass (RYGB, n = 121). BMI, body mass index, WC, waist circumference. Clinical Nutrition DOI: (10.1016/j.clnu.2017.01.010) Copyright © 2017 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism Terms and Conditions