The Accuracy of Visceral Adipose Tissue for the Screening of Metabolic Syndrome: A Systematic Review and Meta‐Analysis

BACKGROUND: The visceral adipose tissue (VAT) is a crucial marker for assessing the extent of visceral fat accumulation. An increasing number of studies have suggested that the VAT can serve as a screening tool for metabolic syndrome (MetS), given the pivotal role of visceral obesity in MetS. Our aim was to comprehensively evaluate the efficacy of the VAT in predicting MetS through consolidating existing findings. METHODS: The PubMed, Cochrane Library, Web of Science, CNKI, Wanfang Data, and VIP databases were electronically searched to collect eligible studies that investigated the association between VAT and MetS from inception to January 2025. The meta-analysis was divided into two parts on the basis of whether MetS excluded waist circumference (WC). The diagnostic test accuracy (DTA) metrics meta-analyses and odds ratio (OR) meta-analyses were conducted by gender. RESULTS: A total of 68 articles were included, comprising 43 articles focused on MetS (including WC) and 25 articles on MetS (excluding WC). The DTA meta-analysis results showed that VAT has moderate-to-high accuracy in predicting MetS (including WC), with an area under the summary receiver operating characteristic curve of 0.77 for males and 0.82 for females. For MetS (excluding WC), the accuracy was lower, at 0.72 for males and 0.77 for females. Additionally, increased VAT was linked to higher MetS risk in pooled OR analyses, regardless of whether WC was excluded. CONCLUSION: The VAT is an accurate and widely available predictive indicator for MetS and performs significantly better in females than in males.