The Potential of Visceral Adipose Tissue in Distinguishing Clear Cell Renal Cell Carcinoma from Renal Angiomyolipoma with Minimal Fat

Figures & data

Figure 1 (A) CT image at the umbilical level. (B) The red part shows the total fat area (TFA). (C) The red part shows the subcutaneous fat area (SFA). (D) The red part shows the visceral fat area (VFA).

Table 1 The Clinical Data of the Patients

	ccRCC (n=166)	RMFAML (n=25)	P
Age, years	58.77±12.84	48.36±15.55	<0.001
Sex, n (%)			<0.001
Male	115(69.28%)	6(24.00%)
Female	51(30.72%)	19(76.00%)
Tumor size [M (Q1, Q3), cm]	4.00(3.00, 5.65)	4.00(2.75, 4.60)	0.238*
Hypertension, n (%)	79(47.59%)	6(24.00%)	0.027
Diabetes, n (%)	33(19.88%)	2(8.00%)	0.264^#
BMI, kg/m^2	24.67±2.80	21.79±3.44	<0.001
SFA, cm^2	139.20±57.98	114.07±61.36	0.046
VFA, cm^2	112.76±50.88	51.03±49.65	<0.001
TFA, cm^2	251.96±89.90	165.10±103.57	<0.001

Notes: *Mann–Whitney rank sum test, ^#Fisher’s exact test.

Figure 2 (A) Student’s t-test showed a significant correlation between VFA and sex (P<0.001). (B) Pearson’s test showed that VFA was significantly associated with age (r=0.222, P<0.001).

Table 2 Univariate Analysis of Predictors for Distinguishing ccRCC from RMFAML

Characteristics	OR (95% CI)	P
Sex	7.141(2.693~18.936)	<0.001
Age	1.059(1.025~1.094)	0.001
Tumor size	1.244(0.971~1.595)	0.084
Hypertension	0.348(0.132~0.915)	0.032
Diabetes	0.350(0.079~1.562)	0.169
BMI	1.435(1.211~1.700)	<0.001
SFA	1.008(1.000~1.017)	0.049
VFA	1.033(1.019~1.047)	<0.001
TFA	1.012(1.006~1.017)	<0.001

Figure 3 (A) Pearson’s test showed that BMI was linearly correlated with VFA (r=0.635, P<0.001), SFA (r=0.596, P<0.001), and TFA (r=0.730, P<0.001). (B) Pearson’s test showed that VFA was linearly correlated with SFA (r=0.826, P<0.001) and TFA (r=0.417, P<0.001). (C) Pearson’s test showed that TFA was linearly correlated with SFA (r=0.857, P<0.001).

Table 3 Multivariate Analysis of Predictors for Distinguishing ccRCC from RMFAML

Characteristics	Model 1	Model 2	Model 3	Model 4	Model 5
	OR (95% CI) P	OR (95% CI) P	OR (95% CI) P	OR (95% CI) P	OR (95% CI) P
Age (years)	1.047(1.008~1.088) 0.017	1.040(1.000~1.081) 0.048	1.049(1.008~1.090) 0.017	1.029(0.990~1.069) 0.152	1.032(0.992~1.074) 0.121
Sex (male)	4.311(1.469~12.653) 0.008	6.918(2.342~20.434) <0.001	9.590(3.187~28.857) <0.001	3.476(1.186~10.189) 0.023	3.855(1.041~14.278) 0.043
Hypertension	1.105(0.338~3.614) 0.868	1.239(0.372~4.126) 0.727	1.114(0.340~3.643) 0.859	1.169(0.357~3.831) 0.796	1.236(0.371~4.119) 0.730
BMI	1.305(1.088~1.566) 0.004				1.075(0.842~1.373) 0.561
TFA		1.011(1.005~1.017) 0.001
SFA			1.013(1.003~1.023) 0.008		1.002(0.989~1.015)0.763
VFA				1.026(1.012~1.041) <0.001	1.021(1.002~1.040) 0.034

Figure 4 ROC curves of ccRCC vs RMFAML. The blue line represents VFA, the green line represents BMI, the Orange line represents TFA, the red line represents sex, the black line represents SFA, and the crimson line represents age.