Body composition analysis
Computed tomography (CT) images were retrieved from digital PACS and analyzed using ImageJ software (ImageJ; The National Institutes of Health, Washington, MD, USA; version 1.47) as previously described9. Briefly, VAT area (cm2) was measured on a single axial CT image at the third lumbar vertebra (L3) using Hounsfield unit (HU) thresholds of -190 to -30, in line with accepted methodology 10,11. This parameter is highly correlated with total body adipose tissue 12.Images analysis was performed by a single researcher specifically trained for the task. VO was defined using sex-specific VAT cut-off values11,13 as follows: VO group with VAT> 163.8 cm2 in males and VAT> 80.1 cm2 in females and non-visceral obese (Non-VO) group with VAT below these thresholds.