Computed Tomography-Measured Abdominal Subcutaneous Fat Thickness and Obstructive Sleep Apnea Risk: A Cross-Sectional Observational Study

To investigate whether umbilical subcutaneous fat thickness (USFT), measured opportunistically on abdominal Computed tomography (CT) performed for clinical indications, is associated with the STOP-BANG score–based perioperative obstructive sleep apnea (OSA) risk stratification. In this cross-sectional observational study, adult participants (n = 64) completed the STOP-BANG questionnaire, and USFT was measured on existing abdominal CT images. Associations were assessed using Spearman correlation and group comparisons across STOP-BANG categories. Statistical analyses were conducted with relevant statistical software. No significant correlation was observed between STOP-BANG scores and USFT (r = 0.172, p = 0.173). USFT was significantly higher among individuals reporting snoring (p = 0.027) and showed strong positive correlations with body mass index (BMI) (r = 0.663, p < 0.001) and neck circumference (r = 0.544, p < 0.001). USFT did not differ significantly across STOP-BANG risk categories (p = 0.506). Of the 64 patients included, 20 (31.3%) underwent abdominal hernia surgery. Five patients with high OSA risk and elevated USFT (7.8% of the total cohort; 25.0% of the surgical subgroup) were classified as Cormack–Lehane grade 3 and experienced difficult intubation under general anesthesia. USFT measured on existing CT images was not associated with STOP-BANG–based OSA risk. These findings suggest that USFT alone is unlikely to provide incremental value beyond established clinical screening variables; larger studies with polysomnography (PSG) confirmation and adequately powered multivariable models are warranted.