The prediction of visceral fat by dual-energy X-ray absorptiometry in the elderly: A comparison with computed tomography and anthropometry

M. B. Snijder, M. Visser, J. M. Dekker, J. C. Seidell, T. Fuerst, Frances Tylavsky, J. Cauley, T. Lang, M. Nevitt, T. B. Harris

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Abstract

INTRODUCTION: Effective methods for assessing visceral fat are important to investigate the role of visceral fat for the increased health risks in obesity. Techniques for direct measurement of soft tissue composition such as CT or MRI are expensive, time-consuming or require a relatively high radiation dose. Simple anthropometric methods, such as waist-to-hip ratio, waist circumference or sagittal diameter are widely used. However, these methods cannot differentiate between visceral and subcutaneous fat and are less accurate. The aim of the present study is to investigate whether the dual-energy X-ray absorptiometry (DXA) method, possibly combined with anthropometry, offers a good alternative to CT for the prediction of visceral fat in the elderly. METHODS: Subjects were participants in the Health ABC-study, a cohort study of black and white men and women aged 70-79, investigating the effect of weight-related health conditions on disablement. Total body fat and trunk fat were measured by DXA using a Hologic QDR 1500. A 10 mm CT scan at the L4-L5 level was acquired to measure visceral fat and total abdominal fat. Weight, height, sagittal diameter and waist circumference were measured using standard methods. Fat in a manually defined DXA subregion (4 cm slice at the top of iliac crest) at the abdomen was calculated in a sub-group of participants (n = 150; 50% male; 45.3% Afro-American/54.7% Caucasian, age 70-79 y). This subregion, the standard trunk region and total fat were used as indicators of visceral fat. RESULTS: Total abdominal fat by DXA (subregion) was strongly correlated with total abdominal fat by CT (r ranging from 0.87 in white men to 0.98 in black women). The DXA subregion underestimated total abdominal fat by 10% compared to the CT slice. The underestimation by DXA was seen especially in people with less abdominal fat. The association of visceral fat by CT with the DXA subregion (r = 0.66, 0.78, 0.79 and 0.65 for white and black men and women, respectively) was comparable with the association of the CT measure with the sagittal diameter (r = 0.74, 0.70, 0.84 and 0.68). Combining DXA measurements with anthropometry gave only limited improvement for the prediction of visceral fat by CT compared to univariate models (maximal increase of r2 4%). CONCLUSION: DXA is a good alternative to CT for predicting total abdominal fat in an elderly population. For the prediction of visceral fat the sagittal diameter, which has a practical advantage compared to DXA, is just as effective.

Original languageEnglish (US)
Pages (from-to)984-993
Number of pages10
JournalInternational Journal of Obesity
Volume26
Issue number7
DOIs
StatePublished - Jan 1 2002

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Anthropometry
Intra-Abdominal Fat
Photon Absorptiometry
Abdominal Fat
Tomography
Fats
Waist Circumference
Health
Weights and Measures
Waist-Hip Ratio
Subcutaneous Fat
Abdomen
Adipose Tissue
Cohort Studies
Obesity
Radiation

All Science Journal Classification (ASJC) codes

  • Medicine (miscellaneous)
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

Cite this

The prediction of visceral fat by dual-energy X-ray absorptiometry in the elderly : A comparison with computed tomography and anthropometry. / Snijder, M. B.; Visser, M.; Dekker, J. M.; Seidell, J. C.; Fuerst, T.; Tylavsky, Frances; Cauley, J.; Lang, T.; Nevitt, M.; Harris, T. B.

In: International Journal of Obesity, Vol. 26, No. 7, 01.01.2002, p. 984-993.

Research output: Contribution to journalArticle

Snijder, M. B. ; Visser, M. ; Dekker, J. M. ; Seidell, J. C. ; Fuerst, T. ; Tylavsky, Frances ; Cauley, J. ; Lang, T. ; Nevitt, M. ; Harris, T. B. / The prediction of visceral fat by dual-energy X-ray absorptiometry in the elderly : A comparison with computed tomography and anthropometry. In: International Journal of Obesity. 2002 ; Vol. 26, No. 7. pp. 984-993.
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abstract = "INTRODUCTION: Effective methods for assessing visceral fat are important to investigate the role of visceral fat for the increased health risks in obesity. Techniques for direct measurement of soft tissue composition such as CT or MRI are expensive, time-consuming or require a relatively high radiation dose. Simple anthropometric methods, such as waist-to-hip ratio, waist circumference or sagittal diameter are widely used. However, these methods cannot differentiate between visceral and subcutaneous fat and are less accurate. The aim of the present study is to investigate whether the dual-energy X-ray absorptiometry (DXA) method, possibly combined with anthropometry, offers a good alternative to CT for the prediction of visceral fat in the elderly. METHODS: Subjects were participants in the Health ABC-study, a cohort study of black and white men and women aged 70-79, investigating the effect of weight-related health conditions on disablement. Total body fat and trunk fat were measured by DXA using a Hologic QDR 1500. A 10 mm CT scan at the L4-L5 level was acquired to measure visceral fat and total abdominal fat. Weight, height, sagittal diameter and waist circumference were measured using standard methods. Fat in a manually defined DXA subregion (4 cm slice at the top of iliac crest) at the abdomen was calculated in a sub-group of participants (n = 150; 50{\%} male; 45.3{\%} Afro-American/54.7{\%} Caucasian, age 70-79 y). This subregion, the standard trunk region and total fat were used as indicators of visceral fat. RESULTS: Total abdominal fat by DXA (subregion) was strongly correlated with total abdominal fat by CT (r ranging from 0.87 in white men to 0.98 in black women). The DXA subregion underestimated total abdominal fat by 10{\%} compared to the CT slice. The underestimation by DXA was seen especially in people with less abdominal fat. The association of visceral fat by CT with the DXA subregion (r = 0.66, 0.78, 0.79 and 0.65 for white and black men and women, respectively) was comparable with the association of the CT measure with the sagittal diameter (r = 0.74, 0.70, 0.84 and 0.68). Combining DXA measurements with anthropometry gave only limited improvement for the prediction of visceral fat by CT compared to univariate models (maximal increase of r2 4{\%}). CONCLUSION: DXA is a good alternative to CT for predicting total abdominal fat in an elderly population. For the prediction of visceral fat the sagittal diameter, which has a practical advantage compared to DXA, is just as effective.",
author = "Snijder, {M. B.} and M. Visser and Dekker, {J. M.} and Seidell, {J. C.} and T. Fuerst and Frances Tylavsky and J. Cauley and T. Lang and M. Nevitt and Harris, {T. B.}",
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T1 - The prediction of visceral fat by dual-energy X-ray absorptiometry in the elderly

T2 - A comparison with computed tomography and anthropometry

AU - Snijder, M. B.

AU - Visser, M.

AU - Dekker, J. M.

AU - Seidell, J. C.

AU - Fuerst, T.

AU - Tylavsky, Frances

AU - Cauley, J.

AU - Lang, T.

AU - Nevitt, M.

AU - Harris, T. B.

PY - 2002/1/1

Y1 - 2002/1/1

N2 - INTRODUCTION: Effective methods for assessing visceral fat are important to investigate the role of visceral fat for the increased health risks in obesity. Techniques for direct measurement of soft tissue composition such as CT or MRI are expensive, time-consuming or require a relatively high radiation dose. Simple anthropometric methods, such as waist-to-hip ratio, waist circumference or sagittal diameter are widely used. However, these methods cannot differentiate between visceral and subcutaneous fat and are less accurate. The aim of the present study is to investigate whether the dual-energy X-ray absorptiometry (DXA) method, possibly combined with anthropometry, offers a good alternative to CT for the prediction of visceral fat in the elderly. METHODS: Subjects were participants in the Health ABC-study, a cohort study of black and white men and women aged 70-79, investigating the effect of weight-related health conditions on disablement. Total body fat and trunk fat were measured by DXA using a Hologic QDR 1500. A 10 mm CT scan at the L4-L5 level was acquired to measure visceral fat and total abdominal fat. Weight, height, sagittal diameter and waist circumference were measured using standard methods. Fat in a manually defined DXA subregion (4 cm slice at the top of iliac crest) at the abdomen was calculated in a sub-group of participants (n = 150; 50% male; 45.3% Afro-American/54.7% Caucasian, age 70-79 y). This subregion, the standard trunk region and total fat were used as indicators of visceral fat. RESULTS: Total abdominal fat by DXA (subregion) was strongly correlated with total abdominal fat by CT (r ranging from 0.87 in white men to 0.98 in black women). The DXA subregion underestimated total abdominal fat by 10% compared to the CT slice. The underestimation by DXA was seen especially in people with less abdominal fat. The association of visceral fat by CT with the DXA subregion (r = 0.66, 0.78, 0.79 and 0.65 for white and black men and women, respectively) was comparable with the association of the CT measure with the sagittal diameter (r = 0.74, 0.70, 0.84 and 0.68). Combining DXA measurements with anthropometry gave only limited improvement for the prediction of visceral fat by CT compared to univariate models (maximal increase of r2 4%). CONCLUSION: DXA is a good alternative to CT for predicting total abdominal fat in an elderly population. For the prediction of visceral fat the sagittal diameter, which has a practical advantage compared to DXA, is just as effective.

AB - INTRODUCTION: Effective methods for assessing visceral fat are important to investigate the role of visceral fat for the increased health risks in obesity. Techniques for direct measurement of soft tissue composition such as CT or MRI are expensive, time-consuming or require a relatively high radiation dose. Simple anthropometric methods, such as waist-to-hip ratio, waist circumference or sagittal diameter are widely used. However, these methods cannot differentiate between visceral and subcutaneous fat and are less accurate. The aim of the present study is to investigate whether the dual-energy X-ray absorptiometry (DXA) method, possibly combined with anthropometry, offers a good alternative to CT for the prediction of visceral fat in the elderly. METHODS: Subjects were participants in the Health ABC-study, a cohort study of black and white men and women aged 70-79, investigating the effect of weight-related health conditions on disablement. Total body fat and trunk fat were measured by DXA using a Hologic QDR 1500. A 10 mm CT scan at the L4-L5 level was acquired to measure visceral fat and total abdominal fat. Weight, height, sagittal diameter and waist circumference were measured using standard methods. Fat in a manually defined DXA subregion (4 cm slice at the top of iliac crest) at the abdomen was calculated in a sub-group of participants (n = 150; 50% male; 45.3% Afro-American/54.7% Caucasian, age 70-79 y). This subregion, the standard trunk region and total fat were used as indicators of visceral fat. RESULTS: Total abdominal fat by DXA (subregion) was strongly correlated with total abdominal fat by CT (r ranging from 0.87 in white men to 0.98 in black women). The DXA subregion underestimated total abdominal fat by 10% compared to the CT slice. The underestimation by DXA was seen especially in people with less abdominal fat. The association of visceral fat by CT with the DXA subregion (r = 0.66, 0.78, 0.79 and 0.65 for white and black men and women, respectively) was comparable with the association of the CT measure with the sagittal diameter (r = 0.74, 0.70, 0.84 and 0.68). Combining DXA measurements with anthropometry gave only limited improvement for the prediction of visceral fat by CT compared to univariate models (maximal increase of r2 4%). CONCLUSION: DXA is a good alternative to CT for predicting total abdominal fat in an elderly population. For the prediction of visceral fat the sagittal diameter, which has a practical advantage compared to DXA, is just as effective.

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