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1 Department of Internal Medicine, Division of Geriatric Medicine, GRECC, University of Michigan, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, MI, USA
2 Department of Radiology, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, MI, USA
3 School of Kinesiology, University of Minnesota, Minneapolis, MN, USA; Research Service, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA
* To whom correspondence should be addressed. E-mail: denge001{at}umn.edu.
A number of methods exist for the estimation of abdominal obesity, ranging from waist-to-hip ratio to computed tomography (CT). While dual-energy x-ray absorptiometry (DXA) was originally used to measure bone density and total body composition, recent improvements in software allow it to determine abdominal fat mass. Sixty-five men and women aged 18-72 participated in a series of studies to examine the validity and reliability of the DXA to accurately measure abdominal fat. Total body fat and abdominal regional fat were measured by DXA using a Lunar DPX-IQ. Multi-slice CT scans were performed between L1 and L4 vertebral bodies (region of interest) using a Picker PQ5000 CT scanner and volumetric analyses were carried out on a Voxel Q workstation. Both abdominal total tissue mass (P=0.02), and abdominal fat mass (P<0.0001) in the L1-L4 region of interest were significantly lower as measured by DXA compared to multi-slice CT. However, Bland-Altman analysis demonstrated good concordance between DXA and CT for abdominal total tissue mass (i.e, limits of agreement = -1.56-2.54 kg) and fat mass (i.e., limits of agreement = -0.40-1.94 kg). DXA also showed excellent reliability among different three operators to determine total, fat and lean body mass in the L1-L4 region of interest (intra-class correlations, R=0.94, 0.97 and 0.89, respectively). In conclusion, the DXA L1-L4 region of interest compared to CT proved to be both reliable and accurate method to determine abdominal obesity.
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