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1Department of Internal Medicine, Division of Geriatric Medicine, University of Michigan; 2The Geriatric Research, Education, and Clinical Center and 3Department of Radiology, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan 48105; 4School of Kinesiology, University of Minnesota, Minneapolis, 55455; and 5Minneapolis Veterans Affairs Medical Center, Minneapolis, Minnesota 55417
Submitted 18 November 2003 ; accepted in final form 1 April 2004
A number of methods exist for the estimation of abdominal obesity, ranging from waist-to-hip ratio to computed tomography (CT). Although 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 yr 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. Multislice 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 with multislice 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 three different operators to determine total, fat, and lean body mass in the L1–L4 region of interest (intraclass correlations, R = 0.94, 0.97, and 0.89, respectively). In conclusion, the DXA L1–L4 region of interest compared with CT proved to be both reliable and accurate method to determine abdominal obesity.
body fat; computed tomography; regional composition
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