DXA reference values and anthropometric screening for visceral obesity in Western Australian adults

Jonathan M D Staynor,Marc K Smith,Timothy R Ackland,Cyril J Donnelly,Amar El Sallam

doi:10.1038/s41598-020-73631-x

Abstract

Limited reference values exist for visceral adipose tissue (VAT) mass measured by DXA. The objectives of this study were to provide reference values for DXA-derived VAT mass and compare the association with anthropometry measures. The study cohort comprised 677 men and 738 women aged 18–65 years from Western Australia. Whole-body scans using a GE Lunar iDXA and anthropometry measures were collected. Reference percentile data were stratified by sex and age. Correlation analysis compared DXA-derived and anthropometry variables. Specificity, sensitivity, and Youden’s Index were used to evaluate the ability of anthropometric thresholds to predict individuals with high VAT. In men, waist circumference (WC), waist-hip ratio, and waist-height ratio (WHtR) had ‘high’ correlations with VAT mass. In women, only WHtR was ‘highly’ correlated with VAT mass. Overweight thresholds for WC, along with a body mass index of 25.0 kg/m2 in women, had the highest combination of sensitivity and specificity when using anthropometry measures to identify individuals with high VAT mass. We provide the first reference data sets for DXA-derived VAT mass among Western Australians. Excessive VAT mass may be identified in men using the overweight WC threshold and in women using both the overweight BMI and WC thresholds.

Highlights

Visceral adipose tissue (VAT) is a fat depot located within the abdominal cavity, in close proximity to the internal organs[1]
visceral adipose tissue (VAT) measurement has been mostly limited to magnetic resonance imaging (MRI), computed tomography (CT) and dual energy X-ray absorptiometry (DXA) scans
waist-hip ratio (WHR) is a commonly recommended measure to screen for at-risk individuals in clinical s ettings[6], and the current results suggest that waist circumference (WC) and waist-height ratio (WHtR) may be more appropriate for representing underlying body composition in Western Australian women

Summary

Introduction

Visceral adipose tissue (VAT) is a fat depot located within the abdominal cavity, in close proximity to the internal organs[1]. VAT secretes free fatty acids and adipocytokines (inflammatory markers), with direct access to the liver through the portal v ein[1]. Within the liver, these biomarkers promote insulin resistance, liver fat accumulation, and hypertension, as well as other risk factors indicative of cardiovascular disease and type 2 diabetes[1,4]. Developments in DXA analysis software provide the ability to indirectly estimate VAT mass and volume within the android region, with significant savings in both data processing time and imaging costs. Imboden et al.[9], and Kelly et al.[10], have both published reference standards for samples of primarily White adults, VAT mass was not included

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