Abstract
Objectives:The prevalence of obesity and diabetes in the Middle East is among the highest in the world. Valid measures of abdominal adiposity are essential to understanding the metabolic consequences of obesity. Dual-energy X-ray absorptiometry (DXA) is increasingly being utilised to assess body composition in population studies, and has recently been used to estimate visceral adipose tissue (VAT). The aim of this study was to determine the accuracy of DXA-derived VAT in a Middle Eastern population using magnetic resonance imaging (MRI) as the criterion measure.Method:VAT was estimated from abdominal DXA measures in 237 adult men (n=130) and women (n=107), aged 18–65 years, participating in the Kuwait Wellbeing Study. These estimates were compared with MRI measures of the corresponding anatomical region. The agreement between methods was assessed using Bland–Altman as well as correlation analysis.Results:Median MRI VAT was 1148.5 cm3 (95% confidence interval: 594.2–1734.6) in men and 711.3 cm3 (95% confidence interval: 395.5–1042.8) in women. DXA estimates of VAT showed high correlations with corresponding MRI measures (r=0.94 (P<0.0001) in men; r=0.93 (P<0.0001) in women). DXA overestimated VAT with a mean bias (95% limits of agreement) of 79.7 cm3 (−767 to 963) in men and 46.8 cm3 (−482 to 866) in women. The imprecision of DXA increased with increasing VAT level in both men and women.Conclusion:DXA estimates of VAT are valid for use in Middle Eastern populations, although accuracy decreases with increasing level of visceral adiposity.
Highlights
Obesity and its related comorbidities have become a major public health challenge in the Middle East and North Africa (MENA) region.[1,2,3,4] Data published by the International Diabetes Federation have shown that the MENA region has the highest prevalence of diabetes in the world, and the country of Kuwait is ranking top in this region at 20.7%.5 Obesity is prevalent in this country, where 59% of women and 46% of men are either overweight or obese.[6]
visceral adipose tissue (VAT) volume from Dual-energy X-ray absorptiometry (DXA) was most strongly related to VAT from magnetic resonance imaging (MRI) in men (r = 0.94) and women (r = 0.93)
We assessed the validity of DXA-derived VAT estimates in a cohort of Kuwaiti men and women using MRI as the criterion method
Summary
Obesity and its related comorbidities have become a major public health challenge in the Middle East and North Africa (MENA) region.[1,2,3,4] Data published by the International Diabetes Federation have shown that the MENA region has the highest prevalence of diabetes in the world, and the country of Kuwait is ranking top in this region at 20.7%.5 Obesity is prevalent in this country, where 59% of women and 46% of men are either overweight or obese.[6]. Obesity and its related comorbidities have become a major public health challenge in the Middle East and North Africa (MENA) region.[1,2,3,4] Data published by the International Diabetes Federation have shown that the MENA region has the highest prevalence of diabetes in the world, and the country of Kuwait is ranking top in this region at 20.7%.5. In particular increased visceral adipose tissue (VAT), is associated with insulin resistance, glucose intolerance and type 2 diabetes.[8–10]. VAT is considered to be more sensitive to lipolytic stimuli than other adipose depots,[11,12] and it has been suggested that visceral obesity decreases insulin action via increased delivery of free fatty acids in insulin-sensitive tissues.[13,14]. Limited data are available on VAT and how this parameter relates to overall obesity and diabetes in populations in the MENA region
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