Validity and reliability of dual-energy X-ray absorptiometry for the assessment of abdominal adiposity

• Published in: Journal of applied physiology (1985) 2004-08, Vol.97 (2), p.509-514
• Main Authors: Glickman, Scott G, Marn, Charles S, Supiano, Mark A, Dengel, Donald R
• Format: Article
• Language: English
• Subjects: Abdomen; Absorptiometry, Photon - standards; Adipose Tissue - diagnostic imaging; Adipose Tissue - pathology; Adolescent; Adult; Aged; Biological and medical sciences; Body Composition; Body fat; Female; Fundamental and applied biological sciences. Psychology; Humans; Lumbar Vertebrae; Male; Middle Aged; Predictive Value of Tests; Regression Analysis; Reliability; Reproducibility of Results; Tomography; Validity
• ISSN: 8750-7587; 1522-1601
• DOI: 10.1152/japplphysiol.01234.2003

1 Department of Internal Medicine, Division of Geriatric Medicine, University of Michigan; 2 The Geriatric Research, Education, and Clinical Center and 3 Department of Radiology, Ann Arbor Veterans Affairs Medical Center, Ann Arbor, Michigan 48105; 4 School of Kinesiology, University of Minnesota, Minneapolis, 55455; and 5 Minneapolis 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 Address for reprint requests and other correspondence: D. R. Dengel, Univ. of Minnesota, 1900 Univ. Ave. S.E., 110 Cooke Hall, Minneapolis, MN 55455 (E-mail: denge001{at}umn.edu ).