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  • Original Article
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Lipids and cardiovascular/metabolic health

DXA-measured visceral adipose tissue predicts impaired glucose tolerance and metabolic syndrome in obese Caucasian and African-American women

European Journal of Clinical Nutrition volume 69, pages 329–336 (2015)Cite this article

Subjects

Abstract

Background/Objectives:

New methods to measure visceral adipose tissue (VAT) by dual-energy X-ray absorptiometry (DXA) may help discern sex, race and phenotype differences in the role of VAT in cardiometabolic risk. This study was designed (1) to compare relationships of DXA-VAT, anthropometric and body composition variables with cardiometabolic risk factors in obese women; (2) to determine which variables most robustly predict impaired glucose tolerance (IGT) and metabolic syndrome (MetSx); and (3) to determine thresholds for DXA-VAT by race.

Subjects/Methods:

VAT mass (g) and volume (cm3) were measured in 229 obese (body mass index (BMI), 30–49.9) women aged 21–69 years of European-American (EA=123) and African-American (AA=106) descent using the CoreScan algorithm on a Lunar iDXA scanner. Linear regression modeling and areas under the curve (AUC of ROC (receiver operating characteristic) curves) compared relationships with cardiometabolic risk. Bootstrapping with LASSO (least absolute shrinkage and selection operator) regression modeling determined thresholds and predictors of IGT and MetSx.

Results:

DXA-VAT explained more of the variance in triglycerides, blood pressure, glucose and homeostatic model assessment-insulin resistance (HOMA-IR) compared with anthropometric and other body composition variables. DXA-VAT also had the highest AUC for IGT (0.767) and MetSx (0.749). Including race as a variable and the interaction between VAT and race in modeling did not significantly change the results. Thresholds at which the probability of developing IGT or MetSx was⩾50% were determined separately for AA women (IGT: 2120 cm3; MetSx: 1320 cm3) and EA women (IGT: 2550 cm3; MetSx: 1713 cm3). The odds for IGT or MetSx were fourfold greater with each standard deviation increase in DXA-VAT.

Conclusions:

DXA-VAT provides robust clinical information regarding cardiometabolic risk in AA and EA obese women and offers potential utility in the risk reduction interventions.

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Acknowledgements

This study was supported by a grant from the Dr Robert C and Veronica Atkins Foundation to Dr Silver, NIH K23 HL103976 PhRMA Foundation Career Development Award to Dr Shibao and resources from Vanderbilt CTSA award UL1TR000445 from the NIH National Center for Advancing Translational Sciences.

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Authors and Affiliations

  1. School of Medicine, Jefferson University, Philadelphia, PA, USA,

    X Bi

  2. Division of Gastroenterology, Department of Medicine, Hepatology and Nutrition, School of Medicine, Vanderbilt University, Nashville, TN, USA

    L Seabolt, M Buchowski, C D Keil, R Tyree & H J Silver

  3. Division of Clinical Pharmacology, Department of Medicine, School of Medicine, Vanderbilt University, Nashville, TN, USA

    C Shibao

  4. Department of Biostatistics, School of Medicine, Vanderbilt University, Nashville, TN, USA

    H Kang

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  1. X Bi
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Correspondence to H J Silver.

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Bi, X., Seabolt, L., Shibao, C. et al. DXA-measured visceral adipose tissue predicts impaired glucose tolerance and metabolic syndrome in obese Caucasian and African-American women. Eur J Clin Nutr 69, 329–336 (2015). https://doi.org/10.1038/ejcn.2014.227

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