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Body composition, energy expenditure and physical activity

Comparison of single-slice CT and DXA-derived measures of central adiposity in South African women

Abstract

Background

Visceral adipose tissue (VAT) accumulation is a known risk factor for cardiometabolic diseases. Efficient imaging modalities are necessary to quantify VAT. The study assessed the agreement between dual-energy x-ray absorptiometry (DXA) and single-slice computed tomography (CT) for abdominal fat quantification in mixed-ancestry South African women, and determined if this differed by body mass index (BMI) categories.

Methods

VAT and abdominal subcutaneous adipose tissue (SAT) were measured using single-slice CT and DXA in 132 women aged 55 (45–64) years. Participants were categorised as normal weight (BMI < 25 kg/m2), overweight (BMI: 25–29.9 kg/m2) and obese (BMI ≥ 30 kg/m2). Pearson correlation coefficients and Bland–Altman analysis were used to determine agreement between the two measurements.

Results

Two thirds of the participants were obese. DXA and CT-derived measurements of abdominal VAT and SAT were significantly correlated in the overall sample (r = 0.872 and r = 0.966, both p < 0.001, respectively) and within BMI categories. DXA overestimated VAT and SAT in the overall sample and across BMI categories. In the overall sample, the mean difference (DXA–CT estimates) was 75.3 cm2 (95% CI: 68.8–81.8 cm2, p ≤ 0.0001) for VAT and 54.7 cm2 (47.1–62.3 cm2, p ≤ 0.0001) for SAT. Within increasing BMI categories, the variance between the two modalities was fixed for VAT (p = 0.359 for obese), whereas the variance for SAT was heteroscedastic (p ≤ 0.0001).

Conclusions

DXA overestimated VAT and abdominal SAT in a sample of middle-aged mixed-ancestry South African women. VAT variance was fixed in the obesity category, an indication that DXA may be valid in measuring VAT in obese people.

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Fig. 1: Bland-Altman analysis of the overall sample.
Fig. 2: Bland-Altman analysis of the obese group.

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Data availability

The datasets used and/or analysed during the current study are available from the PI (TEM), VMH Study on reasonable request.

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Acknowledgements

We thank the Bellville South (Ward 009) community for participating in the study. We are also grateful to the Bellville South Community Health Forum for supporting the engagement with the Bellville South community.

Funding

This research project was funded by the South African Medical Research Council (SAMRC) with funds from National Treasury under its Economic Competitiveness and Support Package (MRC-RFA-UFSP-01-2013/ VMH Study) and strategic funds from the SAMRC received from the South African National Department of Health. Any opinion, finding, and conclusion or recommendation expressed in this material is that of the author(s) and the MRC does not accept any liability in this regard. FED was funded by the Cape Peninsula University of Technology Research fund (URF).

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Authors

Contributions

FED: data analysis and interpretation, preparation of the first draft and approval of final draft. TEM: conception and design, acquisition and interpretation of data, revision for important intellectual content and approval of final draft. RTE: conception and design, revision for important intellectual content and approval of final draft. SI: revision for important intellectual content and approval of final draft. APK: conception and design, data analysis and interpretation of data, revision for important intellectual content and approval of final draft. JHG: data analysis and interpretation, revision for important intellectual content and approval of final draft. Data access, responsibility and analysis: FED, APK, TEM and JHG had access to the data in the study and TEM, APK and JHG take responsibility for the integrity of the data and accuracy of the data analysis.

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Correspondence to Florence E. Davidson.

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Davidson, F.E., Matsha, T.E., Erasmus, R.T. et al. Comparison of single-slice CT and DXA-derived measures of central adiposity in South African women. Eur J Clin Nutr 74, 1282–1289 (2020). https://doi.org/10.1038/s41430-020-0631-6

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