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  • Perspective
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The challenges of assessing adiposity in a clinical setting

Nature Reviews Endocrinology volume 20, pages 615–626 (2024)Cite this article

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Abstract

To tackle the burden of obesity-induced cardiometabolic disease, the scientific community relies on accurate and reproducible adiposity measurements in the clinic. These measurements guide our understanding of underlying biological mechanisms and clinical outcomes of human trials. However, measuring adiposity and adipose tissue distribution in a clinical setting can be challenging, and different measurement methods pose important limitations. BMI is a simple and high-throughput measurement, but it is associated relatively poorly with clinical outcomes when compared with waist-to-hip and sagittal abdominal diameter measurements. Body composition measurements by dual energy X-ray absorptiometry or MRI scans would be ideal due to their high accuracy, but are not high-throughput. Another important consideration is that adiposity measurements vary between men and women, between adults and children, and between people of different ethnic backgrounds. In this Perspective article, we discuss how these critical challenges can affect our interpretation of research data in the field of obesity and the design and implementation of clinical guidelines.

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Fig. 1: Adipocyte types and anatomical location of major white adipose tissue depots.
Fig. 2: Methods for measuring adiposity in the clinic.

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Authors and Affiliations

  1. Department of Biomedicine, Aarhus University, Aarhus, Denmark

    Emma Börgeson, Saeideh Tavajoh, Stephan Lange & Niels Jessen

  2. Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus, Denmark

    Emma Börgeson, Saeideh Tavajoh, Stephan Lange & Niels Jessen

  3. Department of Clinical Immunology and Transfusion Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden

    Emma Börgeson & Saeideh Tavajoh

  4. Department of Cardiology, School of Medicine, UC San Diego, La Jolla, CA, USA

    Stephan Lange

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  4. Niels Jessen
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E.B. researched data for the article. All authors contributed substantially to discussion of the content. All authors wrote the article. All authors reviewed and/or edited the manuscript before submission.

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Correspondence to Emma Börgeson.

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Börgeson, E., Tavajoh, S., Lange, S. et al. The challenges of assessing adiposity in a clinical setting. Nat Rev Endocrinol 20, 615–626 (2024). https://doi.org/10.1038/s41574-024-01012-9

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