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Comparison of regional fat measurements by dual-energy X-ray absorptiometry and conventional anthropometry and their association with markers of diabetes and cardiovascular disease risk

Comparison of regional fat measurements by dual-energy X-ray absorptiometry and conventional anthropometry and their association with markers of diabetes and cardiovascular disease risk
Comparison of regional fat measurements by dual-energy X-ray absorptiometry and conventional anthropometry and their association with markers of diabetes and cardiovascular disease risk
BACKGROUND/OBJECTIVE:

Fat distribution is a strong and independent predictor of type 2 diabetes (T2D) and cardiovascular disease (CVD) and is usually determined using conventional anthropometry in epidemiological studies. Dual-energy X-ray absorptiometry (DXA) can measure total and regional adiposity more accurately. Nonetheless, whether DXA provides more precise estimates of cardiovascular risk in relation to total and regional adiposity is not known. We determined the strength of the associations between DXA- and conventional anthropometry determined fat distribution and T2D and CVD risk.

SUBJECTS/METHODS:

Waist (WC) and hip circumference (HC) and DXA was used to measure total and regional adiposity in 4950 (2119 men) participants aged 29–55 years from the Oxford Biobank without pre-existing T2D or CVD. Cross-sectional associations were compared between WC and HC vs DXA-determined regional adiposity (all z-score normalized) with impaired fasting glucose, hypertriglyceridemia, hypertension and insulin resistance (IR).

RESULTS:

Following adjustment for total adiposity, upper body adiposity measurements showed consistently increased risk of T2D and CVD risk markers except for abdominal subcutaneous fat in both sexes, and arm fat in men, which showed protective associations. Among upper adiposity depots, visceral fat mass showed stronger odds ratios (OR) ranging from 1.69–3.64 compared with WC 1.07–1.83. Among lower adiposity depots, HC showed modest protection for IR in both sexes [men: OR 0.80 (95%CI 0.67, 0.96); women: 0.69 (0.56, 0.86)] whereas gynoid fat and in particular leg fat showed consistent and strong protective effects for all outcomes in both men and women. The differential effect of body fat distribution on CVD and T2D were more pronounced at higher levels of total adiposity.

CONCLUSIONS:

Compared with DXA, conventional anthropometry underestimates the associations of regional adiposity with T2D and CVD risk markers. After correcting for overall adiposity, greater subcutaneous fat mass in particular in the lower body is protective relative to greater android or VAT mass.
0307-0565
Vasan, Senthil K.
57b46c7b-074d-4d99-a284-40b592aec067
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Canoy, Dexter
a063ff8c-75ad-40d1-accb-92a4fcf9a4a3
Christodoulides, Costas
ef374dbe-6b39-4c42-b082-7922e881c0f6
Neville, Matthew J.
b7c9383b-0713-4c97-9d84-cb79ebde7949
Di Gravio, Chiara
4033fc31-5d17-4329-b741-aee8ba31d971
Fall, Caroline H.D.
7171a105-34f5-4131-89d7-1aa639893b18
Karpe, Fredrik
05abcb32-83b7-44eb-ab12-7c360f4f9c12
Vasan, Senthil K.
57b46c7b-074d-4d99-a284-40b592aec067
Osmond, Clive
2677bf85-494f-4a78-adf8-580e1b8acb81
Canoy, Dexter
a063ff8c-75ad-40d1-accb-92a4fcf9a4a3
Christodoulides, Costas
ef374dbe-6b39-4c42-b082-7922e881c0f6
Neville, Matthew J.
b7c9383b-0713-4c97-9d84-cb79ebde7949
Di Gravio, Chiara
4033fc31-5d17-4329-b741-aee8ba31d971
Fall, Caroline H.D.
7171a105-34f5-4131-89d7-1aa639893b18
Karpe, Fredrik
05abcb32-83b7-44eb-ab12-7c360f4f9c12

Vasan, Senthil K., Osmond, Clive, Canoy, Dexter, Christodoulides, Costas, Neville, Matthew J., Di Gravio, Chiara, Fall, Caroline H.D. and Karpe, Fredrik (2017) Comparison of regional fat measurements by dual-energy X-ray absorptiometry and conventional anthropometry and their association with markers of diabetes and cardiovascular disease risk. International Journal of Obesity. (doi:10.1038/ijo.2017.289).

Record type: Article

Abstract

BACKGROUND/OBJECTIVE:

Fat distribution is a strong and independent predictor of type 2 diabetes (T2D) and cardiovascular disease (CVD) and is usually determined using conventional anthropometry in epidemiological studies. Dual-energy X-ray absorptiometry (DXA) can measure total and regional adiposity more accurately. Nonetheless, whether DXA provides more precise estimates of cardiovascular risk in relation to total and regional adiposity is not known. We determined the strength of the associations between DXA- and conventional anthropometry determined fat distribution and T2D and CVD risk.

SUBJECTS/METHODS:

Waist (WC) and hip circumference (HC) and DXA was used to measure total and regional adiposity in 4950 (2119 men) participants aged 29–55 years from the Oxford Biobank without pre-existing T2D or CVD. Cross-sectional associations were compared between WC and HC vs DXA-determined regional adiposity (all z-score normalized) with impaired fasting glucose, hypertriglyceridemia, hypertension and insulin resistance (IR).

RESULTS:

Following adjustment for total adiposity, upper body adiposity measurements showed consistently increased risk of T2D and CVD risk markers except for abdominal subcutaneous fat in both sexes, and arm fat in men, which showed protective associations. Among upper adiposity depots, visceral fat mass showed stronger odds ratios (OR) ranging from 1.69–3.64 compared with WC 1.07–1.83. Among lower adiposity depots, HC showed modest protection for IR in both sexes [men: OR 0.80 (95%CI 0.67, 0.96); women: 0.69 (0.56, 0.86)] whereas gynoid fat and in particular leg fat showed consistent and strong protective effects for all outcomes in both men and women. The differential effect of body fat distribution on CVD and T2D were more pronounced at higher levels of total adiposity.

CONCLUSIONS:

Compared with DXA, conventional anthropometry underestimates the associations of regional adiposity with T2D and CVD risk markers. After correcting for overall adiposity, greater subcutaneous fat mass in particular in the lower body is protective relative to greater android or VAT mass.

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Accepted/In Press date: 1 November 2017
e-pub ahead of print date: 20 November 2017

Identifiers

Local EPrints ID: 416116
URI: http://eprints.soton.ac.uk/id/eprint/416116
ISSN: 0307-0565
PURE UUID: eb80d162-0af1-43bb-bae9-ff64045b4761
ORCID for Clive Osmond: ORCID iD orcid.org/0000-0002-9054-4655
ORCID for Caroline H.D. Fall: ORCID iD orcid.org/0000-0003-4402-5552

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Date deposited: 04 Dec 2017 17:30
Last modified: 29 Oct 2023 05:18

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Contributors

Author: Senthil K. Vasan
Author: Clive Osmond ORCID iD
Author: Dexter Canoy
Author: Costas Christodoulides
Author: Matthew J. Neville
Author: Chiara Di Gravio
Author: Fredrik Karpe

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