DXA-Visceral Adipose Tissue Measurements in Atherosclerotic CVD Risk Assessment

First Report from Clinical Osteoporosis 2017: A Joint Conference of the NOF & ISCD

Visceral or central adipose tissue measured via dual-energy x-ray absorptiometery (DXA) should not be included as part of atherosclerotic cardiovascular disease (ASCVD) risk assessment, according to data presented at the first joint symposium of the National Osteoporosis Foundation (NOF) and the International Society for Clinical Densitometry (ISCD) in Orlando, Florida held from April 20 to 22.

Researchers from various institutions in Minneapolis, Minnesota examined the associations between DXA-visceral adipose tissue and the proportion of central and peripheral adipose tissue, which is measured as the android-gynoid fat mass ratio on DXA.

A total of 2654 older men (mean age, 76.1) were included in the Sleep Substudy of Osteoporotic Fractures in Men (MrOS). The researchers used proportional hazards models to estimate hazard ratios (HR) for incident ASCVD events per standard deviation increase of visceral adipose tissue or the android-gynoid fat mass ratio, which were adjusted for age, race, education, systolic blood pressure, smoking status, oxidized low-density lipoprotein levels, hypertension treatment, statin or aspirin use, and diabetes. They also conducted analyses in men with normal (18.5-24.9 kg/m²) and overweight (25-29.9 kg/m²) body mass indices (BMI).

Incident ASCVD events occurred in 371 men (14%) during a mean follow-up period of 8.2 years. The investigators found that neither DXA-visceral adipose tissue nor android-gynoid fat mass ratios were associated with these events after multivariable adjustments — except for a possible weak association for DXA-visceral adipose tissue in men with normal BMIs (HR 1.13; 95% CI, 1.00-1.29).

While the DXA measurements of visceral and central adipose tissue should not be used for risk assessment in ASCVD, the investigators cautioned that “these results are not generalizable to women or middle-aged individuals, and further investigations among those populations are warranted.” 

Reference

Schousboe J, Ensrud K, Kats A, Langsetmo L, Taylor B, Vo, T. Association of visceral adipose tissue measured on dual-energy x-ray (DXA) with incident atherosclerotic cardiovascular disease events in older men. Presented at: Clinical Osteoporosis 2017, A Joint Symposium of NOF & ISCD. April 20-22, 2017; Orlando, Florida.