title: Preliminary study on the assessment of visceral adipose tissue using dual-energy x-ray absorptiometry in chronic obstructive pulmonary disease.
abstract: BACKGROUND
  Visceral adipose tissue (VAT) was shown to be increased in patients with chronic obstructive pulmonary disease (COPD) compared to control subjects with comparable body mass index (BMI). Our aim was to determine the relation of VAT by dual-energy x-ray absorptiometry (DEXA) in patients with COPD by disease severity, BMI, other indices of body composition and static lung volumes.
  
  
  METHODS
  294 COPD patients admitted for rehabilitation were studied. Lung function, static lung volumes and body composition (i.e. BMI, waist circumference, fat-free mass, fat mass and fat distribution between android and gynoid fat mass) were assessed before entering pulmonary rehabilitation. VAT was estimated within the android region by using DEXA. Patients were stratified for gender, BMI (cut-off of 25 kg/m2) and GOLD stage. To assess the impact of VAT on lung volumes, patients were also stratified for VAT less and above 50thpercentile.
  
  
  RESULTS
  Both male and female patients with more severe airflow limitation had significantly lower VAT values, but these differences disappeared after stratification for BMI. VAT was significantly and strongly correlated with other body composition parameters (allp < 0.001). Patients with moderate to severe airflow limitation and lower VAT had increased static lung hyperinflation and lower diffusing capacity for carbon monoxide. Nevertheless, multivariate stepwise regression models including for BMI, age, gender and forced expiratory volume in 1 s (FEV1) as confounders did not confirm an independent role for VAT on static lung hyperinflation and diffusion capacity.
  
  
  CONCLUSIONS
  After stratification for BMI, VAT is comparable in moderate to very severe COPD patients. Furthermore, BMI and demographics, but not VAT, were independent predictors of static lung hyperinflation and diffusing capacity in COPD.
authors.affiliation: Department of Research and Education, CIRO, Horn, The Netherlands ; Department of Public Health, "Federico II" University of Naples Medical School, Naples, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: De Blasio
authors.affiliation: Department of Research and Education, CIRO, Horn, The Netherlands.
authors.forename: Erica P A
authors.initials: EP
authors.lastname: Rutten
authors.affiliation: Department of Research and Education, CIRO, Horn, The Netherlands.
authors.forename: Emiel F M
authors.initials: EF
authors.lastname: Wouters
authors.affiliation: Department of Public Health, "Federico II" University of Naples Medical School, Naples, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Scalfi
authors.affiliation: Respiratory Medicine and Pulmonary Rehabilitation Section, Clinic Center, Private Hospital, Naples, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: De Blasio
authors.affiliation: Department of Research and Education, CIRO, Horn, The Netherlands.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Akkermans
authors.affiliation: Department of Research and Education, CIRO, Horn, The Netherlands.
authors.forename: Martijn A
authors.initials: MA
authors.lastname: Spruit
authors.affiliation: Department of Research and Education, CIRO, Horn, The Netherlands.
authors.forename: Frits M E
authors.initials: FM
authors.lastname: Franssen
keywords: Body composition; COPD; DEXA; Fat mass; Visceral adipose tissue