title: Comparison of Associations of DXA and CT Visceral Adipose Tissue Measures With Insulin Resistance, Lipid Levels, and Inflammatory Markers.
abstract: Visceral adipose tissue (VAT) measured by computed tomography (CT) is related to insulin resistance, lipids, and serum inflammatory markers. Our objective was to compare the strength of the associations of VAT measured using dual-energy X-ray absorptiometry (DXA-VAT) and CT (CT-VAT) with insulin resistance, serum lipids, and serum markers of inflammation. For 1117 men aged 65 and older enrolled in the Osteoporotic Fractures in Men Study, the cross-sectional associations of DXA-VAT and CT-VAT with homeostasis model assessment of insulin resistance (homa2ir), C-reactive protein, and high-density lipoprotein (HDL) cholesterol were estimated with regression models and compared using a Hausman test. Adjusted for age and body mass index, DXA-VAT was moderately associated with homa2ir (effect size 0.38, 95% confidence interval [CI]: 0.28-0.47) and modestly associated with HDL cholesterol (DXA effect size -0.29, 95% CI: -0.38 to -0.21). These associations were significantly greater than those for CT-VAT with homa2ir (0.30, 95% CI: 0.24-0.37; p value for effect size difference 0.03) and CT-VAT with HDL cholesterol (-0.22, 95% CI: -0.29 to -0.15; p value for difference 0.005). Neither DXA-VAT nor CT-VAT was associated with C-reactive protein after adjustment for age and body mass index (DXA-VAT effect size 0.14, 95% CI: -0.04 to 0.32; CT-VAT effect size 0.08, 95% CI: -0.08 to 0.25; p value for difference 0.35). DXA-VAT has similar or greater associations with insulin resistance and HDL cholesterol as does CT-VAT in older men, confirming the concurrent validity of DXA-VAT. Investigations of how well DXA measurements of VAT predict incident cardiovascular disease events are warranted.
authors.affiliation: Park Nicollet Clinic and Health Partners Institute, HealthPartners, Minneapolis, MN, USA; Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA. Electronic address: scho0600@umn.edu.
authors.forename: John T
authors.initials: JT
authors.lastname: Schousboe
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN; Department of Medicine, University of Minnesota, Minneapolis, MN, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Langsetmo
authors.affiliation: Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Ann V
authors.initials: AV
authors.lastname: Schwartz
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN; Department of Medicine, University of Minnesota, Minneapolis, MN, USA; Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA.
authors.forename: Brent C
authors.initials: BC
authors.lastname: Taylor
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
authors.forename: Tien N
authors.initials: TN
authors.lastname: Vo
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN.
authors.forename: Allyson M
authors.initials: AM
authors.lastname: Kats
authors.affiliation: Department of Family Medicine and Public Health, University of California, San Diego, La Jolla, CA, USA.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Barrett-Connor
authors.affiliation: Bone and Mineral Unit, Department of Medicine, Oregon Health & Sciences University, Portland, OR, USA.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Orwoll
authors.affiliation: Bone and Mineral Unit, Department of Medicine, Oregon Health & Sciences University, Portland, OR, USA; Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, OR, USA.
authors.forename: Lynn M
authors.initials: LM
authors.lastname: Marshall
authors.affiliation: Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
authors.forename: Iva
authors.initials: I
authors.lastname: Miljkovic
authors.affiliation: Department of Medicine, University of California, Davis, Davis, CA, USA; Department of Rheumatology, University of California, Davis, Davis, CA, USA.
authors.forename: Nancy E
authors.initials: NE
authors.lastname: Lane
authors.affiliation: Division of Epidemiology and Community Health, University of Minnesota, Minneapolis, MN; Department of Medicine, University of Minnesota, Minneapolis, MN, USA; Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, Minneapolis, MN, USA.
authors.forename: Kristine E
authors.initials: KE
authors.lastname: Ensrud
mesh_terms: D015502:Absorptiometry, Photon; D000368:Aged; D002097:C-Reactive Protein / Q000378:metabolism*; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance; D015850:Interleukin-6 / Q000097:blood; D050152:Intra-Abdominal Fat / Q000000981:diagnostic imaging*; D008297:Male; D014057:Tomography, X-Ray Computed; D014280:Triglycerides / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; C508600:IL6 protein, human; D015850:Interleukin-6; D014280:Triglycerides; D014409:Tumor Necrosis Factor-alpha; D002097:C-Reactive Protein
keywords: CT-VAT; DXA-VAT; insulin resistance; serum inflammatory markers; visceral adipose tissue (VAT)