Validity and reliability of dual-energy X-ray absorptiometry for the assessment of abdominal adiposity

Scott G. Glickman, Charles S. Marn, Mark A. Supiano, Donald R. Dengel

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210 Scopus citations


A number of methods exist for the estimation of abdominal obesity, ranging from waist-to-hip ratio to computed tomography (CT). Although dual-energy X-ray absorptiometry (DXA) was originally used to measure bone density and total body composition, recent improvements in software allow it to determine abdominal fat mass. Sixty-five men and women aged 18-72 yr participated in a series of studies to examine the validity and reliability of the DXA to accurately measure abdominal fat. Total body fat and abdominal regional fat were measured by DXA using a Lunar DPX-IQ. Multislice CT scans were performed between L1 and L4 vertebral bodies (region of interest) using a Picker PQ5000 CT scanner, and volumetric analyses were carried out on a Voxel Q workstation. Both abdominal total tissue mass (P = 0.02) and abdominal fat mass (P < 0.0001) in the L1-L4 region of interest were significantly lower as measured by DXA compared with multislice CT. However, Bland-Altman analysis demonstrated good concordance between DXA and CT for abdominal total tissue mass (i.e., limits of agreement = -1.56-2.54 kg) and fat mass (i.e., limits of agreement = -0.40-1.94 kg). DXA also showed excellent reliability among three different operators to determine total, fat, and lean body mass in the L1-L4 region of interest (intraclass correlations, R = 0.94, 0.97, and 0.89, respectively). In conclusion, the DXA L1-L4 region of interest compared with CT proved to be both reliable and accurate method to determine abdominal obesity.

Original languageEnglish (US)
Pages (from-to)509-514
Number of pages6
JournalJournal of applied physiology
Issue number2
StatePublished - Aug 2004

Bibliographical note

Funding Information:
This work was supported by the National Institute of Neurological Disorders and Stroke of the National Institutes of Health (1-U54NS081764); the National Institute on Aging of the National Institutes of Health (1K24AG047899-02, P30-AG021684, and P30AG028748); and AARP. This paper was published as part of a supplement sponsored and funded by AARP. The statements and opinions expressed herein by the authors are for information, debate, and discussion, and do not necessarily represent official policies of AARP.


  • Body fat
  • Computed tomography
  • Regional composition


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