Visceral and subcutaneous adiposity measurements in adults: Influence of measurement site

Objective: Excess abdominal adiposity is a known risk factor for cardiovascular diseases. Computed tomography can be used to examine the visceral (VAT) and subcutaneous (SAT) components of abdominal adiposity, but it is unresolved whether single-slice or multi-slice protocols are needed. Research Method and Procedures: Nine computed tomography scans were obtained in the lumbar spine region of 24 adults. The nine slices were obtained at three intervertebral positions (L2-L3, L3-L4, and L4-L5) and at 7 mm above and below these locations. Intra-site and inter-site differences in SAT, VAT, total adipose tissue, and the VAT/SAT ratio were examined using ANOVA and confidence intervals for pairwise differences between means. Results: Intervertebral SAT values increased from 103.1 +/- 50.9 (standard deviation) cm(2) at L2-L3 to 153.3 +/- 68.8 cm(2) at L4-L5, whereas the corresponding VAT values decreased from 164.3 +/- 125.4 to 126.0 +/- 82.7 cm(2). The VAT/SAT ratio was not constant, decreasing from 1.8 +/- 1.4 to 0.9 +/- 0.7. Repeated-measures ANOVA indicated significant inter- and intra-site differences (p <= 0.02) for SAT, VAT, and the VAT/SAT ratio at L3-L4 and L4-L5 (p < 0.001). Discussion: These differences show the limitation of using a single-slice assessment of abdominal fat distribution, both for a subject and between subjects. Furthermore, the sizeable differences in the intra-site scans indicate that precise repositioning is needed for longitudinal studies. In summary, our findings suggest that a multi-site imaging protocol may provide a more complete assessment of abdominal fat stores and distribution than use of a single site.