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Abdominal visceral adiposity (VAT) has been shown to be an independent risk factor for metabolic and cardiovascular disease. Using enCORE analysis version 13.6 on a GE Lunar iDXA, a new fully automated analysis software to measure VAT, we determined the strength of associations between DEXA-derived VAT and other known indicators for diabetes and cardiovascular disease risk in Caucasian and African American obese women. We collected anthropometrics, vital signs, lipid profile, and DXA whole body composition scan for 229 subjects with BMI 30.0 – 49.9 kg/m2 & age 21 to 69 y. We then performed the non-parametric Spearman correlation analysis and found that in subjects overall, DEXA-VAT is positively associated with triglyceride, fasting glucose, fasting insulin, and HOMA-IR, and negatively associated with HDL. Among all anthropometric, body composition and cardiometabolic variables, DEXA-VAT was the most robust predictor of impaired glucose tolerance (IGT) and metabolic syndrome (MetSx) in binary regression analysis, even after adjusting for race. LASSO regression after adjusting for covariates that best predicted IGT and MetSx showed that HOMAIR and DEXA-VAT most significantly predicted IGT (p<0.001, p<0.001, respectively), and DEXA-VAT most significantly predicted MetSx (p<0.001). These observations have implications for VAT associated risk in diabetes and cardiovascular disease.