Agreement of Visceral Adipose Tissue Estimates from Dual-Energy X-Ray Absorptiometry and Multi-Frequency Bioelectrical Impedance

Authors

Christine M. Florez, Texas Tech UniversityFollow
Carina M. Velasquez, Texas Tech UniversityFollow
Ainsley Way, Texas Tech UniversityFollow
Madison H. Sullivan, Texas Tech UniversityFollow
Julia WhitsonFollow
John Alexander, Texas Tech UniversityFollow
Adhirath Malladi, Texas Tech UniversityFollow
Reva Ann Rudolph, Texas Tech UniversityFollow
Grant M. Tinsley, Texas Tech UniversityFollow

Abstract

Visceral adipose tissue (VAT), a defining feature of truncal obesity, is a key diagnostic marker for metabolic syndrome.  Quantifying VAT in accordance with clinical thresholds allows providers to assess and stratify risk for cardiovascular disease and type 2 diabetes. However, the agreement between methods of VAT estimation is not fully elucidated. PURPOSE: Therefore, the purpose of this study was to evaluate the association and agreement of VAT estimates derived from two commonly used body composition techniques. METHODS: Visceral adipose tissue (VAT) estimates were obtained from fifty-seven participants (32 F: age 33 ± 16.1 y, BMI 24.4 ± 4.4 kg/m²; 25 M: age 25.5 ± 5.1 y, BMI 27.1 ± 4.8 kg/m²) using dual-energy X-ray absorptiometry (DXA; GE iDXA) and multi-frequency bioelectrical impedance analysis (MFBIA; Seca mBCA Ultra). VAT values were expressed in milliliters (mL) across devices to ensure unit consistency. Agreement between methodologies was evaluated using Bland–Altman analysis and validity metrics, with strength of associations determined by Pearson correlation coefficients and the coefficient of determination (R²). RESULTS: VAT estimates produced from DXA and MFBIA were significantly correlated (r = 0.80, p = 2 = 0.63). However, line of identity plots demonstrated systematic deviation from identity (DXA = 35.9 + 0.33×MFBIA), [TG1] illustrating poor agreement. MFBIA produced higher VAT estimates than DXA (mean difference: 762 ± 712 mL; pCONCLUSION: Common VAT estimation techniques may produce systematically different VAT estimates due to their underlying estimation approaches, including the portion of the trunk evaluated and use of proprietary prediction equations by manufacturers. These findings emphasize the importance of cautious interpretation of VAT estimates in both research and clinical settings, particularly concerning technological differences between devices and the avoidance of cross-device comparisons.

Recommended Citation

Florez, Christine M.; Velasquez, Carina M.; Way, Ainsley; Sullivan, Madison H.; Whitson, Julia; Alexander, John; Malladi, Adhirath; Rudolph, Reva Ann; and Tinsley, Grant M. (2026) "Agreement of Visceral Adipose Tissue Estimates from Dual-Energy X-Ray Absorptiometry and Multi-Frequency Bioelectrical Impedance," International Journal of Exercise Science: Conference Proceedings: Vol. 2: Iss. 18, Article 166.
Available at: https://digitalcommons.wku.edu/ijesab/vol2/iss18/166