ArticleMayo Clinic proceedings2021
DXA Versus Clinical Measures of Adiposity as Predictors of Cardiometabolic Diseases and All-Cause Mortality in Postmenopausal Women.
Article in Mayo Clinic proceedings, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Comparing DXA and MRI body composition measurements in cross-sectional and longitudinal cohorts.Communications medicine · 2026Article
- Associations of long-term exposure to temperature with coronary artery calcification risk among middle-aged adults: The Coronary Artery Risk Development in Young Adults (CARDIA) study.The Science of the total environment · 2025Article
- The essential role of dual-energy x-ray absorptiometry in the prediction of subclinical cardiovascular disease.Frontiers in cardiovascular medicine · 2024Review
- Contributions of the Women's Health Initiative to Cardiovascular Research: JACC State-of-the-Art Review.Journal of the American College of Cardiology · 2022Review
- Deep learning predicts all-cause mortality from longitudinal total-body DXA imaging.Communications medicine · 2022Article
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Authors and funding
10 authors at 8 institutions in 1 country.
Funding
Abstract
objectiveTo investigate whether dual-energy x-ray absorptiometry (DXA) estimates of adiposity improve risk prediction for cardiometabolic diseases over traditional surrogates, body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR) in older women. PATIENTS AND
methodsWe analyzed up to 9744 postmenopausal women aged 50 to 79 years participating in the Women's Health Initiative who underwent a DXA scan and were free of cardiovascular disease and diabetes at baseline (October 1993 to December 1998) and followed through September 2015. Baseline BMI, WC, WHR, and DXA-derived percent total-body and trunk fat (%TrF) were incorporated into multivariable Cox proportional hazards models to estimate the risk of incident diabetes, atherosclerosis-related cardiovascular diseases (ASCVDs), heart failure, and death. Concordance probability estimates assessed the relative discriminatory value between pairs of adiposity measures.
resultsA total of 1327 diabetes cases, 1266 atherosclerotic cardiovascular disease (ASCVD) cases, 292 heart failure cases, and 1811 deaths from any cause accrued during a median follow-up of up to 17.2 years. The largest hazard ratio observed per 1 standard deviation increase of an adiposity measure was for %TrF and diabetes (1.77; 95% CI, 1.66-1.88) followed by %TrF and broadly defined ASCVD (1.22; 95% CI, 1.15-1.30). These hazard ratios remained significant for both diabetes (1.47; 95% CI, 1.37-1.57) and ASCVD (1.22; 95% CI, 1.14-1.31) even after adjusting for the best traditional surrogate measure of adiposity, WC. Percentage of trunk fat was also the only adiposity measure to demonstrate statistically significant improved concordance probability estimates over BMI, WC, and WHR for diabetes and ASCVD (all P<0.05).
conclusionDXA-derived estimates of abdominal adiposity in postmenopausal women may allow for substantially improved risk prediction of diabetes over standard clinical risk models. Larger DXA studies with complete lipid biomarker profiles and clinical trials are needed before firm conclusions can be made.
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