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Visceral adipose tissue (VAT) is associated with adverse health effects including cardiovascular disease and type 2 diabetes. We developed a dual‐energy X‐ray absorptiometry (DXA) measurement of visceral adipose tissue (DXA‐VAT) as a low cost and low radiation alternative to computed tomography (CT). DXA‐VAT was compared to VAT assessed using CT by an expert reader (E‐VAT). In addition, the same CT slice was also read by a clinical radiographer (C‐VAT) and a best‐fit anthropomorphic and demographic VAT model (A‐VAT) was developed. Whole body DXA, CT at L4–L5, and anthropometry were measured on 272 black and white South African women (age 29 ± 8 years, BMI 28 ± 7 kg/m 2 , waist circumference (WC) 89 ± 16 cm). Approximately one‐half of the dataset ( n  = 141) was randomly selected and used as a training set for the development of DXA‐VAT and A‐VAT, which were then used to estimate VAT on the remaining 131 women in a blinded fashion. DXA‐VAT ( r  = 0.93, standard error of the estimate (SEE) = 16 cm 2 ) and C‐VAT ( r  = 0.93, SEE = 16 cm 2 ) were strongly correlated to E‐VAT. These correlations with E‐VAT were significantly stronger ( P  < 0.001) than the correlations of individual anthropometry measurements and the A‐VAT model (WC + age,  r  = 0.79, SEE = 27 cm 2 ). The inclusion of anthropometric and demographic measurements did not substantially improve the correlation between DXA‐VAT and E‐VAT. DXA‐VAT performed as well as a clinical read of VAT from a CT scan and better than anthropomorphic and demographic models.

Dual‐Energy X‐Ray Performs as Well as Clinical Computed Tomography for the Measurement of Visceral Fat