Associations between abdominal visceral fat and surrogate measures of obesity in Japanese men with spinal cord injury

Study design: Cross-sectional study. Objectives: There are ethnic differences in the distribution of abdominal obesity associated with metabolic disorders. In Japan, the appropriate reference values for abdominal obesity have not been established in individuals with spinal cord injury (SCI), although there are a number of studies in Western countries. This study evaluates the associations between visceral fat area (VFA), waist circumference (WC) and body mass index (BMI), to examine cutoffs and estimate the error for WC and BMI equivalent to 100 cm(2) VFA in Japanese men with SCI. Setting: National Rehabilitation Center for Persons with Disabilities, Japan. Methods: Seventy-four men (aged 45.6 (s.d. 14.3) years) participated in the study. VFA was quantified using computed tomography at the level of the umbilicus, and associations were determined using nonlinear regression analysis. The error of the estimates from the regression equation was assessed using a Bland-Altman plot. Results: The mean VFA was 101.2 (s.d. 53.0) cm(2) and 32 subjects had a VFA >= 100 cm(2). The cutoffs for a VFA of 100 cm(2) were WC, 81.3 cm and BMI, 22.5 kgm(-2). The relationship between the estimated and actual values showed that the error increased as VFA increased, which resulted in a negative proportional bias. Conclusion: The suggested cutoff for Japanese men with SCI is a VFA of 100 cm(2), which is lower than that in the healthy able-bodied population for both WC and BMI. Further investigation is needed to determine the reference value for estimating SCI-specific VF accumulation.