This paper discusses race, sex, and age differences in the patterning of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT). The authors focused particularly on the magnitude and significance of group differences in VAT and SAT areas measured at the conventional L4-L5 site compared with group differences measured at other locations. VAT and SAT measures were obtained from abdominal magnetic resonance images collected from 820 African American and white adults. Study results indicated that magnetic resonance images located 5 to 10 cm above L4-L5 provide better approximations of total VAT accumulation than the traditional L4-L5 image. The authors explained that group differences in the patterning or topography of visceral adiposity, which is not adequately captured using a single image at L4-L5, could cause the VAT volume of white men to be underestimated compared to white women and the VAT volume of African American men to be underestimated compared to African-American women. Moreover, the authors indicated that the use of the L4-L5 measurement site may also overestimate the relative increase in visceral adiposity in older men and women. This study strongly suggests that a single magnetic resonance image obtained from the middle-to-upper abdomen (5 to 10 cm above L4-L5) may provide a more accurate estimation of visceral adiposity than the traditional single image obtained low in the abdomen (L4-L5).
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