DXA ‐Measured Visceral Adipose Tissue and Accelerated Biological Aging in Middle‐Aged Adults

Objective Obesity, particularly excess visceral adipose tissue (VAT), may accelerate biological aging; however, few studies have examined this in middle‐aged adults. We investigated associations between dual‐energy X‐ray absorptiometry (DXA)‐derived VAT and two biomarkers of biological aging—phenotypic age acceleration (PhenoAgeAccel) and leukocyte telomere length (LTL)—in 4799 participants (2614 females, aged 45–69 years) from the Busselton Healthy Ageing Study. Methods Whole‐body DXA (GE Lunar) quantified VAT mass. Phenotypic age was estimated from chronological age and nine biomarkers. In a subsample of 1221 participants, LTL was measured as the telomeric DNA to single‐copy gene ( T / S ) ratio. Sex‐stratified linear regressions assessed associations, adjusting for chronological age and lifestyle factors. Results Mean ± SD VAT mass was 1677 ± 873 g in males and 882 ± 598 g in females. Higher VAT was associated with greater PhenoAgeAccel in both sexes; each 1‐SD increase in VAT corresponds to 1.397 (95% CI 1.197, 1.596) and 1.919 (1.738, 2.099) years higher PhenoAgeAccel in males and females, respectively. In females only, higher VAT was associated with shorter LTL (−0.041 [−0.069, −0.013] per 1 SD). Associations mostly remained significant after adjustment for anthropometric and other DXA‐derived adiposity measures. Conclusions VAT may represent a specific marker of accelerated biological aging, independent of lifestyle and adiposity measures.