Objective: To examine the independent associations of abdominal fat (visceral and subcutaneous) and liver fat with all‐cause mortality.

Research Methods and Procedures: Participants included 291 men [97 decedents and 194 controls; mean age, 56.4 ± 12.0 (SD) years] who received a computed tomography (CT) examination at the preventive medicine clinic in Dallas, TX, between 1995 and 1999, with a mean mortality follow‐up of 2.2 ± 1.3 years. Abdominal fat was determined using contiguous CT images from the L3‐L4 to L4‐L5 intervertebral space. Liver fat was assessed using the CT‐determined liver attenuation value, which is inversely related to liver fat. Logistic regression was used to determine the independent association between the fat depots and all‐cause mortality.

Results: During the study, there were 97 deaths. Visceral fat [odds ratio (OR) per SD: 1.83; 95% CI: 1.23 to 2.73], abdominal subcutaneous fat (1.44; 1.02 to 2.03), liver fat (0.64; 0.46 to 0.87), and waist circumference (1.41; 1.01 to 1.98) were significant individual predictors of mortality after controlling for age and length of follow‐up. In a model including all three fat measures (subcutaneous, visceral, and liver fat), age, and length of follow‐up, only visceral fat (1.93; 1.15 to 3.23) was a significant predictor of mortality.

Discussion: Visceral fat is a strong, independent predictor of all‐cause mortality in men.