Abdominal fat increases cardiovascular disease (CVD) risk. Despite a higher prevalence of CVD in the chronic spinal cord injury (SCI) population, abdominal fat in those with vs. without SCI has not been determined. Our objectives were to (1) compare total (TAT), visceral (VAT), subcutaneous (SAT) and the ratio of visceral to subcutaneous (V/S) abdominal adipose tissue in adults with chronic SCI with that of age-, sex- and waist circumference (WC)-matched able-bodied (AB) controls; and (2) determine the relationship between WC and VAT in both groups. 28 adults (14 SCI, 14 AB) participated in this cross-sectional study. Abdominal fat was quantified by computed tomography. WC was measured at three sites (lowest rib, iliac crest, midpoint between the two). The V/S ratio was 45% greater in the SCI vs. AB group (0.48±0.23 vs. 0.33±0.14, p<0.05). After adjusting for differences in body weight, TAT and SAT were not different, however VAT was 64% greater in the SCI group (p<0.01). WC at all sites was associated with VAT in both groups (SCI: 0.863 ≤ r ≤ 0.892, AB: 0.821 ≤ r ≤ 0.852, both p<0.001). Analysis of metabolic risk factors is in progress. The higher VAT and V/S ratio may explain, in part, the higher prevalence of CVD in those with SCI. WC appears to be a valid surrogate measure of VAT in this population, providing a tool for clinicians to identify those at risk for CVD. [ABSTRACT FROM AUTHOR]