Precision of body composition measurements by dual energy X-ray absorptiometry

Bone mineral content and body composition in overweight children and adolescents

The aim of this study was to analyze the bone mineral content (BMC) of the skeleton and the body composition in lean and fat masses in a population of young overweight subjects, before diet or medical intervention. A total of 496 white youths (298 females, 198 males) were studied. Their body mass index (BMI) values were 29.2+/-5.5 kg/m2 in females and 28.3+/-5.1 kg/m2 in males, corresponding to relative weights (wts) [actual wt, W, divided by the mean wt normal for height (ht), Wi] of 1.55+/-0.24 and 1.53+/-0.24, respectively. Whole-body dual-energy x-ray absorptiometry (DXA) scans were performed (Norland XR36 DXA system) to obtain the total BMC (BMCt), lean tissue mass (LTMt) and fat mass (FMt), as well as the values of the corresponding parameters in arms (a), legs (l), and abdomen (ab). The measured data were compared with theoretical values calculated for Wi. The differences with reference values in LTMt and FMt were sex dependent, and the accretion in FMt, greater in males than in females, yielded a similar FMt/LTMt ratio in both sexes. The wt corresponding to the BMC of the bearing skeleton, lower than the actual wt by about 20%, seemed a reasonable first step to consider in the wt management of these youths.

Annual Changes in Bone Mineral Content and Body Composition during Growth

OBJECTIVES

To compute the annual changes in total bone mineral content (BMCt), lean tissue mass and fat mass (LTM and FM) during growth.

METHODS

Whole body DXA data were used to calculate the annual changes of the parameter P (P = BMCt, LTM or FM), as a percentage, as DeltaP% = 100 x (P(i+1) - P(i)) / P(i); with P(i) and P(i+1) the values for P at age i and age (i+1). Smoothed curves were then obtained from DeltaP% values plotted against age.

RESULTS

Changes in FM were different in males and females. A peak velocity was marked for the three tissues at age 6.5 in boys, and at age 6.5-7.5 in girls; a pubertal peak spurt appeared at age 12 in girls and between age 13 and 14 in boys. This latter peak was followed by an exponential decrease, and no significant changes were found for the three components after age 20 in girls and age 21-22 in boys.

CONCLUSION

Changes in tissue accretion during growth are easy to follow when expressed in percentages. Fat changes, especially, should be around 17% in girls and 15% in boys at the age of puberty.

Male sex and low physical activity are associated with reduced spine bone mineral density in survivors of childhood acute lymphoblastic leukemia

Survivors of acute lymphoblastic leukemia (ALL) are at risk of osteoporosis and obesity. We studied bone mineral density (BMD), percent of fat mass (%FM), and activity levels in survivors of ALL treated without radiotherapy. Lumbar and total areal BMD (g/cm2) and %FM were measured in 28 survivors (aged 5.7-14.7 years) of childhood ALL by dual-energy X-ray absorptiometry (DXA) scan (GE Lunar, Prodigy) an average of 5 years after completion of chemotherapy (UK Medical Research Council randomized trial protocol XI [UKALL XI]). One boy fractured his arm during treatment. Apparent volumetric lumbar BMD (BMD(vol); g/cm3) was calculated and %FM was adjusted for sex and age (%FM(adj)). Physical activity was measured by accelerometer and questionnaire. The results were compared with 28 sex- and age-matched healthy controls. Total body and lumbar areal BMD (g/cm2) were not different between the ALL group and the control group. However, mean lumbar BMD(vol) in survivors of ALL was significantly lower than in controls (0.303 +/- 0.036 g/cm3 vs. 0.323 +/- 0.03 g/cm3; p < 0.01), which mostly was caused by the difference in boys (0.287 +/- 0.032 g/cm3 vs. 0.312 +/- 0.027 g/cm3; p < 0.05). Weekly activity score by questionnaire was significantly lower in the ALL group than in the control group (geometric mean 50 vs. geometric mean 74; p < 0.05). Male gender, low activity levels and an intravenous (iv) high dose of methotrexate were associated with low lumbar BMD(vol). Patients who received an iv high dose of methotrexate (n = 18) had significantly higher %FM(adj) than those with intrathecal methotrexate only (n = 10; 141 +/- 70% vs. 98 +/- 37%;p < 0.05). In conclusion, male survivors of childhood ALL have reduced lumbar BMD(vol), whereas no such difference was seen in girls. Overall, survivors of ALL were physically less active than their healthy controls and lower activity correlated with lower lumbar BMD(vol) and higher %FM(adj).

Measurement precision of body composition variables using the lunar DPX-L densitometer

The objective of the study was to determine the precision of total- and regional-body composition measurements from a total-body scan using dual-energy X-ray absorptiometry (DXA). This is critical information necessary to determine the smallest change from baseline that could be detected with statistical significance when conducting longitudinal measurements of body composition variables in an individual. Twenty volunteers were scanned once each day for 4 consecutive days using a Lunar DPX-L densitometer and manufacturer-supplied software (version 1.3z). Coefficients of variation (CV, %) derived from data using the (preferred) extended research mode of analysis were 0.62, 1.89, 0.63, 2.0, 1.11, 1.10, and 1.09% for total-body bone mineral density (BMD), total percentage fat, total body tissue mass, fat mass, lean mass, bone mineral content (BMC), and total bone calcium, respectively. Regional measurements (arm, leg, trunk, pelvis, and spine) were less precise than total body measurements, with CVs in the range of 1% to 3% (but fat mass for arms was 4.26%, trunk 3.08%, BMC 3.65%). Small but statistically significant differences in mean values for most body composition variables were found when data were compared between extended and standard modes of analysis. Inconsistent use of analysis mode in a cohort or when following a patient longitudinally may negatively affect precision. We conclude that the measurement precision of total and regional body composition variables was generally comparable to the precision limits typically associated with lumbar spine and proximal femur BMD data.

Methods for measuring body composition in newborns--a comparative analysis

The complexity of nutritional support in infants now makes it necessary to use body-composition methods for accurate nutritional assessment. For this goal a variety of methods of determining body composition have been introduced in research on human nutrition. The purpose of this paper is to review the background and to describe the precision of established techniques, focusing on the results obtained in newborns and infants. The ideal method for assessing newborns' and infants' body composition should be non-invasive, reproducible, accurate, and also relatively inexpensive. In addition, we summarize in this paper data on body composition obtained in normal and pathological newborns by using dual X-ray absorptiometry, one of the reference techniques.