The Relationship between Bone Mineral Densitometry and Visceral Adiposity Index in Postmenopausal Women / A relação entre a densitometria mineral óssea e o índice de adiposidade visceral em mulheres na pós-menopausa

Abstract Objective It was aimed to compare visceral adiposity index (VAI) levels in patients with normal bone mineral density (BMD), osteopenia, and osteoporosis. Methods One hundred twenty postmenopausal women (40 with normal BMD, 40 with osteopenia, and 40 with osteoporosis) between the ages of 50 to 70 years were included in the study. For females, the VAI was calculated using the formula (waist circumference [WC]/[36.58 + (1.89 x body mass index (BMI))]) x (1.52/High-density lipoprotein [HDL]-cholesterol [mmol/L]) x (triglyceride [TG]/0.81 [mmol/L]). Results The time of menopause from the beginning was similar in all groups. Waist circumference was found to be higher in those with normal BMD than in the osteopenic and osteoporotic groups (p = 0.018 and p < 0.001, respectively), and it was also higher in the osteopenic group than in the osteoporotic group (p = 0.003). Height and body weight, BMI, blood pressure, insulin, glucose, HDL-cholesterol, and homeostasis model assessment-insulin resistance (HOMA-IR) levels were similar in all groups. Triglyceride levels were found to be higher in the normal BMD group, compared with the osteoporotic group (p = 0.005). The level of VAI was detected as higher in those with normal BMD, compared with the women with osteoporosis (p = 0.002). Additionally, the correlation analysis showed a positive correlation between dual-energy X-ray absorptiometry (DXA) spine T-scores, WC, VAI, and a negative correlation between DXA spine T-scores and age. Conclusion In our study, we found higher VAI levels in those with normal BMD, compared with women with osteoporosis. We consider that further studies with a larger sample size will be beneficial in elucidating the entity.

Resumo Objetivo O objetivo foi comparar os níveis de índice de adiposidade visceral (IVA) em pacientes com densidade mineral óssea (DMO) normal osteopenia e osteoporose. Métodos Cento e vinte mulheres na pós-menopausa (40 com DMO normal 40 com osteopenia e 40 com osteoporose) com idades entre 50 e 70 anos foram incluídas no estudo. Para o sexo feminino o VAI foi calculado pela fórmula (circunferência da cintura [CC]/[36 58 + (1 89 x índice de massa corporal (IMC))]) x (1 52/lipoproteína de alta densidade [HDL]-colesterol [mmol/L]) x (triglicerídeo [TG]/0 81 [mmol/L]). Resultados O tempo de menopausa desde o início foi semelhante em todos os grupos. A circunferência da cintura foi maior naqueles com DMO normal do que nos grupos osteopênicos e osteoporóticos (p = 0 018 e p < 0 001 respectivamente) e também foi maior no grupo osteopênico do que no grupo osteoporótico (p = 0 003) . Altura e peso corporal IMC pressão arterial insulina glicose HDL-colesterol e os níveis de avaliação do modelo de homeostase-resistência à insulina (HOMA-IR) foram semelhantes em todos os grupos. Os níveis de triglicerídeos foram maiores no grupo DMO normal em comparação com o grupo osteoporótico (p = 0 005). O nível de VAI foi detectado como maior naquelas com DMO normal em comparação com as mulheres com osteoporose (p = 0 002). Além disso a análise de correlação mostrou uma correlação positiva entre a absorciometria de raios-X de dupla energia (DXA) nas pontuações T da coluna CC VAI e uma correlação negativa entre as pontuações T da coluna DXA e a idade. Conclusão Em nosso estudo encontramos níveis mais elevados de VAI naquelas com DMO normal em comparação com mulheres com osteoporose. Consideramos que novos estudos com maior tamanho amostral serão benéficos na elucidação da entidade.

Dual-energy X-ray absorptiometry and adiposity index are sensitive methods to evaluate central fat accumulation in women with polycystic ovary syndrome and normal body mass index

ABSTRACT Objective: This study aimed to determine the differences in body fat distribution and central obesity indicators using dual-energy X-ray absorptiometry (DXA), adiposity indices, and anthropometric indices between women with and without polycystic ovary syndrome (PCOS). Materials and methods: Clinical and laboratory examination history, including transvaginal ultrasound, fasting blood samples, anthropometric measurements, and DXA scans were conducted in 179 women with PCOS (PCOS group) and 100 without PCOS (non-PCOS group). The volunteers were grouped by body mass index (BMI): normal (18-24.9 kg/m2), overweight (25-29.9 kg/m2), or obese (>30 kg/m2). The visceral adiposity index (VAI) and lipid accumulation product (LAP) were calculated, regions of interest (ROIs) were determined, and the fat mass index (FMI) was calculated using DXA. Results: VAI, LAP, ROIs, FMI, and adiposity indices by DXA were higher in women with PCOS and normal BMI. In both PCOS and non-PCOS groups, the ROIs progressively increased from normal BMI to overweight and obese, and from overweight to obese. Obese women with PCOS showed high trunk fat mass. However, obesity was not able to modify these trunk/periphery fat ratios in PCOS from overweight to higher BMI. These variables were associated with the incidence of PCOS. Conclusion: In women with PCOS and normal BMI, both DXA and the adiposity indices, VAI and LAP, are more sensitive methods to evaluate total body fat and fat accumulation in the central abdominal region. It was also observed that as BMI increased, the differences in measurements between women with and without PCOS decreased.

Update on trabecular bone score

ABSTRACT Trabecular bone score (TBS) is an indirect and noninvasive measure of bone quality. A low TBS indicates degraded bone microarchitecture, predicts osteoporotic fracture, and is partially independent of clinical risk factors and bone mineral density (BMD). There is substantial evidence supporting the use of TBS to assess vertebral, hip, and major osteoporotic fracture risk in postmenopausal women, as well as to assess hip and major osteoporotic fracture risk in men aged > 50 years. TBS complements BMD information and can be used to adjust the FRAX (Fracture Risk Assessment) score to improve risk stratification. While TBS should not be used to monitor antiresorptive therapy, it may be potentially useful for monitoring anabolic therapy. There is also a growing body of evidence indicating that TBS is particularly useful as an adjunct to BMD for fracture risk assessment in conditions associated with increased fracture risk, such as type-2 diabetes, chronic corticosteroid excess, and other conditions wherein BMD readings are often misleading. The interference of abdominal soft tissue thickness (STT) on TBS should also be considered when interpreting these findings because image noise can impact TBS evaluation. A new TBS software version based on an algorithm that accounts for STT rather than BMI seems to correct this technical limitation and is under development. In this paper, we review the current state of TBS, its technical aspects, and its evolving role in the assessment and management of several clinical conditions.

Estimation of body fat in children with intellectual disability: development and cross-validation of a simple anthropometric method

Abstract Objective Population-level monitoring of body composition requires accurate, biologically-relevant, yet feasible methods for estimating percent body fat (%BF). The aim of this study was to develop and cross-validate an equation for %BF from Body Mass Index (BMI), age, and sex among children with intellectual disability (ID). This study further aimed to examine the performance of an existing BMI-based equation (Deurenberg equation) for %BF in children with ID. Method Participants were 107 children (63 boys; aged 6-15 years) with ID randomly allocated to development (n= 81) and cross-validation (n= 26) samples. Dual-Energy X-Ray Absorptiometry provided the criterion %BF. Results The model including BMI, age, and sex (0 = male; 1 = female) had a significant goodness-of-fit in determining %BF (p< 0.001; R2= 0.69; SEE =5.68%). The equation was: %BF = - 15.416 + (1.394 × BMI) + (4.538 × age) - (0.262 × age2) + (5.489 × sex). The equation was cross-validated in the separate sample based on (i) strong correlation (r = 0.82; p< 0.001) and non-significant differences between actual and predicted %BF (28.6 ± 9.6% and 30.1 ± 7.1%, respectively); (ii) mean absolute error (MAE) = 4.4%; and (iii) reasonable %BF estimations in Bland-Altman plot (mean: 1.48%; 95% CI: 12.5, -9.6). The Deurenberg equation had a large %BF underestimation (mean: -7.1%; 95% CI: 5.3, -19.5), significant difference between actual and estimated %BF (28.6 ± 9.7% and 21.5 ± 7.0%, respectively; p< 0.001), and MAE = 8.1%. Conclusions The developed equation with BMI, sex, and age provides valid %BF estimates for facilitating population-level body fat screening among children with ID.

Application and progress of dual-energy X-ray absorptiometry / 中华内分泌代谢杂志

Dual-energy X-ray absorptiometry(DXA) has been widely used for more than 30 years with continuous technological innovations, which makes DXA a reliable and feasible tool for clinical use. In addition to the measurement of bone mineral density for osteoporosis, DXA has a variety of applications, such as vertebral fracture analysis, grading of abdominal aortic calcifications, atypical femur fracture, trabecular bone score, hip structures analysis, finite element analysis and body composition etc. This review is aimed to provide updates on aforementioned application.

Consistency between multifrequency bioelectrical impedance analysis and dual-energy x-ray absorptiometry for muscle mass assessment in elderly patients with advanced chronic kidney disease / 中华老年医学杂志

Objective:To compare the consistency between bioelectrical impedance analysis(BIA)and dual-energy X-ray absorptiometry(DXA)in skeletal muscle mass assessment in elderly patients with advanced chronic kidney disease(CKD), and to provide a basis for accurate clinical diagnosis of sarcopenia.Methods:Elderly patients with advanced CKD at the Department of Nephrology of Shanghai Sixth People's Hospital were included.Parameters for physical performance included handgrip strength and gait speed, and body muscle mass was measured by DXA and multifrequency BIA.The consistency between the two methods was assessed by the intraclass correlation coefficient, Bland-Altman analysis and kappa coefficient test.Results:This study included 67 elderly patients with advanced CKD with a mean age of(70.7±6.1)years and an average BMI of(24.6±3.5)kg/m 2.The proportion of enrolled male patients was 61.2% and the mean estimated glomerular filtration rate was(27.7±12.7)ml·min -1·1.73m -2.The intraclass correlation coefficients of muscle mass and appendicular skeletal-muscle mass index(ASMI)measured by BIA and DXA ranged from 0.81 to 0.90.Bland-Altman analysis showed that BIA overestimated muscle mass against DXA, and the mean difference in ASMI was(0.44±0.13)kg/m 2.In addition, there was a moderate agreement between the two measurement methods for determining muscle loss(Kappa=0.47). Conclusions:BIA and DXA offer a fair level of consistency in the assessment of muscle mass in elderly patients with advanced CKD.However, compared with DXA, BIA overestimates muscle mass in elderly patients with CKD.

Validación y generación de ecuaciones para estimar masa grasa corporal en adultos chilenos, formuladas a partir de bioimpedanciometría, en un amplio rango de edad e índice de masa corporal

Background: Equations for the evaluation of fat-free mass (FFM) and fat mass (FM) with Bioelectrical impedance analysis (BIA) were formulated in Caucasian populations. International recommendations suggest that population-specific equations should be formulated. Aim: To validate an equation previously formulated in Chileans adults and compare it to a new equation generated on an independent sample. Material and Methods: In 108 adult volunteers aged 38.1±14.1 years (44% males), with a body mass index (BMI) of 25.1± 4.1 kg/m2, body composition was measured by BIA (Bodystat) and dual X-ray absorptiometry (DXA: Lunar Prodigy). Body composition estimated using Schifferli equation and BIA were compared with DEXA, by the Bland-Altman method and simple linear regression. Results: FFM and FM measured by DXA were 45.2 ± 9.8 kg and 29.6 ± 11.7 % respectively. Resistance was 467.7 ± 76.3 ohm. Schifferli equation and BIA significantly overestimated FFM by 7.3 and 7.4 kg, respectively. The error was higher for high levels of FFM (slope β < 1, p < 0.01). Both equations underestimated FM measured by DXA (averages of 7.5 and 7.8%, respectively, p < 0.01), without a differential bias for Schifferli equation, but with a bias in low levels of FM measured with BIA (slope β < 1, p < 0.01). Estimation biases could be eliminated using the regression coefficients. Conclusions: Both equations behave similarly and have biases, although less with Schifferli. Statistically correcting for biases, the new adjusted equations provide clinically valid estimates of FFM and FM. Equations should not only be population-specific, but also device-specific.

Cambios de composición corporal posterior a un programa de rehabilitación cardíaca fase II / Changes in body composition after a phase II cardiac rehabilitation programme

Resumen Objetivo: Identificar los cambios en la composición corporal posterior a un programa de rehabilitación cardíaca fase II. Materiales y métodos: Se siguió un grupo de 20 pacientes luego de al menos 36 sesiones de ejercicio supervisado dentro de un programa de rehabilitación cardiaca. Se midió la composición corporal (masa magra y grasa) antes y después por medio de Absorciometría de Energía Dual de Rayos X. Resultados: Se encontró que el cambio en la masa grasa total no fue significativo; sin embargo, la disminución en la masa grasa total en hombres tuvo una correlación positiva fuerte con la disminución del tejido adiposo visceral con r = 0,85 (p 0,0002). Hubo aumento significativo en masa magra total de 1,76% (p 0,053), destacado en la masa magra de piernas en 5,21% (p 0,001). El índice de masa muscular esquelética tuvo un aumento estadísticamente significativo 2,27% (p 0,016), más notable en hombres. Se encontró un aumento no significativo del peso de 0,38 kg en promedio. Hubo un aumento de cambio significativo en equivalentes metabólicos con aumento de 2,62 a 6,35 MET (p < 0,0001) y aumento de 1,22% (p 0,031) en la tasa metabólica basal. Conclusión: Un programa de rehabilitación cardíaca mejora significativamente la tolerancia al ejercicio y aumenta la masa magra total, de piernas y el índice de masa muscular esquelética; no modifica el índice de masa corporal, el perímetro de cintura, ni la masa grasa total en forma significativa.

Abstract Objective: To identify changes in body composition after a phase II cardiac rehabilitation programme. Materials and methods: A group of 20 patients was followed up after at least 36 supervised sessions of exercise within a cardiac rehabilitation programme. The body composition (lean mass and fat mass) was measured before and after the programme using Dual Energy X-ray Absorptiometry. Results: Although it was found that the change in total fat mass was not significant, there was a strong positive correlation between the decrease in total fat mass in males and the decrease in visceral adipose tissue, with an r=0.85 (P=.0002). There was a significant increase in total lean mass of 1.76% (P=.053), highlighted in the lean mass of the legs with 5.21% (P=.001). The skeletal muscle mass index showed a statistically significant increase of 2.27% (P=.016), more notable in males. There was a non-significant increase (0.38 kg) in the mean weight. There was a significant change in metabolic equivalents (METS), with an increase from 2.62 to 6.35 MET (P<.0001), and an increase of 1.22% (P=.031) in basal metabolic rate. Conclusion: Although there was no change in body mass index, waist circumference, or total body fat, a cardiac rehabilitation programme significantly improved the tolerance to exercise. It also produced an increase in the skeletal muscle mass index, as well as the total lean mass, mainly in the legs.

Osteopenia and osteoporosis among treatment-experienced people living with HIV

Abstract Introduction Life expectancy of people living with human immunodeficiency (PLHIV) has increased mainly due to the accessibility and effectiveness of antiretroviral therapy (ART). However, adverse effects from long-term use of antiretrovirals, and the physiological changes associated with aging, may compromise the quality of life of PLHIV, in addition to causing new demands on the healthcare system. Objectives Estimate the frequency of osteoporosis and osteopenia in patients on prolonged ART and to verify their associated factors. Methods A cross-sectional study was conducted in Belo Horizonte, Minas Gerais, Brazil, from August 2017 to June 2018, in a sample of PLHIV (age≥18 years) who started ART between 2001 and 2005. Data were collected through face-to-face interviews, physical evaluation, laboratory tests, and Dual-Energy X-Ray Absorptiometry Screening (DEXA). The outcome of interest was presence of bone alteration, defined as presence of osteopenia or osteoporosis in DEXA. The association between the explanatory variables and the event was assessed through odds ratio (OR) estimate, with 95% confidence interval (CI). Multiple logistic regression was performed to evaluate factors independently associated with bone alteration. Results Among 92 participants, 47.8% presented bone alteration (19.6% osteoporosis and 28.2% osteopenia). The variables that remained in the final logistic regression model were age ≥ 50 years (OR: 12.53; 95% CI: 4.37-35.90) and current alcohol use (OR: 2.63; 95% CI: 0.94-7.37). Conclusions This study showed a high frequency of bone changes, especially in PLHIV older than 50 years. This information is useful to stimulate the screening and timely intervention of this comorbidity of PLHIV on prolonged use of ART in order to prevent or minimize complications and new demands on the healthcare system.

A study on WHO Frax score to predict fracture risk in predialysis patients of chronic kidney disease

Background: Disturbances in mineral and bone metabolism are prevalent in chronic kidney disease (CKD) and are an important cause of morbidity and decreased quality of life. These disturbances include renal osteodystrophy and CKD-Mineral and Bone Disorder (CKD-MBD). The Frax tool developed by WHO is an attempt to better estimate the fracture risk. It calculates a 10 year probability of osteoporotic fractures of spine, forearm, hip or shoulder based on clinical risk factors with or without BMD measurements.Methods: It is a Cross sectional observational study which was done from 01 November 2013 to 31 March 2015. The study group included 60 cases of pre dialysis Chronic Kidney Disease attending OPD, Emergency or admitted in medicine wards of Dr. RML Hospital, New Delhi. Bone mineral density measured by dual-energy X-ray absorptiometry and all patients were classified according to World Health Organization criteria. DEXA SCAN (manufacturer-Hologic INC.) was done of the lumbar spine, radius bone and neck of the femur. Frax score was calculated as per WHO guidelines.Results: On using the Indian Frax calculator the average 10 year probability for major osteoporotic fractures in stage 4 (9.47±2.62%) was found to be significantly higher (p<0.0001) than that in stage 3 (1.92±0.8%).Similarly, the average 10 year probability for hip fracture in stage 4 (4.61±1.45%) was also found to be significantly higher (p< 0.0001) than that in the stage 3 (0.75±0.49%).Conclusions: The study confirmed the high incidence of low BMD in patients of CKD. The 10 year fracture risk in these patients as predicted by Frax score was significantly higher in CKD patients irrespective of whether the Chinese or the Indian calculator was used.

Concordance in prediction body fat percentage of Brazilian women in reproductive age between different methods of evaluation of skinfolds thickness

ABSTRACT Objective To assess the utility of bioimpedance (BIA) and skinfolds thickness (SF) in body fat percentage measuring (%BF) compared to the reference method dual-energy x-ray absorptiometry (DXA) in Brazilian reproductive age women, as well as to estimate of inter- and intra-observer precision for SF. Subjects and methods 170 women aged 18-37 years with BMI between 18 and 39.9 kg/m2 were selected for this cross-sectional study. Body density was evaluated through equations proposed by Jackson, Pollock and Ward (1980) (EqJPW) and Petroski (1995) (EqPET), and %BF was estimated by BIA, DXA and Siri's formula (1961). The SF were measured by two separate observers: A and B (to determine inter-observer variability), who measured the folds at three times with 10-minute interval between them (to determine intra-observer variability - we used only observer A). Results The %BF by DXA was higher than those measured by SF and BIA (p<0.01, for all) of 90 volunteers. The Lin coefficient of agreement was considered satisfactory for %BF values obtained by EqJPW and BIA (0.55) and moderate (0.76) for sum of SF (ΣSF) values obtained by EqJPW and EqPET. No agreement was observed for the values obtained by SF (EqJPW and EqPET), BIA and DXA. Analysis of inter- and intra-observer of 59 volunteers showed that different measures of SF thickness met acceptability standards, as well as the % BF. Conclusion BIA and SF measurements may underestimate %BF compared with DXA. In addition, BIA and SF measurements are not interchangeable with DXA. However, our results suggest the equation proposed by Jackson, Pollock and Ward (three skinfolds) compared to BIA are interchangeable to quantify the %BF in Brazilian women in reproductive age. Furthermore, our results show acceptable accuracy for intra- and inter-observer skinfold measurements. Arch Endocrinol Metab. 2020;64(3):257-68

The comparison of bone mineral density in primary hyperparathyroidim, vitamin D induced secondary hyperparathyroidism, and patients with both condition: a single center experience

Background: To compare bone mineral densities via dual energy X-ray absorptiometry method (DXA) between various hyperparathyroidism (HPT) types such as primary, vitamin D induced secondary, and both conditions.Methods: Participants who were aged between 18-45 years and had elevated parathyroid hormone levels were included. After initial evaluations, patients were divided into 3 groups according to diagnoses: primary HPT (pHPT), vitamin D induced secondary HPT (sHPT), and combined (primary+secondary) one. In addition to the bone mineral density (BMD), demographic and laboratory datas were recorded.Results: Of 166 patients, 147 of the patients were female, 19 were male, and average age was 38.10±7.24 years. Significant difference was found in terms of age (p=0.03) between pHPT and sHPT. Blood calcium, PTH, 25-OH vitamin D, and daily urine calcium excretion levels were significantly higher and phosphorus levels were lower in the pHPT group compared to the sHPT and combined disease group. Both T and Z scores of the pHPT group were significantly lower than the sHPT group especially in the lumbar region. However, no significant difference was noted between pHPT and combined disease group with respect to T and Z scores in all regions.Conclusions: The results of this study indicate that pHPT has a significantly worse impact on skeletal mineral density particularly in the lumbar region than sHPT. The addition of vitamin D deficiency to the clinical picture seems to have no significant influence on BMD in pHPT. To confirm and clarify these findings, prospective studies with larger number of participants are needed.

Discuss about Key Issues of Dual Energy X-ray Absorptiometry Evaluation / 中国医疗器械杂志

The Dual energy X-ray absorptiometry is the most commonly used for measuring bone mineral density. This method involves core clinical functions, phantom and database. This article discusses the three key issues of dual energy X-ray absorptiometry evaluation, including core clinical functions, phantom and database. This article aims at helping manufacturers to scientifically carry out relevant processes during research and development and also manufacturers may refer to this article when they apply for registration.

Relationship of body mass index with bone mineral density in postmenopausal women: an Indian perspective

Background: Osteoporosis is a common health problem that affects postmenopausal females, leading to increased susceptibility to fractures. Body mass index (BMI) has been shown to be an important predictor of bone mineral density (BMD) with increased body weight correlating with positive influence on bone metabolism. Low BMI predisposes postmenopausal females to rapid bone loss and low bone mass, crucial in the pathogenesis of osteoporosis. However, a specific BMI value chart to accurately predict osteoporosis remains to be fully established. The present study aimed to investigate the relationship of BMI and BMD in postmenopausal Indian females.Methods: 90 healthy postmenopausal females with 1-5 years of menopause were enrolled in the study. Subjects were categorized according to their BMI into normal, overweight and obese. BMD was assessed using dual energy X-ray absorptiometry (DEXA) scan at L1-L4 vertebrae and femoral neck and expressed as T-scores. Quantitative variables were compared using ANOVA/Kruskal Wallis Test.Results: Bone mineral density was significantly higher in the obese group as compared to normal BMI group at both lumbar spine (p=0.001) and femoral neck (p=0.001). BMD at lumbar spine was lower than that at femoral neck across all the three groups of BMI.Conclusions: BMI and body weight are important factors affecting BMD. Postmenopausal females with low BMI are more likely to have osteopenia and osteoporosis and are thus at an increased risk of pathological fractures. Routine BMD monitoring in postmenopausal females with low BMI may be necessary to initiate early clinical interventions for osteoporosis.

Correlation of body composition parameters using different methods among Brazilian obese adults / Correlação de parâmetros de composição corporal utilizando diferentes métodos entre adultos obesos brasileiros

Abstract Data comparing anthropometric measurements, bioelectrical impedance analysis (BIA) and dual-energy X-ray absortiometry (DXA) parameters are somehow limited and conflicting. The objective of this study was to correlate anthropometric, BIA and DXA parameters among obese Brazilian adults with focus on the comparison with visceral adipose tissue (VAT) obtained from DXA and in the value of antropometric measurements. Fifty voluntary participants were enrolled. The Spearman correlation test was used to assess the correlation of VAT with anthropometric measurements, BIA and other DXA parameters. The intra-class correlation coefficient (ICC) was used to evaluate concordance between lean mass (LM), fat mass (FM), %body fat (%BF) and %upper body fat (%UBF) obtained from BIA and DXA. Most were female (80%) and had an average body index mass (BMI) of 39.0 (± 6.4) kg/m2. The only anthropometric measurements showing a strong correlation with VAT were abdominal circumference (AC) and waist-to-height ratio (WHtR), but just in females. There was a very good correlation for LM [ICC = 0.951 (CI = 0.913 - 0.972)], FM [ICC = 0.987 (CI = 0.977 - 0.993)], %BF [ICC = 0.961 (CI = 0.931-0.978)], and %UBF [ICC = 0.873 (CI = 0.776 - 0.928)], between data collected through BIA and DXA. Among the anthropometric measurements assessed, only AC and WHtR seems to estimate patients with abdominal fat distribution and higher VAT in females. DXA and BIA proved similar for the evaluation of LM, FM, %BF and %UBF, although DXA has the advantage of estimating VAT.

Resumo Dados comparando medidas antropométricas, análise de impedância bioelétrica (BIA) e parâmetros de absorciometria de raios-X de dupla energia (DXA) são de alguma forma limitados e conflitantes. O objetivo deste estudo foi correlacionar parâmetros antropométricos de BIA e de DXA entre adultos obesos brasileiros, com foco na comparação com tecido adiposo visceral (TAV) obtido na DXA e no valor das medidas antropométricas. Cinquenta participantes voluntários foram inscritos. O teste de correlação de Spearman foi utilizado para avaliar a correlação do TAV com medidas antropométricas, da BIA e de outros parâmetros da DXA. O coeficiente de correlação intra-classe (ICC) foi usado para avaliar a concordância entre massa magra (MM), massa gorda (MG), % de gordura corporal (%GC) e % de gordura corporal na parte superior do corpo (%GSC) obtidos por BIA e DXA. A maioria era do sexo feminino (80%) e apresentava índice de massa corporal médio (IMC) de 39,0 (± 6,4) kg / m2. As únicas medidas antropométricas que mostraram uma forte correlação com o TAV foram a circunferência abdominal (CA) e a relação cintura / estatura (RCE), mas apenas no sexo feminino. Houve uma correlação muito boa para MM [ICC = 0,951 (IC = 0,913 - 0,972)], MG [ICC = 0,987 (IC = 0,977 - 0,993)], % GC [ICC = 0,961 (IC = 0,931-0,978)], e % GSC [ICC = 0,873 (IC = 0,776 - 0,928)], entre os dados coletados através de BIA e DXA. Dentre as medidas antropométricas avaliadas, apenas a CA e a RCE parecem estimar pacientes com distribuição de gordura abdominal e maior TAV no sexo feminino. A DXA e a BIA mostraram-se semelhantes para a avaliação de MM, MG,% GC e % GSC, embora a DXA tenha a vantagem de estimar o VAT.

Prevalence of osteoporosis in China: a multicenter, large-scale survey of a health checkup population / 中华健康管理学杂志

Objective The present study aimed to establish a bone mineral density (BMD) reference database in China and to investigate the prevalence of osteoporosis in Chinese adults aged 50 years and older using dual energy X-ray absorptiometry (DXA). Method A total of 75321 examineers over 25 years old who underwent health checkups in 7 health check centers between 2008 and 2018 were included. All centers used a GE Lunar-DXA system to measure BMD of the lumbar spine (L1-L4), femoral neck, and total femur. The same European Spine Phantom (ESP) was used for scanning 10 times at every center, a regression equation was generated, and BMD data were cross-calibrated in each center. Peak BMD and standard deviation (SD) were identified according to 5-year age groups, and T scores were calculated based on the peak BMD and SD. Osteoporosis was defined according to the World Health Organization criteria. The prevalence of osteoporosis was standardized based on 2010 national census data for the Chinese population. Result The mean BMD values decreased with age, were highest in North China, followed by Northeast China, East China, and Southwest China, respectively, and increased with body mass index. Males aged 20-30 years and females aged 35-40 years had peak BMD values. Peak BMD values of the lumbar spine, femoral neck, and total femur were 1.09 g/cm2, 0.97 g/cm2, and 0.97 g/cm2 in males, and 1.11 g/cm2, 0.84 g/cm2, and 0.88 g/cm2 in females, respectively. Among all scanned sites, the prevalence of osteoporosis was highest in the femoral neck in males (4.58％) and in the lumbar spine in females (23.38％). The age-standardized prevalence of osteoporosis at any site was 6.46％ in males and 29.13％ in females aged 50 years and older. Based on the 2010 national census data, 10879115 males and 49286542 females currently have osteoporosis. Conclusion Mean BMD values varied according to geographic region, body mass index, age group, and sex in Chinese adults. The age-standardized prevalence of osteoporosis was 6.46％ in males and 29.13％ in females aged 50 years and older.

Short-Term Effects of Bariatric Surgery on Body Composition Assessed by Dual-Energy X-Ray Absorptiometry / 中国医科大学学报

Objective To assess the short-term effects of bariatric surgery on body composition. Methods Fifty-seven patients who underwent bariatric surgery were assessed by dual-energy x-ray absorptiometry (DEXA) before surgery, and 1 and 3 months after surgery. The body composition indexes of whole body and different regions were compared. Results The body mass index (BMI) decreased by 10.61％ and 18.51％, and the lean mass (LM) by 13.22％ and 14.35％ at 1 and 3 months after surgery, respectively. The A/G far mass (FM) decreased significantly 3 months after surgery (P ＜ 0.05). The bone mineral density (BMD) of the spine increased, but that of the pelvis decreased at 1 and 3 months after the operation, and a reduction was observed in the BMD of the whole body by 1.23％ and 1.45％, respectively (P ＜ 0.05). Compared to the baseline, the bone mineral content (BMC) of the spine, pelvis, and whole body increased at 1 and 3 months post-surgery, with a statistically significant difference (P ＜ 0.05). The FM of the whole body (9.52％ and 22.77％) and four regions (legs, trunk, android, and gynoid) reduced. A significant loss of FM (P ＜ 0.05) was observed in the android region by 15.80％ and 31.86％ at the two follow-ups. Conclusion Bariatric surgery can effectively reduce the patient's BMI and FM in the short term, and promotes the redistribution of fat; however, it may be accompanied by a reduction in LM, while the BMD and BMC change trend of pelvis and whole body are opposite.

Recent Issues on Body Composition Imaging for Sarcopenia Evaluation

Recently, sarcopenia has garnered renewed interest. Sarcopenia is a disease characterized by decreased skeletal muscle mass and strength/function, which can impair the quality of life and increase physical disability, adverse metabolic effects, and mortality. Imaging tools for evaluating and diagnosing sarcopenia have developed rapidly. Radiologists should be aware of sarcopenia and its clinical implications. We review current knowledge about sarcopenia, its pathophysiological impact, and advantages and disadvantages of methods for evaluation of sarcopenia focusing on body composition imaging modalities such as whole-body dual-energy X-ray absorptiometry, CT, and MRI. Controversial issues are discussed, including the lack of consensus and standardization of the disease definition, imaging modality, measurement methods, and diagnostic cutoff points.

Measurement and Interpretation of Dual-Energy X-ray Absorptiometry Bone Density Measurements / 대한내과학회지

Dual-energy X-ray absorptiometry (DXA) is a widely used technology used to diagnosis osteoporosis and monitor changes in bone mineral density (BMD). The present paper reviews the clinical application of DXA in evaluating osteoporosis, including indications for BMD testing, interpretation of DXA results, diagnosis of osteoporosis, and serial BMD follow up. As the clinical utility of DXA depends on the quality of the scan acquisition, the precision assessment of DXA is also discussed.

Correlation between diabetic retinopathy and bone mineral density in type 2 diabetic patients / 国际眼科杂志(Guoji Yanke Zazhi)

@#AIM: To explore the relationship between diabetic retinopathy(DR)and bone mineral density(BMD)in type 2 diabetic patients, and to provide evidence for the prevention and treatment of osteoporosis in diabetic retinopathy patients.<p>METHODS: A prospective, controlled study was conducted on 101 type 2 diabetic patients and 17 non-diabetic patients who visited the Department of Ophthalmology and Endocrinology of Huangshi Central Hospital from January 2018 to September 2018. General information, BMD results(LB, HB), and laboratory results were recorded for analysis.<p>RESULTS: In patients with diabetes, HB was negatively correlated with the severity of DR(<i>r</i>=-0.23, <i>P</i>=0.02). Further analysis of BMD and severity of DR was performed by gender grouping. There was no statistically significant difference between LB and HB groups in male patients. There were statistically significant differences between the LB and HB groups in female patients(<i>F</i>=3.52, <i>P</i>=0.02; <i>F</i>=5.21, <i>P</i><0.05). In female patients with type 2 diabetes, both LB and HB showed a declining trend with the development of DR.<p>CONCLUSION: In women with type 2 diabetes mellitus accompanied by DR, the bone mineral density decreased significantly. In the treatment of basic diseases, active intervention for osteoporosis should be paid attention to reduce the risk of fracture.