Anthropometrics Do Not Influence Dual X-ray Absorptiometry (DXA) Measurement of Fat in Normal to Obese Adults: A Comparison with In Vivo Neutron Activation Analysis (IVNA)

Dual-energy X-ray absorptiometry (DXA) is now a commonly used method for the determination of bone mineral status and body composition in humans. The purposes of this study were to compare fat mass by in vivo neutron activation analysis (FM_IVNA) with that by DXA (FM_DXA) in an anthropometrically heterogeneous sample of healthy adult men (n=33) and women (n=36) (19=≤BMI≤39), and to determine whether differences in fat mass estimates between the two methods (ΔFM) were attributable to subject anthropometry as defined by several circumference (waist, iliac crest, thigh) and skinfold thickness (umbilical, suprailiac, abdominal) measurements. No significant differences between FM_DXA and FM_IVNA were observed in men (p=0.46) or women (p=0.09). The two methods were very highly correlated in both sexes (women r²=0.97, p<0.001, men r²=0.91, p<0.001), although the regression line for men was significantly different from the line of identity (p=0.043). These results suggest modest trends toward underestimation of FM_DXA in men when FM_IVNA<18 kg, and overestimation in men when FM_IVNA>18 kg. ΔFM (IVNA-DXA) was not significantly related to any combination of skinfold thicknesses and circumferences in either gender. Age explained 27% of the variance in ΔFM for the men (p=0.008). Furthermore, ΔFM was not significantly related to inter-method disparity in total-body bone mineral measurements in men or women (p<0.05). The present study demonstrates strong correlation in fat measurements between IVNA and DXA in men and women ranging from normal to markedly obese. Correction for subject anthropometry does not significantly improve this relationship.     

Bioelectrical impedance vs. four-compartment model to assess body fat change in overweight adults

Objective: The Tanita TBF‐305 body fat analyzer is marketed for home and clinical use and is based on the principles of leg‐to‐leg bioelectrical impedance analysis (BIA). Few studies have investigated the ability of leg‐to‐leg BIA to detect change in percentage fat mass (%FM) over time. Our objective was to determine the ability of leg‐to‐leg BIA vs. the four‐compartment (4C) model to detect small changes in %FM in overweight adults. Research Methods and Procedures: Thirty‐eight overweight adults (BMI, 25.0 to 29.9 kg/m²; age, 18 to 44 years; 31 women) participated in a 6‐month, randomized, double‐blind, placebo‐controlled study of a nutritional supplement. Body composition was measured at 0 and 6 months using the Tanita TBF‐305 body fat analyzer [using equations derived by the manufacturer (%FM_T‐Man) and by Jebb et al. (%FM_T‐Jebb)] and the 4C model (%FM_4C). Results: Subjects in the experimental group lost 0.9%FM_4C (p = 0.03), a loss that did not reach significance using leg‐to‐leg BIA (0.6%FM_T‐Man, p = 0.151; 0.6%FM_T‐Jebb, p = 0.144). We observed large standard deviations (SDs) in the mean difference in %FM between the 4C model and the Tanita_Manufacturer (2.5%) and Tanita_Jebb (2.2%). Ten subjects fell outside ±1 SD of the mean differences at 0 and 6 months; those individuals were younger and shorter than those within ±1 SD. Discussion: Leg‐to‐leg BIA performed reasonably well in predicting decreases in %FM in this group of overweight adults but resulted in wide SDs vs. %FM_4C in individuals. Cross‐sectional determinations of %FM of overweight individuals using leg‐to‐leg BIA should be interpreted with caution.     

Birth weight is inversely associated with central adipose tissue in healthy children and adolescents

Objective: Previous studies have explored the association between birth weight and excess childhood body fat, but few have used precise measures of body composition, leading to equivocal and sometimes contradictory results. Research Methods and Procedures: Subjects included 101 children who underwent DXA measurements between 1995 and 2000. Birth weight and gestational age were assessed using maternal recall. Multiple linear regression analysis was used to determine the relationship between birth weight and the following four outcome variables: total fat mass (FM), truncal fat mass (TrFM), percentage body fat (%BF), and TrFM adjusted for FM (TrFMadj), controlling for current weight and Tanner stage. Results: The mean age of the children studied was 12.9 ± 2.4 years, and the mean birth weight reported by subjects’ mothers was 3.3 ± 0.5 kg. The FM and TrFM were 12.8 ± 8.7 kg and 5.1 ± 4.1 kg, respectively, and the mean %BF was 22.9 ± 10.3%. Birth weight was a significant predictor of FM (p = 0.02) and %BF (p = 0.038). However, birth weight adjusted for gestational age (BWTadj) was a significant (p = 0.03) negative predictor of TrFMadj, independently of race, sex, Tanner stage, and current weight. Discussion: These results provide evidence that, even in childhood and adolescence, a higher birth weight is associated with higher FM and %BF, while a low birth weight is associated with TrFM, adjusted for FM.     

Fat Mass Measured by DXA Varies with Scan Velocity

Objective: To study the influence of scan velocities of DXA on the measured size of fat mass, lean body mass, bone mineral content and density, and total body weight. Research Methods and Procedures: The subjects were 71 healthy white adults, 38 women and 33 men. The mean age was 41.7 ± 13.5 years and body mass index was 28.6 ± 5.6 kg/m². The subjects were scanned consecutively in slow, medium, and fast scan mode by a Lunar DPX-IQ DXA scanner. Results: Throughout the body mass index and sagittal height ranges, scanned lean body mass significantly decreased with higher scan velocity and lean body mass was 2.7% lower in fast than in medium mode (p < 0.0001). In contrast, fat mass, percentage of body fat, and bone mineral contents were higher with increasing scan velocity. Areas not analyzed by the scanner, so called blue spots, increased with scan velocity and sagittal height, and their presence significantly enhanced the error. Body weight estimated by DXA in slow mode was −0.8% lower than scale weight in the women (p < 0.001) and −0.2% in men (not significant), and the difference was greater with increasing scan velocity. Discussion: Scan velocity significantly influences the measured fat mass size, lean body mass, bone mineral content, and body weight. To obtain the most accurate results, slow mode is preferable and fast scans should be avoided. Future studies should report and take scan velocity into consideration.     

Opposite Contributions of Trunk and Leg Fat Mass with Plasma Lipase Activities: The Hoorn Study

Objective: Lipoprotein lipase (LPL) and hepatic lipase (HL) are essential in hydrolysis of triglyceride‐rich lipoproteins. LPL activity is negatively, whereas HL activity is positively, associated with total body fat. We determined the associations of trunk and leg fat mass with plasma LPL and HL activities in a cross‐sectional study. Research Methods and Procedures: LPL and HL activities were determined in post‐heparin plasma in a sample of 197 men and 209 women, 60 to 87 years of age. A total body DXA scan was performed to determine trunk and leg fat mass. Results: In women, but not in men, trunk fat mass was negatively associated with LPL activity, whereas leg fat mass was positively associated, after mutual adjustment and adjustment for age. Standardized βs (95% confidence interval) for trunk and leg fat mass were ?0.24 (?0.41; ?0.08) and 0.14 (?0.02; 0.31), respectively (interaction by sex, p = 0.03). Larger trunk fat mass was associated with higher HL activity in men [0.48 (0.28; 0.68)] and women [0.40 (0.24; 0.56)]. A negative association of leg fat mass and HL activity was observed in men, although not statistically significant [?0.13 (?0.33; 0.06)], and in women [?0.28 (?0.38; ?0.18)]. Discussion: Abdominal fat is associated with unfavorable and femoral fat with favorable LPL and HL activities in plasma.     

Improved Prediction of Body Fat by Measuring Skinfold Thickness,Circumferences, and Bone Breadths

Objective: To develop improved predictive regression equations for body fat content derived from common anthropometric measurements. Research Methods and Procedures: 117 healthy German subjects, 46 men and 71 women, 26 to 67 years of age, from two different studies were assigned to a validation and a cross‐validation group. Common anthropometric measurements and body composition by DXA were obtained. Equations using anthropometric measurements predicting body fat mass (BFM) with DXA as a reference method were developed using regression models. Results: The final best predictive sex‐specific equations combining skinfold thicknesses (SF), circumferences, and bone breadth measurements were as follows: BFM_New (kg) for men = ?40.750 + [(0.397 × waist circumference) + [6.568 × (log triceps SF + log subscapular SF + log abdominal SF)]] and BFM_New (kg) for women = ?75.231 + [(0.512 × hip circumference) + [8.889 × (log chin SF + log triceps SF + log subscapular SF)] + (1.905 × knee breadth)]. The estimates of BFM from both validation and cross‐validation had an excellent correlation, showed excellent correspondence to the DXA estimates, and showed a negligible tendency to underestimate percent body fat in subjects with higher BFM compared with equations using a two‐compartment (Durnin and Womersley) or a four‐compartment (Peterson) model as the reference method. Discussion: Combining skinfold thicknesses with circumference and/or bone breadth measures provide a more precise prediction of percent body fat in comparison with established SF equations. Our equations are recommended for use in clinical or epidemiological settings in populations with similar ethnic background.     

PIXImus DXA with Different Software Needs Individual Calibration to Accurately Predict Fat Mass

Objective: To validate GE PIXImus2 DXA fat mass (FM) estimates by chemical analysis, to compare previously published correction equations with an equation from our machine, and to determine intermachine variation. Research Methods and Procedures: C57BL/6J (n = 16) and Aston (n = 14) mice (including ob/ob), Siberian hamsters (Phodopus sungorus) (n = 15), and bank voles (Clethrionomys glareolus) (n = 37) were DXA scanned postmortem, dried, then fat extracted using a Soxhlet apparatus. We compared extracted FM with DXA‐predicted FM corrected using an equation designed using wild‐type animals from split‐sample validation and multiple regression and two previously published equations. Sixteen animals were scanned on both a GE PIXImus2 DXA in France and a second machine in the United Kingdom. Results: DXA underestimated FM of obese C57BL/6J by 1.4 ± 0.19 grams but overestimated FM for wild‐type C57BL/6J (2.0 ± 0.11 grams), bank voles (1.1 ± 0.09 grams), and hamsters (1.1 ± 0.13 grams). DXA‐predicted FM corrected using our equation accurately predicted extracted FM (accuracy 0.02 grams), but the other equations did not (accuracy, ?1.3 and ?1.8 grams; paired Student's t test, p < 0.001). Two similar DXA instruments gave the same FM for obese mutant but not lean wild‐type animals. Discussion: DXA using the same software could use the same correction equation to accurately predict FM for obese mutant but not lean wild‐type animals. PIXImus machines purchased with new software need validating to accurately predict FM.     

Measuring and interpreting age‐related loss of vertebral bone mineral density in a medieval population

This study investigates the age‐ and sex‐related patterns in vertebral bone mineral density (BMD) and the relationship between BMD and vertebral osteophytosis (VO), using a specialized peripheral densitometer in a skeletal sample excavated from the British medieval village Wharram Percy. A total of 58 individuals were divided by sex into three broad age categories (18–29, 30–49, 50+ years.). Each fourth intact vertebral centra was scored for VO and 5‐mm thick coronal sections scanned in a specialized peripheral densitometer (GE Lunar Piximus DXA). Changes in BMD associated with age, sex, and VO severity were examined in the whole vertebral section, a strictly trabecular region, and a primarily cortical region of bone separately. Significant change in vertebral BMD was found to occur by middle age with little or no statistical change in BMD between middle and old age. Females appear to suffer greater bone loss at an earlier age with no change in BMD between middle and old age, whereas males show a more steady loss of BMD across the age groups. The bone mineral content and BMD of the cortical region is higher in individuals with pronounced/severe osteophytosis. The unusual age‐ and sex‐related patterns of change in vertebral BMD at Wharram Percy are compared with the patterns of age‐related change from recent longitudinal population‐based studies. The results emphasize the different pattern of bone loss in young adulthood seen in trabecular regions of the skeleton and highlight the importance of consideration of degenerative joint disease in BMD studies. The influence of lifestyle factors on vertebral BMD in this medieval population is also discussed. Am J Phys Anthropol 2009. © 2009 Wiley‐Liss, Inc.     

Fat and energy partitioning: longitudinal observations in leptin-treated adults homozygous for a Lep mutation

Objective: Partitioning of body energy content in the aleptinemic ob/ob mouse differs from that in wild‐type mice, but it is not known whether parallel differences exist between humans with leptin (Lep) gene mutations and healthy adults. The objective of this study was to evaluate body composition in three leptin‐treated Turkish adults homozygous for a missense mutation (C→T substitution at codon 105 resulting in Arg→Trp) of Lep. Research Methods and Procedures: Subjects, one male and two female Turkish family members, were evaluated at baseline and treated for 18 months with r‐MetHuLeptin. Patient data (fat mass, energy content) were compared with adult sex‐specific predicted values (adjusted for weight, height, and age) derived in healthy control subjects. Results: Weight loss with leptin treatment was substantial, ranging from 43.9% to 52.1%. At baseline and with leptin treatment, the two women had a fat mass and energy content similar (±12%) to predicted values. Baseline fat and energy content in the male patient was high compared with predicted values (e.g., fat +33%) but approached and reached normal values (e.g., fat, +2%) after 18 months of leptin therapy. Discussion: Adult women with Lep mutations had body composition similar to normal women at baseline and with leptin treatment. In contrast, the man with a Lep mutation had high body fat in the untreated state but a normal male phenotype with leptin administration, possibly secondary to androgenic fat partitioning effects. Fat and energy partitioning can, thus, be quantitatively assessed and linked with potential hormonal mechanisms in humans with inherited disturbances in energy regulation.     

Precision and Accuracy of Dual‐Energy X‐ray Absorptiometry for Determining in Vivo Body Composition of Mice

Objective: To evaluate the precision and accuracy of dual‐energy X‐ray absorptiometry (DXA) for the measurement of total‐bone mineral density (TBMD), total‐body bone mineral (TBBM), fat mass (FM), and bone‐free lean tissue mass (LTM) in mice. Research Methods and Procedures: Twenty‐five male C57BL/6J mice (6 to 11 weeks old; 19 to 29 g) were anesthetized and scanned three times (with repositioning between scans) using a peripheral densitometer (Lunar PIXImus). Gravimetric and chemical extraction techniques (Soxhlet) were used as the criterion method for the determination of body composition; ash content was determined by burning at 600°C for 8 hours. Results: The mean intraindividual coefficients of variation (CV) for the repeated DXA analyses were: TBMD, 0.84%; TBBM, 1.60%; FM, 2.20%; and LTM, 0.86%. Accuracy was determined by comparing the DXA‐derived data from the first scan with the chemical carcass analysis data. DXA accurately measured bone ash content (p = 0.942), underestimated LTM (0.59 ± 0.05g, p < 0.001), and overestimated FM (2.19 ± 0.06g, p < 0.001). Thus, DXA estimated 100% of bone ash content, 97% of carcass LTM, and 209% of carcass FM. DXA‐derived values were then used to predict chemical values of FM and LTM. Chemically extracted FM was best predicted by DXA FM and DXA LTM [FM = ?0.50 + 1.09(DXA FM) ? 0.11(DXA LTM), model r² = 0.86, root mean square error (RMSE) = 0.233 g] and chemically determined LTM by DXA LTM [LTM = ?0.14 + 1.04(DXA LTM), r² = 0.99, RMSE = 0.238 g]. Discussion: These data show that the precision of DXA for measuring TBMD, TBBM, FM, and LTM in mice ranges from a low of 0.84% to a high of 2.20% (CV). DXA accurately measured bone ash content but overestimated carcass FM and underestimated LTM. However, because of the close relationship between DXA‐derived data and chemical carcass analysis for FM and LTM, prediction equations can be derived to more accurately predict body composition.