Reproducibility of Pediatric Whole Body Bone and Body Composition Measures by Dual-Energy X-Ray Absorptiometry Using the GE Lunar Prodigy

2005 ◽  
Vol 8 (3) ◽  
pp. 298-304 ◽  
Author(s):  
Lauren Margulies ◽  
Mary Horlick ◽  
John C. Thornton ◽  
Jack Wang ◽  
Elli Ioannidou ◽  
...  
Keyword(s):  
Body Composition ◽  
Dual Energy ◽  
Whole Body ◽  
X Ray ◽  
Body Bone

MO047COMPARISON BETWEEN DUAL-ENERGY X-RAY ABSORPTIOMETRY AND BIOELECTRICAL IMPEDANCE FOR BODY COMPOSITION MEASUREMENTS IN ADULTS WITH CHRONIC KIDNEY DISEASE

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Natália Tomborelli Bellafronte ◽  
Lorena Vega-Piris ◽  
Paula Garcia Chiarello ◽  
Guillermina Barril Cuadrado
Keyword(s):  
Chronic Kidney Disease ◽  
Body Composition ◽  
Peritoneal Dialysis ◽  
Renal Transplantation ◽  
Bioelectrical Impedance ◽  
Total Sample ◽  
Dual Energy ◽  
Error Tolerance ◽  
Whole Body ◽  
X Ray

Abstract Background and Aims Chronic kidney disease (CKD) patients frequently have an altered body composition driven by metabolic disorders from the uremic syndrome that usually leads to increased protein catabolism, with obesity and muscle impairment being common conditions associated with worse clinical prognosis and high mortality rates. Therefore, with increased mortality and disability rates of CKD patients in the last quarter of a century and the association of a poor body composition with low survival, routine and longitudinal assessment of body composition could improve clinical outcomes. Due to limited availability of reference methods to assess nutritional status, alternative methods are used. In view of the above, our goal was to evaluate the agreement between multifrequency bioelectrical impedance spectroscopy (BIS) and Dual-energy X-ray Absorptiometry (DXA) for assessment of body composition in CKD. Method Cross-sectional and prospective analyses by DXA (Hologic, GE®) and BIS (BCM, Fresenius Medical Care®) in whole-body (BISWB) and segmental (BISSEG) protocols were performed in CKD non-dialysis-dependent, hemodialysis and peritoneal dialysis (for at least 3 months), and renal transplantation (for at least 6 months) adult (18 ≤ age ≤ 60 years old) patients. Measurements were performed consecutively by the same professional after an 8-hour fast, drainage of the peritoneal dialysate and just after the midweek hemodialysis session. Intraclass correlation coefficient (ICC) and Bland-Altman plots were evaluated for agreement analysis in group and individual levels, respectively; linear regression analysis was performed for bias assessment and development of new equations; ROC curve was constructed for diagnosis of inadequate error tolerance (DXA - BIS > ± 2kg). Results A total of 266 patients were included: 137 men (M) and 129 women (W); 81 were in non-dialysis-dependent treatment, 83 in hemodialysis, 24 in peritoneal dialysis, and 80 had renal transplantation. Total sample had a mean age of 47 ± 10 years old. CKD was secondary to systemic arterial hypertension in 29% of the total sample, to glomerulonephritis in 25%, to diabetes mellitus in 10%, to polycystic kidney in 7%, to glomerulosclerosis and systemic syndromes in 8%, and to other causes and unknown etiology in 20%. Fourteen patients (4 M and 10 W) were in automated and 9 (4 M and 5 W) in continuous ambulatory PD. KTx was by living donor in 18 (14 M and 4 W) and by deceased donor in 63 (34 M and 29 W) patients. The agreement with DXA was greater for BISWB than BISSEG; for fat mass (FM) (ICC in M = 0.89; ICC in W = 0.93) than for fat free mass (FFM) (ICC in M = 0.57; ICC in W = 0.52). Bland-Altman plots showed high limits of agreement (FFM: from -9.51 to 15.64kg; FM: from -7.71 to 7.32kg) with greater bias for FFM as muscular mass increases and for FM in extremes of body fat. The agreement was lower when using the prospective data (body change analysis) (ICC for FFM in M = 0.20; ICC for FFM in W = 0.49; ICC for FM in M = 0.46; ICC for FM in W = 0.58). The factors that interfered in bias between methods were extra to intracellular water ratio (ECW/ICW), body mass index, fat mass index, waist circumference, resistance and reactance (adjusted r2 for FFM = 0.90; r2 for FM = 0.87). FFM had poorer agreement in the last tertile of ECW/ICW sample (ICC in M = 0.69, 0.68 and 0.51; ICC in W = 0.71, 0.74 and 0.38 for first, second and third tertiles, respectively). An ECW/ICW cut-off point of > 0.725 for inadequate error tolerance was determined. New prediction equations for FFM (r2 = 0.91) and FM (r2 = 0.89) presented adequate error tolerance in 55% and 63% in the validation sample compared to 30% and 39% of the original equation, respectively. Conclusion For body composition evaluation in CKD, BIS applied using the whole-body protocol, in normal hydration CKD patients is as reliable as DXA; BIS must be used with caution among overhydrated patients with ECW/ICW > 0.725. The newly developed equations are indicated for greater precision.

DUAL-ENERGY X-RAY ABSORPTIOMETRY FOR REGIONAL AND WHOLE-BODY COMPOSITION: THE NEW GOLD STANDARD? 481

1996 ◽  
Vol 28 (Supplement) ◽  
pp. 81
Author(s):  
A D Martin ◽  
S B Heymsfield ◽  
W M Kohrt ◽  
T G Lohman
Keyword(s):  
Body Composition ◽  
Gold Standard ◽  
Dual Energy ◽  
Whole Body ◽  
X Ray

Assessment of whole-body composition with dual-energy x-ray absorptiometry.

Radiology ◽  
1992 ◽  
Vol 185 (2) ◽  
pp. 593-598 ◽  
Author(s):  
D O Slosman ◽  
J P Casez ◽  
C Pichard ◽  
T Rochat ◽  
F Fery ◽  
...  
Keyword(s):  
Body Composition ◽  
Dual Energy ◽  
Whole Body ◽  
X Ray

scholarly journals Investigating the level of agreement of two positioning protocols when using dual energy X-ray absorptiometry in the assessment of body composition

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3880 ◽  
Author(s):  
Flinn Shiel ◽  
Carl Persson ◽  
Vini Simas ◽  
James Furness ◽  
Mike Climstein ◽  
...  
Keyword(s):  
Body Composition ◽  
Correlation Coefficient ◽  
Dual Energy ◽  
Mean Difference ◽  
Whole Body ◽  
Confidence Limits ◽  
X Ray ◽  
Change In Mean ◽  
Very High ◽  
Level Of Agreement

Background Dual energy X-ray absorptiometry (DXA) is a commonly used instrument for analysing segmental body composition (BC). The information from the scan guides the clinician in the treatment of conditions such as obesity and can be used to monitor recovery of lean mass following injury. Two commonly used DXA positioning protocols have been identified—the Nana positioning protocol and the National Health and Nutrition Examination Survey (NHANES). Both protocols have been shown to be reliable. However, only one study has assessed the level of agreement between the protocols and ascertained the participants’ preference of protocol based upon comfort. Given the paucity of research in the field and the growing use of DXA in both healthy and pathological populations further research determining the most appropriate positioning protocol is warranted. Therefore, the aims of this study were to assess the level of agreement between results from the NHANES protocol and Nana protocol, and the participants’ preference of protocol based on comfort. Methods Thirty healthy participants (15 males, 15 females, aged 23–59 years) volunteered to participate in this study. These participants underwent two whole body DXA scans in a single morning (Nana positioning protocol and NHANES positioning protocol), in a randomised order. Each participant attended for scanning wearing minimal clothing and having fasted overnight, refrained from exercise in the past 24 h and voided their bladders. Level of agreement, comparing NAHNES to Nana protocol was assessed using an intra-class correlation coefficient (ICC), concordance correlation coefficient (CCC) and percentage change in mean. Limit of agreement comparing the two protocols were assessed using plots, mean difference and confidence limits. Participants were asked to indicate the protocol they found most comfortable. Results When assessing level of agreement between protocols both the ICC and CCC scores were very high and ranged from 0.987 to 0.997 for whole body composition, indicating excellent agreement between the Nana and NHANES protocols. Regional analysis (arms, legs, trunk) ICC scores, ranged between 0.966 and 0.996, CCC ranged between 0.964 and 0.997, change in mean percentage ranged between −0.58% and 0.37% which indicated a very high level of agreement. Limit of agreement analysis using mean difference ranged between −0.223 and 0.686 kg and 95% CL produced results ranging between −1.262 kg and 1.630 kg. The majority (80%) of participants found the NHANES positioning protocol more comfortable. Discussion This study reveals a strong level of agreement as illustrated by high ICC’s and CCC’s between the positioning protocols, however systematic bias within limit of agreement plot and a large difference in 95% confidence limits indicates that the protocols should not be interchanged when assessing an individual. The NHANES protocol affords greater participant comfort.

Techniques for Undertaking Dual-Energy X-Ray Absorptiometry Whole-Body Scans to Estimate Body Composition in Tall and/or Broad Subjects

2012 ◽  
Vol 22 (5) ◽  
pp. 313-322 ◽  
Author(s):  
Alisa Nana ◽  
Gary J. Slater ◽  
Will G. Hopkins ◽  
Louise M. Burke
Keyword(s):  
Body Composition ◽  
Dual Energy ◽  
The Body ◽  
Whole Body ◽  
Whole Body Scan ◽  
Body Scan ◽  
Physically Active ◽  
X Ray ◽  
Scanning Area ◽  
Dxa Scans

Dual-energy X-ray absorptiometry (DXA) is becoming a popular tool to measure body composition, owing to its ease of operation and comprehensive analysis. However, some people, especially athletes, are taller and/or broader than the active scanning area of the DXA bed and must be scanned in sections. The aim of this study was to investigate the reliability of DXA measures of whole-body composition summed from 2 or 3 partial scans. Physically active young adults (15 women, 15 men) underwent 1 whole-body and 4 partial DXA scans in a single testing session under standardized conditions. The partial scanning areas were head, whole body from the bottom of the chin down, and right and left sides of the body. Body-composition estimates from whole body were compared with estimates from summed partial scans to simulate different techniques to accommodate tall and/or broad subjects relative to the whole-body scan. Magnitudes of differences in the estimates were assessed by standardization. In simulating tall subjects, summation of partial scans that included the head scan overestimated whole-body composition by ~3 kg of lean mass and ~1 kg of fat mass, with substantial technical error of measurement. In simulating broad subjects, summation of right and left body scans produced no substantial differences in body composition than those of the whole-body scan. Summing partial DXA scans provides accurate body-composition estimates for broad subjects, but other strategies are needed to accommodate tall subjects.

scholarly journals Dual-energy X-ray absorptiometry is a reliable non-invasive technique for determining whole body composition of chickens

2019 ◽  
Vol 98 (6) ◽  
pp. 2652-2661
Author(s):  
S. Schallier ◽  
C. Li ◽  
J. Lesuisse ◽  
G.P.J. Janssens ◽  
N. Everaert ◽  
...  
Keyword(s):  
Body Composition ◽  
Dual Energy ◽  
Whole Body ◽  
Invasive Technique ◽  
X Ray ◽  
Non Invasive

In vivo validation of whole body composition estimates from dual-energy X-ray absorptiometry

1997 ◽  
Vol 83 (2) ◽  
pp. 623-630 ◽  
Author(s):  
Barry M. Prior ◽  
Kirk J. Cureton ◽  
Christopher M. Modlesky ◽  
Ellen M. Evans ◽  
Mark A. Sloniger ◽  
...  
Keyword(s):  
Body Composition ◽  
Dual Energy ◽  
Component Model ◽  
Whole Body ◽  
Body Density ◽  
X Ray ◽  
Athletic Status ◽  
Musculoskeletal Development ◽  
Four Component Model ◽  
The Difference

Prior, Barry M., Kirk J. Cureton, Christopher M. Modlesky, Ellen M. Evans, Mark A. Sloniger, Michael Saunders, and Richard D. Lewis. In vivo validation of whole body composition estimates from dual-energy X-ray absorptiometry. J. Appl. Physiol. 83(2): 623–630, 1997.—We validated whole body composition estimates from dual-energy X-ray absorptiometry (DEXA) against estimates from a four-component model to determine whether accuracy is affected by gender, race, athletic status, or musculoskeletal development in young adults. Measurements of body density by hydrostatic weighing, body water by deuterium dilution, and bone mineral by whole body DEXA were obtained in 172 young men ( n = 91) and women ( n = 81). Estimates of body fat (%Fat) from DEXA (%FatDEXA) were highly correlated with estimates of body fat from the four-component model [body density, total body water, and total body mineral (%Fatd,w,m); r = 0.94, standard error of the estimante (SEE) = 2.8% body mass (BM)] with no significant difference between methods [mean of the difference ± SD of the difference = −0.4 ± 2.9 (SD) % BM, P = 0.10] in women and men. On the basis of the comparison with %Fatd,w,m, estimates of %FatDEXA were slightly more accurate than those from body density ( r = 0.91, SEE = 3.4%; mean of the difference ± SD of the difference = −1.2 ± 3.4% BM). Differences between %FatDEXA and %Fatd,w,m were weakly related to body thickness, as reflected by BMI ( r= −0.34), and to the percentage of water in the fat-free mass ( r = −0.51), but were not affected by race, athletic status, or musculoskeletal development. We conclude that body composition estimates from DEXA are accurate compared with those from a four-component model in young adults who vary in gender, race, athletic status, body size, musculoskeletal development, and body fatness.

scholarly journals Techniques for the study of energy balance in man

2003 ◽  
Vol 62 (2) ◽  
pp. 529-537 ◽  
Author(s):  
Marinos Elia ◽  
Rebecca Stratton ◽  
James Stubbs
Keyword(s):  
Body Composition ◽  
Measurement Error ◽  
Energy Balance ◽  
Energy Intake ◽  
Dual Energy ◽  
The Body ◽  
Fat Free Mass ◽  
Whole Body ◽  
X Ray ◽  
Body Segments

Energy balance can be estimated in tissues, body segments, individual subjects (the focus of the present article), groups of subjects and even societies. Changes in body composition in individual subjects can be translated into changes in the energy content of the body, but this method is limited by the precision of the techniques. The precision for measuring fat and fat-free mass can be as low as 0.5 kg when certain reference techniques are used (hydrodensitometry, air-displacement plethysmography, dual-energy X-ray absorptiometry), and approximately 0.7 kg for changes between two time points. Techniques associated with a measurement error of 0.7 kg for changes in fat and fat-free mass (approximately 18MJ) are of little or no value for calculating energy balance over short periods of time, but they may be of some value over long periods of time (18 MJ over 1 year corresponds to an average daily energy balance of 70 kJ, which is <1% of the normal dietary energy intake). Body composition measurements can also be useful in calculating changes in energy balance when the changes in body weight and composition are large, e.g. >5–10 kg. The same principles can be applied to the assessment of energy balance in body segments using dual-energy X-ray absorptiometry. Energy balance can be obtained over periods as short as a few minutes, e.g. during measurements of BMR. The variability in BMR between individuals of similar age, weight and height and gender is about 7–9%, most of which is of biological origin rather than measurement error, which is about 2%. Measurement of total energy expenditure during starvation (no energy intake) can also be used to estimate energy balance in a whole-body calorimeter, in patients in intensive care units being artificially ventilated and by tracer techniques. The precision of these techniques varies from 1 to 10%. Establishing energy balance by measuring the discrepancy between energy intake and expenditure has to take into consideration the combined validity and reliability of both components. The measurement error for dietary intake may be as low as 2–3% in carefully controlled environments, in which subjects are provided only with certain food items and bomb calorimetry can be undertaken on duplicate samples of the diet. Reliable results can also be obtained in hospitalised patients receiving enteral tube feeding or parenteral nutrition as the only source of nutrition. Unreliability increases to an unknown extent in free-living subjects eating a mixed and varied diet; thus, improved methodology is needed for the study of energy balance.

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