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Estimation of Whole-Body and Appendicular Lean Mass from Spine and Hip Dual Energy X-ray Absorptiometry: A Cross-Sectional Study

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Abstract

Whole-body dual X-ray absorptiometry (DXA) accurately measures lean mass but is not routinely used in clinical practice. Hip and spine DXA are used in the diagnosis of osteoporosis, and with the common co-occurrence of sarcopenia with osteoporosis, regional DXA scans provide an opportunity for assessment of lean mass. The aim of this study is to develop predictive equations for the estimation of whole-body lean mass (WBLM), appendicular lean mass (ALM) and whole-body fat mass (WBFM) from regional DXA scans. A total of 2427 participants (ages 20–96 year; 57.7% men) from the Geelong Osteoporosis Study who underwent both regional and whole-body DXA were included in the analysis. Using forward stepwise multivariable linear regression, percentage fat (spine%fat, hip%fat) values from lumbar spine and femoral neck DXA were used in combination with clinical data to develop and validate equations for the estimation of WBLM, WBFM and ALM. Mean age was 53.5 year (± 19.2), weight 78.2 kg (± 15.4), height 169.6 cm (± 9.4), WBLM 50.4 kg (± 11.1), ALM 22.8 kg (± 5.4) and WBFM 24.3 kg (± 10.4). Spine%fat (r = 0.21) and hip%fat (r = − 0.34) were correlated with whole-body lean mass (p < 0.001). Final predictive equations included age, sex, weight, height, spine%fat, and hip%fat and possessed high predictive value (Adj R2 0.91–0.94, RMSE 1.60–2.84 kg). K-fold cross-validation methods produced median root mean square error (RMSE) ranging from 1.59 to 2.81 kg for the three models. Regional DXA scans of the spine and hip can be used to estimate whole-body and appendicular lean mass, to assist in the identification of low muscle mass.

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Acknowledgements

The authors acknowledge the men and women who participate in GOS.

Funding

The Geelong Osteoporosis Study has received funding from the National Health and Medical Council (NHMRC) Australia (Grant Nos. 299831, 251638, 628582).

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Authors and Affiliations

  1. IMPACT (Institute of Mental and Physical Health and Clinical Translation), Deakin University, Geelong, Australia

    Matthew Thackeray, Neil R. Orford, Mark A. Kotowicz, Mohammadreza Mohebbi & Julie A. Pasco

  2. Barwon Health, Geelong, Australia

    Matthew Thackeray, Neil R. Orford, Mark A. Kotowicz & Julie A. Pasco

  3. Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), Department of Epidemiology and Preventive Medicine (DEPM), Monash University, Melbourne, Australia

    Neil R. Orford

  4. Department of Medicine-Western Health, The University of Melbourne, St Albans, Australia

    Mark A. Kotowicz & Julie A. Pasco

  5. Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia

    Julie A. Pasco

  6. Faculty of Health, Biostatistics Unit, Deakin University, Geelong, Australia

    Mohammadreza Mohebbi

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  1. Matthew Thackeray
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Correspondence to Matthew Thackeray.

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Conflict of interest

Matthew Thackeray, Neil R. Orford, Mark A. Kotowicz, Mohammadreza Mohebbi and Julie A. Pasco have no relevant financial or non-financial interests to disclose.

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Ethics approval for the study was provided by Barwon Health Human Research Ethics Committee.

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This study was performed in accordance with the ethical standards as laid down in the 1964 declaration of Helsinki and its later amendments.

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Thackeray, M., Orford, N.R., Kotowicz, M.A. et al. Estimation of Whole-Body and Appendicular Lean Mass from Spine and Hip Dual Energy X-ray Absorptiometry: A Cross-Sectional Study. Calcif Tissue Int 110, 341–348 (2022). https://doi.org/10.1007/s00223-021-00922-4

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