Abstract
Background/Objectives:
Dual energy X-ray absorptiometry (DXA) is a recognized tool for measurement of body composition and provides benefits of low dose radiation, quick scan time and multiple measurement options. Challenges arise in scanning children, particularly with limb movement. We aimed to validate the use of surrogate limb substitutions compared with whole-body scans by DXA for measuring fat, lean and bone mass in children.
Subjects/Methods:
DXA scans were obtained from 3-year-old children who had normal positioning and no limb movement (n=246) or movement of a single limb (n=55). By replacing the measurements of one scanned limb with those of the opposite limb, we obtained an estimate value that was compared with the original whole-body scan measures for fat, lean and bone mass, percent whole-body fat and total mass for scans without or with movement.
Results:
Original normal scan analyses were highly correlated with estimates using substitution of the surrogate limb for all body compartments (R2=0.986–0.999, P<0.005). The Bland–Altman analysis demonstrated high levels of agreement between the estimates using surrogate limb and original whole-body measurements. Differences in estimate values and variance were greater with limb substitution in scans with movement compared to without movement.
Conclusions:
Use of limb surrogate methodology for fat mass, lean mass, bone mineral content, percent fat and total mass, is a valid alternative that minimizes variation in estimates of body composition from DXA scans in young children in which a single limb is affected by movement. This will allow inclusion of scans with movement artifact in a single limb for data analysis.
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References
Ellis KJ . Human body composition: in vivo methods. Physiol Rev 2000; 80: 649–680.
Bredella MA, Ghomi RH, Thomas BJ, Torriani M, Brick DJ, Gerweck AV et al. Comparison of DXA and CT in the assessment of body composition in premenopausal women with obesity and anorexia nervosa. Obesity 2010; 18: 2227–2233.
Lane JT, Mack-Shipman LR, Anderson JC, Moore TE, Erickson JM, Ford TC et al. Comparison of CT and dual-energy DEXA using a modified trunk compartment in the measurement of abdominal fat. Endocrine 2005; 27: 295–299.
Direk K, Cecelja M, Astle W, Chowienczyk P, Spector TD, Falchi M et al. The relationship between DXA-based and anthropometric measures of visceral fat and morbidity in women. BMC Cardiovasc Disord 2013; 13: 25.
Helba M, Binkovitz LA . Pediatric body composition analysis with dual-energy X-ray absorptiometry. Pediatr Radiol 2009; 39: 647–656.
Binkovitz LA, Henwood MJ, Sparke P . Pediatric DXA: technique, interpretation and clinical applications. Pediatr Radiol 2008; 38: S227–S239.
Weber DR, Leonard MB, Zemel BS . Body composition analysis in the pediatric population. Pediatr Endocrinol Rev 2012; 10: 130–139.
Koo WW . Body composition measurements during infancy. Ann N Y Acad Sci 2000; 904: 383–392.
Tataranni PA, Ravussin E . Use of dual-energy X-ray absorptiometry in obese individuals. Am J Clin Nutr 1995; 62: 730–734.
Rothney MP, Brychta RJ, Schaefer EV, Chen KY, Skarulis MC . Body composition measured by dual-energy X-ray absorptiometry half-body scans in obese adults. Obesity 2009; 17: 1281–1286.
Breithaupt P, Colley RC, Adamo KB . Body composition measured by dual-energy X-ray absorptiometry half-body scans in obese children. Acta Paediatr 2011; 100: e260–e266.
Morrison KM, Atkinson SA, Yusuf S, Bourgeois J, McDonald S, McQueen MJ et al. The family atherosclerosis monitoring in earLY life (FAMILY) study: rationale, design, and baseline data of a study examining the early determinants of atherosclerosis. Am Heart J 2009; 158: 533–539.
Sawyer A, Backrack L, Fung E . New software versions. In: Bone Densitometry in Growing Patients: Guidelines for Clinical Practice. Humana Press: NJ, USA, 2007, pp 104–106.
Bland JM, Altman DG . Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986; 1: 307–310.
Libber J, Binkley N, Krueger D . Clinical observations in total body DXA: technical aspects of positioning and analysis. J Clin Densitom 2012; 15: 282–289.
Acknowledgements
The substudy was funded by Dairy Farmers of Canada and an Ontario Graduate Scholarship to DJR. The main FAMILY Study was funded by Canadian Institutes of Health Research and Heart and Stroke Foundation of Canada. We gratefully acknowledge the patience and cooperation of the young children and their families in the conduct of the DXA scans.
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Contributors: DJR is a graduate student under the supervision of SAA. She assisted in the design of the study, conducted the scan analyses, analyzed the data, drafted the initial manuscript and approved the final manuscript as submitted. SAA is a primary investigator of the FAMILY birth cohort study; she conceptualized and designed this DXA validation study, supervised data collection and statistical analysis, contributed to interpretation of results and had primary responsibility for the final manuscript as submitted.
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Rodrigopulle, D., Atkinson, S. Validation of surrogate limb analysis for body composition in children by dual energy X-ray absorptiometry (DXA). Eur J Clin Nutr 68, 653–657 (2014). https://doi.org/10.1038/ejcn.2014.44
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DOI: https://doi.org/10.1038/ejcn.2014.44