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Determination of skeletal muscle and fat-free mass by nuclear and dual-energy X-ray absorptiometry methods in men and women aged 51–84 y^1,2,3

¹ From the Department of Life Sciences, The University of Sydney, Australia; the Gastrointestinal Investigation Unit, Department of Nuclear Medicine, University Department of Surgery, Royal North Shore Hospital, Sydney, Australia; and the Cancer Care Centre, St George Hospital, Sydney, Australia.

Background: Skeletal muscle mass (SMM) and fat-free mass (FFM) are important variables in nutritional studies. Accurate techniques for measuring these variables have not been thoroughly validated in elderly subjects.

Objectives: The objectives of this study were to 1) compare SMM values derived from dual-energy X-ray absorptiometry (DXA) with those calculated by a nuclear method from total body potassium (TBK) and total body nitrogen (TBN) measurement (both: KN) in older subjects, and 2) assess the accuracy of FFM measurement by DXA in these subjects.

Design: TBK, TBN, DXA (model XR36; Norland, Fort Atkinson, WI), bioimpedance, and anthropometric measurements were performed on healthy women (n = 50) and men (n = 25) aged 51–84 y.

Results: Mean SMM by KN was not significantly different from SMM by DXA in either sex. SMM by KN predicted SMM by DXA with an SEE of 2.1 kg (r = 0.95, P < 0.0001 for women and men together). In the men, FFM by DXA agreed well with FFM estimated by TBK, skinfold thicknesses, bioimpedance analysis, and a multicompartment model. In women, FFM by DXA was 4–5 kg less than that by the other methods (P < 0.01). Truncal fat was related to intermethod FFM differences (r = 0.58, P < 0.0001).

Conclusions: These data indicate that 1) either the nuclear or the DXA method can be applied to estimate SMM in healthy older subjects, and 2) the Norland DXA instrument significantly underestimates FFM in older women, in part, because of the influence of truncal adiposity.

Key Words: Skeletal muscle mass • dual-energy X-ray absorptiometry • sarcopenia • total body potassium • total body nitrogen • bioimpedance analysis • aging • anthropometry • humans

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