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Comparison of the effectiveness of 2 dual-energy X-ray absorptiometers with that of total body water and computed tomography in assessing changes in body composition during weight change^1,2,3

¹ From the University of Tennessee, Memphis (FAT and JYW); the University of Arizona, Tucson (TGL); the University of California, San Francisco (MD, TL, and MN); the University of Wisconsin, Madison (DAS); SYNARC, Inc, San Francisco (TF); the University of Pittsburgh (JAC); and the National Institute on Aging, National Institutes of Health, Bethesda, MD (TBH).

Background: Little information is available on the assessment of changes in body composition as a function of weight change with the use of the fan beam of dual-energy X-ray absorptiometry (DXA).

Objective: The objective was to determine the accuracy of the fan beam of the QDR 4500A densitometer and the pencil beam of the QDR 2000 densitometer in estimating changes in whole-body lean soft tissue mass (LSTM_DXA) and fat mass (FM) with weight change.

Design: Thirty-seven subjects who lost 5.7 ± 4.5 kg were measured before and after weight change. Using total body water and computed tomography (CT) of the midthigh, we compared changes in FFM_TBW and LSTM_CT with changes in LSTM_DXA.

Results: Overall, compared with TBW, the fan beam gave a larger estimate of change ( ± SD) in LSTM (fan beam - TBW: -0.7 ± 1.6 kg) than did the pencil beam (pencil beam - TBW: -0.1 ± 1.6 kg). When the change in LSTM obtained with the fan beam and pencil beam was regressed against the change in FFM_TBW, the slope of the line for the fan beam was 0.97 (r² = 0.61) and that for the pencil beam was 0.86 (r² = 0.61). Regression analysis showed that the results between the 2 units were not interchangeable. For the midthigh region, the change in LSTM_CT was moderately correlated with the change in LSTM_DXA with the fan beam and pencil beam.

Conclusions: The measurement of change in LSTM with the fan and pencil beams provides the same relation to changes in FFM assessed by TBW, but the 2 systems are not interchangeable.

Key Words: Body composition • dual-energy X-ray absorptiometry • DXA • computed tomography • weight loss • lean body mass • fat mass • total body water

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