Abstract
Dual-energy X-ray absorptiometry (DEXA) is a non-invasive imaging modality that can estimate whole-body and regional composition in terms of fat, lean, and bone mass. We examined the ability of DEXA body composition measures (whole-body, trunk, and limb fat mass and fat-free mass) to predict mortality in conjunction with basic body measures (anthropometrics), expressed using body mass index (BMI) and a body shape index (ABSI). We used data from the 1999–2006 United States National Health and Nutrition Examination Survey (NHANES), with mortality follow-up to 2015. We found that all DEXA-measured masses were highly correlated with each other and with ABSI and that adjustment for BMI and ABSI reduced these dependencies. Whole-body composition did not substantially improve mortality prediction compared to basic anthropometrics alone, but regional composition did, with high trunk fat-free mass and low limb fat-free mass both associated with elevated mortality risk. These findings illustrate how DEXA body composition could guide health assessment in conjunction with the more widely employed simple anthropometrics.
Highlights
Health 2021, 18, 7927. https://The basic anthropometrics of height, weight, and waist circumference (WC), and the derived quantities body mass index (BMI, weight adjusted for height) and a body shape index (ABSI, WC adjusted for weight and height) are robust predictors of mortality hazard as well as many health conditions and forms of morbidity [1,2]
Whole-body composition did not substantially improve mortality prediction compared to basic anthropometrics alone, but regional composition did, with high trunk fat-free mass and low limb fat-free mass both associated with elevated mortality risk
Adjusting for H, W, WC reduced the variance of body composition measures substantially, with the limb fat mass remaining with the highest coefficient of variation
Summary
Health 2021, 18, 7927. https://The basic anthropometrics of height, weight, and waist circumference (WC), and the derived quantities body mass index (BMI, weight adjusted for height) and a body shape index (ABSI, WC adjusted for weight and height) are robust predictors of mortality hazard as well as many health conditions and forms of morbidity [1,2]. A number of imaging methods are available that provide such information, all are much less widely used than basic anthropometrics, and their benefits for prognosis are less well quantified [7]. Of these imaging modalities, dual-energy X-ray absorptiometry (DEXA) scanning is considered a reference method for the assessment of human body composition, due to its relative non-invasiveness, good discrimination ability, and low cost compared to other techniques [8,9]. Employed only to monitor bone mass and density for fracture risk assessment, DEXA was established in the 1990s to distinguish between fat and lean tissue in the different body regions [10,11]. DEXA measurements, along with other clinical and laboratory examinations, were conducted for the 1999–2006 cohorts of the United
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