Dual X-ray Absorptiometry Data Research Articles

Changes in Body Composition and Athletic Performance in National Collegiate Athletic Association Division I Female Field Hockey Athletes Throughout a Competitive Season.

Summer, LC, Cheng, R, Moran, JT, Lee, M, Belanger, AJ, TaylorIV, WL, and Gardner, EC. Changes in body composition and athletic performance in National Collegiate Athletic Association Division I female field hockey athletes throughout a competitive season. J Strength Cond Res XX(X): 000-000, 2023-The purposes of this study were (a) to analyze the changes in total and regional body composition measurements in a National Collegiate Athletic Association (NCAA) Division I female field hockey team throughout a 17-game competitive season using dual X-ray absorptiometry (DXA); (b) to examine improvements, if any, in athletic performance measures after a season; and (c) to report on the relationship between these body composition changes and changes in athletic performance. Preseason and postseason dual-energy DXA and performance data from the 2019-2020 season were retrospectively identified for 20 field players (forwards, midfielders, and defenders). Body composition data included total and regional fat mass, lean mass, and body fat percentage, whereas athletic performance measures included the vertical jump, 10-yard dash, and pro-agility (5-10-5) shuttle run. All variables were quantitative and analyzed using paired t-tests or its nonparametric equivalent and an alpha level of p < 0.05 was used to determine significance. After a competitive season, athletes had significant decreases in fat mass and increases in lean mass in their arms, legs, trunks, gynoids, and total body measurements. Android fat mass and body fat percentage also decreased. Athletes performed significantly better on the pro-agility shuttle run at the end of the season, but no significant differences were observed in other performance metrics. Moderate correlations were observed between changes in body composition (total fat mass and total lean mass) and changes in athletic performance. Our study provides a novel, longitudinal assessment of body composition and athletic performance for elite female field hockey athletes that will help trainers and coaches better understand how these variables change throughout a season and allow them to better prepare their players for competitive success.

Fracture in Patients with Normal Bone Mineral Density: An Evaluation of the American Orthopaedic Association's Own the Bone Registry.

Fractures often occur in patients with normal dual x-ray absorptiometry (DXA)-measured bone mineral density (BMD). DXA does not consider clinical fracture risk factors or bone quality. We hypothesized that patients with normal BMD who sustain a fracture have other characteristics suggesting abnormal bone and an elevated fracture risk requiring additional bone health evaluation and potential anti-osteoporotic treatment. A total of 7,219 patients who were ≥50 years of age, had sustained a fracture from July 2016 to July 2021, and had DXA data in the American Orthopaedic Association's Own the Bone (AOA OTB) registry were included in this study. The index and prior fracture site data were obtained. BMD status was classified by the World Health Organization T-score criteria. The Fracture Risk Assessment Tool (FRAX) scores with and without BMD were calculated in patients with normal BMD. An elevated risk was defined as a major osteoporotic fracture risk of ≥20% or a hip fracture risk of ≥3%. The mean patient age (and standard deviation) was 70.8 ± 9.71 years, 84% of patients were female, and 92% of patients were Caucasian. Normal BMD was present in 8.6% of patients. The index fracture was a major osteoporotic fracture in 68.6% of patients with normal BMD and 75.6% of patients with osteoporosis. The most common site for index and prior fractures other than major osteoporotic fractures was the foot and ankle; of patients with normal BMD, 13.9% had this as the most common index site and 17.4% had this as the most common prior site. The FRAX risk calculated without BMD was elevated in 72.9% of patients with normal BMD, and the FRAX risk calculated with BMD was elevated in 12.0% of patients. Most patients with a fracture and normal BMD met indications, including a prior fracture or elevated FRAX risk, for anti-osteoporotic therapies. Most patients were Caucasian and therefore potentially had a higher baseline fracture risk. The FRAX risk calculated without BMD was elevated more often than the FRAX risk with BMD, implying that clinical risk factors, which highlight multiple opportunities for non-pharmacologic secondary fracture prevention, should be considered along with DXA. Fractures other than major osteoporotic fractures were more common in patients with normal BMD, suggesting that minor fractures in adults who are ≥50 years of age should be considered sentinel events warranting further evaluation. Surgeons must recognize that other important risk factors apart from BMD may help to guide further bone health evaluation. Prognostic Level III . See Instructions for Authors for a complete description of levels of evidence.

Effect of standing frames used in real life on bone remodeling in non-walking children with cerebral palsy.

To compare the bone health of children with severe cerebral palsy who use a static standing frame in real life to that of children who do not. A total of 24 children with severe cerebral palsy GMFCS IV & V were included in the study and were divided into two groups: 13 were using a passive standing frame and 11 were not. We performed a single center retrospective cross-sectional study comparing the two groups using dual X-ray absorptiometry data and tests on biological samples, including bone remodeling factors. Total body (less head) bone mineral content was significantly higher in children who used a standing frame for an average of 30min/day. This was confirmed in the lumbar spine. Although the total body bone mineral density (less head and proximal femur) densitometric data were not significantly higher, a positive trend favored the use of a standing frame in the children. Bone resorptive factors (CTX) were higher in the non-standing-frame group, whereas there was no difference among osteoformation factors. No difference infracture historywas found. We show that non-ambulant children with cerebral palsy who use a static standing frame in real life have better bone health, with lower bone resorption, than children who do not. Further studies are needed to determine how standing practice could impact bone mineralization over time in real life and to explore more bone remodeling factors.

Dual X-ray absorptiometry has limited utility in detecting bone pathology in children with hypophosphatasia: A pooled post hoc analysis of asfotase alfa clinical trial data.

Asfotase alfa is an enzyme replacement therapy approved for treatment of patients with pediatric-onset hypophosphatasia (HPP), a rare, inherited, systemic disease causing impaired skeletal mineralization, short stature, and reduced physical function in children. The role of dual X-ray absorptiometry (DXA) in the assessment of children with HPP has been insufficiently explored. This post hoc analysis included pooled DXA data from 2 open-label, multicenter studies in 19 children with HPP. The study population was aged ≥5 to <18years and had received asfotase alfa for ≤6.6years at enrollment (male: 79%; median age at enrollment: 10.4 y [range: 5.9-16.7]; treatment duration: 6.3 y [range: 0.1-6.6]. Baseline height Z-scores indicated short stature (median [min, max]: -1.26 [-6.6, 0]); mean [SD]: -2.30 [1.97]), thus requiring height adjustment of DXA Z-scores. At Baseline, few patients had height-adjusted bone mineral density (BMDht) Z-scores of -2 or less for whole body (n=3) or lumbar spine (n=5). In treated patients, mean whole body and lumbar spine BMDhtZ-scores did not change over time, but whole body and lumbar spine height- adjusted bone mineral content (BMCht) Z-scores increased significantly from Baseline to Last Assessment (P≤0.0056). Improvements in Radiographic Global Impression of Change (RGI-C) scale scores correlated significantly with increases in whole body and lumbar spine BMChtZ-scores (P<0.05) but not BMDhtZ-Scores. Improvements in Rickets Severity Score (RSS) correlated significantly with increases in lumbar spine BMDhtZ-scores and whole body BMCht Z-scores (P<0.05). No significant correlations were observed between any DXA and bone histomorphometry measure. These findings suggest that DXA BMD Z-scores, which are commonly used in clinical practice, have limited utility in assessing deficient bone mineralization in patients with HPP. Although BMChtZ-scores increased significantly over time with asfotase alfa therapy, the lack of significant changes in more than one DXA parameter suggests that this tool may not be useful in everyday clinical practice. Furthermore, the use of BMC as an independent metric is not typical or recommended by guidelines. Complementary measures, such as skeletal radiographs supplemented with age-appropriate functional assessments, should be considered.

Systematic review of the effects of bisphosphonates on bone density and fracture incidence in childhood acute lymphoblastic leukaemia.

EMBASE, Medline and the Cochrane Library were thoroughly searched by two researchers. Inclusion criteria was any child under the age of 18years with a diagnosis of ALL, who had received any bisphosphonate treatment and had serial measurements of bone density performed thereafter. All primary research studies of any study design, excluding case reports, were included. Ten full text papers were identified with two exclusively meeting the inclusion criteria. Both studies administered bisphosphonates to children receiving maintenance chemotherapy for varying durations. Bone density was assessed at regular intervals by dual x-ray absorptiometry (DXA). The majority of participants had an improvement in bone density at the end of each study. However, no size adjustment of DXA data was performed. Limited information on fracture occurrence was provided by one study but did not include routine screening for vertebral fractures. This systematic review identified that there is insufficient evidence to support routine use of prophylactic bisphosphonate therapy in childhood ALL for prevention of fracture and improvement of bone mass. Future well-designed clinical trials in those at highest risk of fractures in ALL are now needed.

Total and Regional Body Composition of NCAA Division I Collegiate Female Softball Athletes.

The purpose of this study was to evaluate total, regional, and throwing versus non-throwing arm body composition measures across the 4 major positions of NCAA Division I female softball players using dual X-ray absorptiometry (DXA) (n=128). Total and regional total mass (TM), fat mass (FM), lean mass (LM), bone mineral density (BMD), bone mineral content (BMC), and visceral adipose tissue were measured. Athletes were separated into: pitchers (n=32), catchers (n=13), outfielders (n=39), and infielders (n=44). ANOVA and Tukey's HSD assessed total and regional differences between positions. Although no significant total or regional LM differences were observed across positions, outfielders had significantly (p=0.006-0.047) lower total-body, arm, and trunk TM and FM, leg FM, and leg BMC in comparison to pitchers. The throwing arm had significantly (p<0.0001-0.018) greater LM, BMD, and BMC than the non-throwing arm for all positions. Notably, there were minimal body composition differences among softball positions, with the primary differences being that pitchers had larger total and regional fat values than outfielders. The throwing arm of all positions had greater LM, BMD, and BMC than the non-throwing arm. These values can be used by coaches and trainers as descriptive DXA data for collegiate softball players.

Total and Regional Body Composition of NCAA Division I Collegiate Baseball Athletes.

This study's purpose was to evaluate total, regional, and throwing versus non-throwing arm body composition measurements between various positions of NCAA Division I male baseball players using dual X-ray absorptiometry (DXA). Two hundred and one collegiate baseball athletes were measured using DXA. Visceral adipose tissue (VAT), total and regional fat mass (FM), lean mass (LM), and bone mineral density (BMD) were measured. Athletes were separated into: pitchers (n=92), catchers (n=25), outfielders (n=43), and infielders (n=41). ANOVA and Tukey's honest significant difference assessed total and regional differences between positions. Infielders had significantly (p<0.05) lower total LM than pitchers and outfielders. Additionally, outfielders had significantly lower total FM compared to pitchers and catchers. No significant differences between positions were observed for total BMD and VAT. Pitchers' and infielders' throwing arm demonstrated significantly greater total mass, FM, LM, and BMD compared to the non-throwing arm. Further, outfielders' throwing arm total mass, LM, and BMD were significantly higher vs. the non-throwing arm. Significant differences were observed in total and regional body composition measurements across position, in addition to differences in throwing arm vs. non-throwing arm composition. These measurement values are important to coaches and trainers as normative positional DXA data for collegiate baseball players.

Positional Body Composition of Division I Volleyball Players, Consortium of College Athlete Research (C-CAR) Study

PURPOSE: To identify normative values for total and regional body composition by position for female NCAA Division I collegiate volleyball players using dual X-ray absorptiometry (DXA). METHODS: Eighty-nine female volleyball players (ages 17-23) from multiple universities received a DXA scan. Athletes were categorized by position: Middle Blocker (MB=30), Outside Hitter (OH=32), Setter (ST=9), and Libero (LB=18). Total fat mass (FM) and lean masses (LM) were measured by DXA, as well as abdominal visceral adipose tissue (VAT) and total and regional measures of bone mineral density (BMD). An ANOVA assessed the effect of position on body composition and BMD measurements. Tukey’s HSD post-hoc analysis test identified significance between positions. RESULTS: As expected, height was statistically significant (p<0.01) between all positions: MB (185.8 ± 4.6 cm) > OH (181.7 ± 4.1 cm) > ST (174.7 ± 3.7 cm) > LB (167.8 ± 8.0 cm). Weight was significantly greater in MB and OH (80.1 ± 9.3 kg, 76.6 ± 7.8 kg) compared to LB (64.5 ± 7.6 kg, p<0.001), and MB compared to ST (69.7 ± 5.7 kg, p=0.006). Body percent fat was not statistically significant by position (mean = 25.3%). Total LM was greater in MB and OH (55.7 ± 4.6 kg, 54.1 ± 4.7 kg) compared to LB and ST (45.9 ± 4.9 kg, 48.3 ± 3.2 kg, p<0.01). Total FM was significantly greater in MB than LB (21.0 ± 6.9 kg, 16.1 ± 4.0 kg, p=0.016). VAT mass was not significantly (p>0.05) different between positions. After adjusting for weight, total BMD was significantly greater in MB (1.39 ± 0.1 g/cm3, p<0.001) and OH (1.41 ± 0.09 g/cm3, p=0.002) compared to LB (1.30 ± 0.08 g/cm3), but not ST (1.31 ± 0.07 g/cm3, p>0.05). Leg BMD was higher in MB and OH (1.54 ± 0.11 g/cm3, 1.53 ± 0.11 g/cm3) compared to LB and ST (1.39 ± 0.09 g/cm3, 1.4 ± 0.06 g/cm3, p=0.001-0.008). Spine BMD was higher in MB and OH (1.32 ± 0.15 g/cm3, 1.33 ± 0.12 g/cm3) compared to LB (1.22 ± 0.09 g/cm3, p=0.03). CONCLUSIONS: Total body composition measures vary significantly by position; however, the similarities in percent body fat imply differences may be influenced primarily by height. Future studies should examine the distribution of mass. BMD differences may be influenced by repeated impacts of jumping during the attacking and blocking actions of front row players. These data provide some normative DXA data for collegiate volleyball players.

A retrospective analysis of longitudinal changes in bone mineral content in cystic fibrosis.

We aimed to describe the longitudinal changes in bone mineral content and influencing factors, in children with cystic fibrosis (CF). One hundred children (50 females) had dual X-ray absorptiometry (DXA) performed. Of these, 48 and 24 children had two to three scans, respectively over 10 years of follow-up. DXA data were expressed as lumbar spine bone mineral content standard deviation score (LSBMCSDS) adjusted for age, gender, ethnicity and bone area. Markers of disease, anthropometry and bone biochemistry were collected retrospectively. Baseline LSBMCSDS was >0.5 SDS in 13% children, between -0.5; 0.5 SDS, in 50% and ≤-0.5 in the remainder. Seventy-eight percent of the children who had baseline LSBMCSDS >-0.5, and 35% of the children with poor baseline (LSBMCSDS<-0.5), showed decreasing values in subsequent assessments. However, mean LS BMC SDS did not show a significant decline in subsequent assessments (-0.51; -0.64; -0.56; p=0.178). Lower forced expiratory volume in 1 s percent (FEV1%) low body mass index standard deviation scores (BMI SDS) and vitamin D were associated with reduction in BMC. Bone mineral content as assessed by DXA is sub-optimal and decreases with time in most children with CF and this study has highlighted parameters that can be addressed to improve bone health.

Collagen fragment biomarkers as serological biomarkers of lean body mass - a biomarker pilot study from the DAHANCA25B cohort and matched controls.

BackgroundLoss of muscle mass and function is an important complication to ageing and a range of pathologies, including, but not restricted to, cancer, organ failures, and sepsis. A number of interventions have been proposed ranging from exercise to anabolic pharmacological therapy, with varying success. Easily applicable serological biomarkers of lean and/or muscle mass and change therein would benefit monitoring of muscle mass during muscle atrophy as well as during recovery. We set out to validate if novel peptide biomarkers derived from Collagen III and VI were markers of lean body mass (LBM) or change therein in head and neck cancer patients in the Danish Head and Neck Cancer Group(DAHANCA) 25B cohort subjected to resistance training as well as in an age-matched and gender-matched control group.MethodsBlood samples and dual X-ray absorptiometry data were measured at baseline, after 12 and 24 weeks in 41 HNSCC subjects of the DAHANCA 25B cohort of subjects recovering from neck and head cancer (stages provided in Table 1), and at baseline only in 21 healthy age-matched and gender-matched controls. Serum from blood was analyzed for the ProC3, IC6, and C6M peptide biomarkers and LBM were derived from the dual X-ray absorptiometry scans.ResultsWe were not able to show any correlation between biomarkers and LBM or C6M and anabolic response to exercise in recovering head and neck cancer patients. However, we did find that the biomarkers IC6, IC6/C6M, and ProC3 are biomarkers of LBM in the control group subjects (R2/P of 0.249/0.035, 0.416/0.007 and 0.178 and P = 0.057, respectively),ConclusionIn conclusion, the IC6, ProC3, and IC6/C6M biomarkers are indeed biomarkers of LBM in healthy individuals of both genders, but not in HNSCC patients.

Accuracy of plantar electrodes compared with hand and foot electrodes in fat-free-mass measurement.

This paper investigates the measurement of fat-free mass (FFM) by bioimpedance using foot-to-foot impedancemeters (FFI) with plantar electrodes measuring the foot-to-foot resistance R34 and hand-to-foot medical impedancemeters. FFM measurements were compared with corresponding data using Dual X-ray absorptiometry (DXA). Equations giving FFM were established using linear multiple regression on DXA data in a first group of 170 subjects. For validation, these equations were used on a second group of 86 subjects, and FFM were compared with DXA data; no significant difference was observed. The same protocol was repeated, but using electrodes on the right hand and foot in standing position to measure the hand to-foot resistance R13. Mean differences with DXA were higher for R13 than for R34. Effect of electrode size and feet position on resistance was also investigated. R34 decreased when electrode area increased or if feet were moved forward. It decreased if feet were moved backward. A proper configuration of contact electrodes can improve measurement accuracy and reproducibility of FFI.