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The accuracy of body-composition measurements in vivo by dual-energy x-ray absorptiometry (DEXA) was assessed in seven pigs (weight: 35-95 kg) by measurement by DEXA in vivo and chemical analysis after postmortem homogenization. The regression lines between these measurements were not significantly different from the line of identity (P > 0.05), the r values were > 0.97, and the corresponding SEEs were 2.9%, 1.9 kg, and 2.7 kg for percent fat, fat tissue mass, and lean body mass, respectively. Changes in fat and lean tissue mass (simulated by placing 8.8 kg porcine lard on the trunk of six women) were accurately measured by DEXA. The measured total-body bone mineral (TBBM) was significantly affected by the lard (P < 0.05). In conclusion, DEXA is an accurate method for measurement of soft-tissue body composition. TBBM measurements in longitudinal studies may, however, be difficult to interpret if considerable change in soft-tissue composition has occurred.

The present study validates the use of dual energy X-ray absorptiometry (DEXA) for measurement of body composition. The precision error was expressed as the SD (CV%) for fat mass, FAT%, lean tissue mass, and total body bone mineral: 1.1 kg (6.4%), 1.6% (5.7%), 1.4 kg (3.1%), and 0.03 kg (1.2%), respectively. The accuracy study in vitro used (1) mixtures of water and alcohol, (2) mixtures of ox muscle and lard, and (3) dried bones. In the clinically relevant range of values there were only small influences on DEXA measurements of variations in amount and composition of the soft tissue equivalents. The accuracy study in vivo compared the components of body composition measured recently by DEXA and earlier by dual photon absorptiometry, counting of naturally occurring total body 40K, and body density by underwater weighing in 25 healthy adult subjects. We found agreement between fat percentage (and lean body mass) by DEXA and the three established measurements modalities; mean differences were (-5.3 to -0.4%) and (-0.7 to 2.5 kg) for fat percentage and lean body mass, respectively. We conclude that DEXA provides a new method of measuring body composition with precision and accuracy errors, which are compatible with the application of DEXA in group research studies and probably also in clinical measurements of the single subject.

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We performed a prospective study to evaluate the normal changes in bone mineral density (BMD) in the forearm, hip, spine and total body, and to study the agreement between changes in BMD estimated from cross-sectional data and the actual longitudinal changes. Six hundred and twenty subjects (398 women, 222 men; age 20-89 years) without diseases or medication known to affect bone metabolism undertook baseline evaluations, and 525 (336 women, 189 men) completed the study. BMD was measured twice 2 years apart by dual-energy X-ray absorptiometry. From cross-sectional evaluations the only premenopausal bone loss (<0.003 g/cm2/year) was found in the hip. In women after menopause and in men an age-related bone loss (0.002-0.006 g/cm2/year) was found at all sites. The data from the longitudinal evaluation showed a small bone loss in women before menopause at the hip and lumbar spine (<0.4%/year (<0.004 g/cm2/year)); this bone loss nearly tripled in the early postmenopausal years (<10 years since menopause), and thereafter decreased to the premenopausal rate for the hip, and to zero for the lumbar spine. The most pronounced bone loss after menopause occurred in the forearm (1.2%/year (0.006 g/ cm2/year)), and it remained constant throughout life. In men there was a small longitudinal bone loss in the hip throughout life, and a small bone loss in the distal forearm after the age of 50 years. In all groups, except for the early postmenopausal women, we found a small increase in total body BMD with age. When comparing the changes in BMD estimated from cross-sectional data with the longitudinal changes, only the hip and forearm generally displayed agreement, whereas the changes in the total body and spine generally were incongruous. In conclusion, the hip and forearm appear to be the sites with the best agreement between the cross-sectional estimated and the longitudinal age-related changes in BMD.

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