National Health and Nutrition Examination Survey Whole-Body Dual-Energy X-Ray Absorptiometry Reference Data for GE Lunar Systems

Fan, Bo; Shepherd, John; Levine, Michael A.; Steinberg, Dee; Wacker, Wynn; Barden, Howard S.; Ergun, David L.; Wu, Xing

doi:10.1016/j.jocd.2013.08.019

Cited by 88 publications

(84 citation statements)

References 10 publications

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“…Because of known differences between DXA platforms and the reference populations used by the two manufacturers to calculate Z- and T-Scores, direct comparisons within our cohort may be limited. [22] Nevertheless, DXA is currently the most widely used method of assessing BMD and fracture risk in the clinical setting and our results confirm that low BMD is a common finding on clinical DXA reports in patients with HCU. Additionally, DXA cannot differentiate between trabecular and cortical bone compartments, nor assess bone material quality, which may be important considerations for future studies aimed at elucidating the mechanisms of skeletal disease in HCU.…”

Section: Discussionsupporting

confidence: 80%

Low bone mineral density is a common finding in patients with homocystinuria

Weber

Coughlin

Brodsky

et al. 2016

Molecular Genetics and Metabolism

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Homocystinuria (HCU) due to deficiency of cystathionine beta-synthetase is associated with increased plasma levels of homocysteine and methionine and is characterized by developmental delay, intellectual impairment, ocular defects, thromboembolism and skeletal abnormities. HCU has been associated with increased risk for osteoporosis in some studies, but the natural history of HCU-related bone disease is poorly understood. The objective of this study was to characterize bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DXA) in a multi-center, retrospective cohort of children and adults with HCU. We identified 19 subjects (9 males) aged 3.5 to 49.2 years who had DXA scans performed as a part of routine clinical care from 2002–2010. The mean lumbar spine (LS) BMD Z-score at the time of first DXA scan in this cohort was −1.2 (± SD of 1.3); 38% of participants had low BMD for age (as defined by a Z-score ≤ −2). Homocysteine and methionine were positively associated with LS BMD Z-score in multiple linear regression models. Our findings suggest that low BMD is common in both children and adults with HCU and that routine assessment of bone health in this patient population is warranted. Future studies are needed to clarify the relationship between HCU and BMD.

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Section: Discussionsupporting

confidence: 80%

Low bone mineral density is a common finding in patients with homocystinuria

Weber

Coughlin

Brodsky

et al. 2016

Molecular Genetics and Metabolism

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“…Data generated on Hologic 4500 scanners (software version Apex 3.0) were cross calibrated to GE Lunar iDXA values (Software version 14.0) (29, 34). However, despite being the largest published database (approximately 20 000 measurements), only data for total body measurements were presented.…”

Section: Discussionmentioning

confidence: 99%

Amalgamated Reference Data for Size-Adjusted Bone Densitometry Measurements in 3598 Children and Young Adults—the ALPHABET Study

Crabtree

Shaw

Bishop

et al. 2016

Journal of Bone and Mineral Research

103

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The increasing use of dual-energy X-ray absorptiometry (DXA) in children has led to the need for robust reference data for interpretation of scans in daily clinical practice. Such data need to be representative of the population being studied and be "future-proofed" to software and hardware upgrades. The aim was to combine all available pediatric DXA reference data from seven UK centers to create reference curves adjusted for age, sex, ethnicity, and body size to enable clinical application, using in vivo cross-calibration and making data back and forward compatible. Seven UK sites collected data on GE Lunar or Hologic Scanners between 1996 and 2012. Males and females aged 4 to 20 years were recruited (n = 3598). The split by ethnic group was white 2887; South Asian 385; black Afro-Caribbean 286; and mixed heritage 40. Scans of the total body and lumbar spine (L to L ) were obtained. The European Spine Phantom was used to cross-calibrate the 7 centers and 11 scanners. Reference curves were produced for L to L bone mineral apparent density (BMAD) and total body less head (TBLH) and L to L areal bone mineral density (aBMD) for GE Lunar Prodigy and iDXA (sex- and ethnic-specific) and for Hologic (sex-specific). Regression equations for TBLH BMC were produced using stepwise linear regression. Scans of 100 children were randomly selected to test backward and forward compatibility of software versions, up to version 15.0 for GE Lunar and Apex 4.1 for Hologic. For the first time, sex- and ethnic-specific reference curves for lumbar spine BMAD, aBMD, and TBLH aBMD are provided for both GE Lunar and Hologic scanners. These curves will facilitate interpretation of DXA data in children using methods recommended in ISCD guidelines. The databases have been created to allow future updates and analysis when more definitive evidence for the best method of fracture prediction in children is agreed. © 2016 American Society for Bone and Mineral Research.

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“…Further, it should be noted that the values reports are only valid to directly compare in new measurements that use the same procedure and same machines as the NHANES dataset. Comparisons of these values to those derived on machines from different manufacturers could only be done after a cross-calibration process, as previously described for other NHANES DXA data [42,43]. Further studies will need to be performed in order to elucidate the usefulness of these regional values and how to best use them in conjunction with full body composition measures for risk assessment.…”

Section: Discussionmentioning

confidence: 99%

Dual energy X-ray absorptiometry body composition reference values of limbs and trunk from NHANES 1999–2004 with additional visualization methods

Hinton

Fan

et al. 2017

PLoS ONE

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Body Mass Index has traditionally been used as a measure of health, but Fat Mass Index (FMI) and Lean Mass Index (LMI) have been shown to be more predictive of mortality and health risk. Total body FMI and LMI reference curves have particularly been useful in quantifying sarcopenia and sarcopenic obesity. Research has shown regional composition has significant associations to health outcomes. We derived FMI and LMI reference curves of the regions of the body (leg, arm, and trunk) for 15,908 individuals in the 1999–2004 National Health and Nutrition Examination Survey data for each sex and ethnicity using the Lambda-Mu-Sigma (LMS) method and developed software to visualize this regional composition. These reference curves displayed differentiation between males and females during puberty and sharper limb LMI declines during late adulthood for males. For adults ages 30–50, females had 39%, 83%, and 47% larger arm, leg, and trunk FMI values than males, respectively. Males had 49%, 20%, and 15% higher regional LMI values than females for the arms, legs, and trunk respectively. The leg FMI and LMI of black females were 14% and 15% higher respectively than those of Hispanic and white females. White and Hispanic males had 37% higher trunk FMI values than black males. Hispanic females had 20% higher trunk FMI than white and black females. These data underscore the importance of accounting for sex and ethnicity in studies of regional composition. This study is the first to produce regional LMI and FMI reference tables and curves from the NHANES dataset. These reference curves provide a framework useful in studies and research involving sarcopenia, obesity, sarcopenic obesity, and other studies of compositional phenotypes. Further, the software tool we provide for visualizing regional composition will prove useful in monitoring progress in physical therapy, diets, or other attempts to attain healthier compositions.

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National Health and Nutrition Examination Survey Whole-Body Dual-Energy X-Ray Absorptiometry Reference Data for GE Lunar Systems

Cited by 88 publications

References 10 publications

Low bone mineral density is a common finding in patients with homocystinuria

Low bone mineral density is a common finding in patients with homocystinuria

Amalgamated Reference Data for Size-Adjusted Bone Densitometry Measurements in 3598 Children and Young Adults—the ALPHABET Study

Dual energy X-ray absorptiometry body composition reference values of limbs and trunk from NHANES 1999–2004 with additional visualization methods

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