Comparison of Whole Body Bone Mineral Density Measurements Between Dual Energy X-ray Absorptiometry and Novel Bioelectrical Impedance Analysis

Overview

Journal Sci Rep

Specialty Science

Date 2024 Nov 24

PMID 39582046

Authors

Chih-Lin Chuang

Chung-Liang Lai

Ai-Chun Huang

Po-Hua Su

Lee-Ping Chu

Kuen-Chang Hsieh

Hsueh-Kuan Lu

Affiliations

Soon will be listed here.

Abstract

Bone mineral density (BMD) is a crucial indicator of osteoporosis. Bioelectrical impedance analysis (BIA) introduces a new method for assessing body composition, specifically BMD measurement. Compared with existing ultrasound and dual-energy X-ray absorptiometry for BMD screening and diagnosis, BIA has the advantages of safety, convenience and speed. However, the accuracy of BIA for BMD measurement needs to be explored. This study aimed to evaluate the accuracy of the novel BIA technique in conducting whole-body BMD assessments in the general population of Taiwan. Overall, 318 healthy adults in Taiwan (37.67 ± 19.44 years of age; 145 male and 173 female patients) were included. Whole-body BMD was measured via foot-to-foot BIA-StarBIA-201 (StarBIA Meditek Co. LTD, Taichung, Taiwan) and the dual-energy X-ray absorptiometry (DXA) Lunar Prodigy technology (GE Medical Systems, Madison, WI, USA). Linear regression analysis, Pearson's correlation coefficient, the Bland-Altman plot, and paired t tests were used. The whole-body BMDs measured by BIA and DXA were 1.139 ± 0.124 g/cm and 1.202 ± 0.168 g/cm, respectively. The regression equation was y = 1.057x + 0.063. The Pearson correlation coefficient, mean difference, and limits of agreement were r = 0.737, - 0.053 g/cm, and - 0.290-0.165 g/cm, respectively. The regression equation was y = 1.057x + 0.063. The Pearson correlation coefficient, mean difference, and limits of agreement were r = 0.737 (p < 0.001), - 0.053 g/cm, and - 0.290-0.165 g/cm, respectively. Standing BIA was correlated with the DXA gold standard for estimating whole-body BMD in adults; however, its interchangeability remains limited. The potential bias in the measurement results of this study represents a current challenge with BIA compared with that of DXA, and there is still room for improvement. The convenient BIA method for measuring whole-body BMD may be useful in the application of primary screening and future development of BMD assessment methods. BIA is widely used to measure body composition, but its application to the measurement of BMD represents a novel technological breakthrough.

References

Bland J, Altman D . Statistical methods for assessing agreement between two methods of clinical measurement. Lancet. 1986; 1(8476):307-10. View

Tu K, Lie J, Wan C, Cameron M, Austel A, Nguyen J . Osteoporosis: A Review of Treatment Options. P T. 2018; 43(2):92-104. PMC: 5768298. View

Njeh C, Boivin C, Langton C . The role of ultrasound in the assessment of osteoporosis: a review. Osteoporos Int. 1997; 7(1):7-22. DOI: 10.1007/BF01623454. View

Ellis K . Human body composition: in vivo methods. Physiol Rev. 2000; 80(2):649-80. DOI: 10.1152/physrev.2000.80.2.649. View

Ngai H, Cheung C, Yao T, Kung A . Bioimpedance: can its addition to simple clinical criteria enhance the diagnosis of osteoporosis?. J Bone Miner Metab. 2009; 27(3):372-8. DOI: 10.1007/s00774-009-0043-0. View

Schott A, Cormier C, Hans D, Favier F, HAUSHERR E, Dargent-Molina P . How hip and whole-body bone mineral density predict hip fracture in elderly women: the EPIDOS Prospective Study. Osteoporos Int. 1998; 8(3):247-54. DOI: 10.1007/s001980050061. View

Nuti R, Martini G . Measurements of bone mineral density by DXA total body absorptiometry in different skeletal sites in postmenopausal osteoporosis. Bone. 1992; 13(2):173-8. DOI: 10.1016/8756-3282(92)90008-k. View

Shen Y, Huang X, Wu J, Lin X, Zhou X, Zhu Z . The Global Burden of Osteoporosis, Low Bone Mass, and Its Related Fracture in 204 Countries and Territories, 1990-2019. Front Endocrinol (Lausanne). 2022; 13:882241. PMC: 9165055. DOI: 10.3389/fendo.2022.882241. View

Beck T . Measuring the structural strength of bones with dual-energy X-ray absorptiometry: principles, technical limitations, and future possibilities. Osteoporos Int. 2003; 14 Suppl 5:S81-8. DOI: 10.1007/s00198-003-1478-0. View

10.

Antunes M, Cyrino E, Silva D, Tomeleri C, Nabuco H, Cavalcante E . Total and regional bone mineral density are associated with cellular health in older men and women. Arch Gerontol Geriatr. 2020; 90:104156. DOI: 10.1016/j.archger.2020.104156. View

11.

Warming L, Hassager C, Christiansen C . Changes in bone mineral density with age in men and women: a longitudinal study. Osteoporos Int. 2002; 13(2):105-12. DOI: 10.1007/s001980200001. View

12.

Yang N, Jen I, Chuang S, Chen S, Chou P . Screening for low bone mass with quantitative ultrasonography in a community without dual-energy X-ray absorptiometry: population-based survey. BMC Musculoskelet Disord. 2006; 7:24. PMC: 1434741. DOI: 10.1186/1471-2474-7-24. View

13.

Tanaka S, Ando K, Kobayashi K, Hida T, Ito K, Tsushima M . A low phase angle measured with bioelectrical impedance analysis is associated with osteoporosis and is a risk factor for osteoporosis in community-dwelling people: the Yakumo study. Arch Osteoporos. 2018; 13(1):39. DOI: 10.1007/s11657-018-0450-8. View

14.

Xu Y, Guo B, Gong J, Xu H, Bai Z . The correlation between calcaneus stiffness index calculated by QUS and total body BMD assessed by DXA in Chinese children and adolescents. J Bone Miner Metab. 2013; 32(2):159-66. DOI: 10.1007/s00774-013-0474-5. View

15.

Lu H, Lai C, Lee L, Chu L, Hsieh K . Assessment of total and regional bone mineral density using bioelectrical impedance vector analysis in elderly population. Sci Rep. 2021; 11(1):21161. PMC: 8551151. DOI: 10.1038/s41598-021-00575-1. View

16.

Evans A, Paggiosi M, Eastell R, Walsh J . Bone density, microstructure and strength in obese and normal weight men and women in younger and older adulthood. J Bone Miner Res. 2014; 30(5):920-8. DOI: 10.1002/jbmr.2407. View

17.

Blake G, Fogelman I . The role of DXA bone density scans in the diagnosis and treatment of osteoporosis. Postgrad Med J. 2007; 83(982):509-17. PMC: 2600106. DOI: 10.1136/pgmj.2007.057505. View

18.

Briot K, Roux C . What is the role of DXA, QUS and bone markers in fracture prediction, treatment allocation and monitoring?. Best Pract Res Clin Rheumatol. 2005; 19(6):951-64. DOI: 10.1016/j.berh.2005.06.004. View

19.

Ono Y, Kasukawa Y, Sasaki K, Miyakoshi N . Association of the Bioimpedance Phase Angle and Quality of Life in Postmenopausal Osteoporosis. Med Princ Pract. 2022; 32(1):71-76. PMC: 10267484. DOI: 10.1159/000528004. View

20.

Ozturk N, Ozturk-Isik E, Ulgen Y . Screening Post-menopausal Women for Bone Mineral Level by Bioelectrical Impedance Spectroscopy of Dominant Arm. J Electr Bioimpedance. 2021; 9(1):39-47. PMC: 7852016. DOI: 10.2478/joeb-2018-0007. View