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. 2019 Mar 14;5(3):20170078.
doi: 10.1259/bjrcr.20170078. eCollection 2019 Sep.

Body composition, dual-energy X-ray absorptiometry and obesity: the paradigm of fat (re)distribution

Federico Ponti  1 , Andrea Plazzi  2 , Giuseppe Guglielmi, Giulio Marchesini  2 , Alberto Bazzocchi  1
Affiliations

Body composition, dual-energy X-ray absorptiometry and obesity: the paradigm of fat (re)distribution

Federico Ponti et al. BJR Case Rep. .

Abstract

Objective: The amount of lean and fat tissues in different body compartments is likely to drive the cardiovascular risk. The longitudinal effects of changes of lean and fat mass, particularly following weight loss programs, cannot be reliably identified by the sole measurement of anthropometry. We discuss this problem on the basis of data collected in obese females with the use of dual-energy X-ray absorptiometry (DXA), anthropometry and laboratory.

Methods: We present longitudinal data in six obese females (three pairs-weight stable, weight loss, weight increase) assigned to a medical treatment. All patients underwent whole-body scan (Lunar iDXA, GE Healthcare, WI) and laboratory analysis (blood fasting glucose, total low-density lipoprotein and high-density lipoprotein cholesterol, triglycerides) before treatment and after 12 months. Fat mass and non-bone lean mass were assessed at whole-body and regional levels. Android visceral adipose tissue was estimated by a recently validated software.

Results: The most common anthropometric measures (body mass index, waist circumference) were totally ineffective in documenting the changes in body composition in 12 month follow-up, whereas DXA could detect regional changes, which were paralleled in part by changes in biochemical indices.

Conclusion: Serial DXA measurements could provide a comprehensive assessment of body compartments, independent of changes in classic anthropometry (body mass index and waist circumference), identifying a significant redistribution of lean and fat mass and providing clues to explain changes in cardiovascular risk profile.

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Figures

Figure 1.
Figure 1.
DXA body composition analysis. Colored soft tissues map of whole-body scan by DXA (red, high fat percentage—conventionally >60%; yellow, medium fat percentage—between 25 and 60%; green, low fat percentage—<25%) of the subject A3, at baseline (left) and after 12 months (right), in order to outline regional changes of body composition (trunk,T; upper limbs, U; lower limbs, L; android, A [the portion of the abdomen included between the line joining the two superior iliac crests and extending cranially up to the 20% of the distance between this line and the chin]; gynoid, G [the portion of legs stretching caudally from the femoral great trochanter to a distance double of the android region]). An enlargement of the android region is also presented (center) with the representation of the abdominal muscles and subcutaneous and visceral fat compartments (anatomic picture by Andrea Plazzi, Imola, Italy). DXA, dual-energy X-ray absorptiometry; SAT, subcutaneous adiposetissue; VAT, visceral adipose tissue.
See this image and copyright information in PMC

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