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Comparative Study
. 2025 Jan;40(1):274-281.
doi: 10.1111/jgh.16806. Epub 2024 Nov 7.

Comparison of the ability between dual-energy X-ray absorptiometry and bioelectrical impedance analysis for diagnosing low skeletal muscle mass and sarcopenia in patients with chronic liver disease

Yuki Tamura  1   2 , Chisato Saeki  1   2 , Tomoya Kanai  1   2 , Sachie Kiryu  1   2 , Masanori Nakano  1   2 , Tsunekazu Oikawa  1 , Yuichi Torisu  1   2 , Masayuki Saruta  1 , Akihito Tsubota  3
Affiliations
Comparative Study

Comparison of the ability between dual-energy X-ray absorptiometry and bioelectrical impedance analysis for diagnosing low skeletal muscle mass and sarcopenia in patients with chronic liver disease

Yuki Tamura et al. J Gastroenterol Hepatol. 2025 Jan.

Abstract

Background and aim: Sarcopenia and osteoporosis adversely impact the clinical outcomes of patients with chronic liver disease (CLD). The Japan Society of Hepatology (JSH) sarcopenia criteria utilize bioelectrical impedance analysis (BIA) for assessing muscle mass rather than dual-energy X-ray absorptiometry (DXA), which can simultaneously diagnose these comorbidities. We investigated the correlations and interchangeability between the appendicular skeletal muscle mass index (ASMI) values determined using BIA and DXA and evaluated the diagnostic ability of DXA for sarcopenia and osteosarcopenia in patients with CLD.

Methods: This cross-sectional study included 173 patients with CLD. Sarcopenia was defined as low ASMIBIA according to the JSH and Asian Working Group for Sarcopenia (AWGS) criteria (ASMIBIA cutoff) or low ASMIDXA according to the AWGS criteria (ASMIDXA cutoff) and low handgrip strength. For women, a provisional cutoff value was set for ASMIDXA using the ASMIBIA cutoff (ASMIDXA-altered cutoff).

Results: We found that ASMIBIA and ASMIDXA were significantly correlated (r = 0.921; P < 0.001). The Bland-Altman plots demonstrated substantial agreement between ASMIBIA and ASMIDXA, with a mean difference of 0.0116 kg/m2. The prevalence rates of sarcopenia and osteosarcopenia diagnosed using the ASMIBIA cutoff were 26.0% and 17.3%, respectively. The kappa coefficients for the prevalence of sarcopenia and osteosarcopenia were 0.759 and 0.775 between ASMIBIA cutoff and ASMIDXA cutoff and 0.780 and 0.806 between ASMIBIA cutoff and ASMIDXA-altered cutoff, respectively.

Conclusions: The utilization of DXA can facilitate the comprehensive assessment and management of musculoskeletal comorbidities in patients with CLD.

Keywords: bioelectrical impedance analysis; chronic liver disease; dual‐energy X‐ray absorptiometry; osteoporosis; sarcopenia.

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References

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