使用笔束和扇形束双能 X 射线吸收仪评估儿科人群体成分评估的一致性。
The evaluation of consistency between body composition assessments in pediatric population using pencil beam and fan beam dual-energy x-ray absorptiometers.
机构信息
The Department of Biochemistry and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland.
The Department of Biochemistry and Experimental Medicine, The Children's Memorial Health Institute, Warsaw, Poland.
出版信息
J Clin Densitom. 2010 Jan-Mar;13(1):84-95. doi: 10.1016/j.jocd.2009.11.001.
The replacement of the old dual-energy X-ray absorptiometry system with a novel one should be preceded by a cross-calibration procedure. Therefore, the study was aimed at investigating the consistency of bone and body composition measures performed in pediatric population using pencil beam (DPX-L; GE Healthcare, GE Healthcare, Madison, WI) and fan beam (Prodigy; GE Healthcare, GE Healthcare, Madison, WI) densitometers. The study group consisted of 212 healthy children aged 4-18yr. Total body (TB) and lumbar spine (S) (L2-L4) measurements were performed using DPX-L and Prodigy during the same visit. Bland-Altman analysis, linear regressions, and paired t-test were performed to evaluate the consistency of measurements and to establish a cross-calibration equation. The average Prodigy values for TB and lumbar spine bone mineral density (BMD) and content (BMC) were 2.7%, 2.4% and 1.6%, 1.6% higher than those of DPX-L, respectively (p<0.0001). Prodigy-assessed bone area (BA) was lower by 1.4% for TBBA (p<0.0001) and 1.1% for SBA (p<0.001). Lean body mass (LBM) from Prodigy was higher by 6.9% (p<0.0001), whereas fat mass (FM) was lower by 8.4% compared with those from DPX-L (p<0.0001). Bland-Altman analyses revealed the effect of magnitude that was nonlinear (2nd degree polynomial) for TBBMD (r=0.32, p=0.001), TBBMC (r=0.51, p<0.0001), TBBA (r=0.34, p<0.0001), and LBM (r=0.56, p<0.0001), but not for FM (r=0.14, not significant [n.s.]). In contrast, in lumbar spine, the magnitude dependence was linear and significant for SBMC (r=0.46, p<0.0001) and SBA (r=0.34, p<0.0001) but not for SBMD (r=0.12, n.s.). Both skeletal and body composition variables assessed by DPX-L and Prodigy devices were highly correlated, showing R(2) values ranging from 0.976 for FM to 0.994 for SBMC. The results of this study document a necessity for implementation of calculated cross-calibration equations to transform DPX-L-based local pediatric references into a novel Prodigy system.
用新型双能 X 射线吸收仪（Dual-Energy X-ray Absorptiometry，DXA）替换旧设备时，应先进行交叉校准程序。因此，本研究旨在调查使用笔形束（DPX-L；GE 医疗保健，GE 医疗保健，麦迪逊，威斯康星州）和扇形束（Prodigy；GE 医疗保健，GE 医疗保健，麦迪逊，威斯康星州）密度仪对儿科人群进行骨和身体成分测量的一致性。研究组包括 212 名 4-18 岁的健康儿童。在同一访问期间，使用 DPX-L 和 Prodigy 对全身（TB）和腰椎（S）（L2-L4）进行测量。使用 Bland-Altman 分析、线性回归和配对 t 检验来评估测量的一致性并建立交叉校准方程。Prodigy 评估的全身骨矿物质密度（BMD）和含量（BMC）的平均 Prodigy 值分别比 DPX-L 高 2.7%、2.4%和 1.6%、1.6%（p<0.0001）。对于全身骨面积（BA），Prodigy 评估值低 1.4%（p<0.0001），对于腰椎 BA 低 1.1%（p<0.001）。Prodigy 评估的瘦体重（LBM）高 6.9%（p<0.0001），而脂肪量（FM）低 8.4%（p<0.0001）。Bland-Altman 分析显示，TB 骨矿物质密度（BMD）（r=0.32，p=0.001）、TB 骨矿物质含量（BMC）（r=0.51，p<0.0001）、TBBA（r=0.34，p<0.0001）和 LBM（r=0.56，p<0.0001）的效应存在非线性（二次多项式），但 FM（r=0.14，不显著[n.s.]）不存在。相比之下，在腰椎中，SBMC（r=0.46，p<0.0001）和 SBA（r=0.34，p<0.0001）的大小依赖性呈线性，而 SBMD（r=0.12，n.s.）则没有。DPX-L 和 Prodigy 设备评估的骨骼和身体成分变量高度相关，显示出从脂肪量（FM）的 0.976 到腰椎 BMC 的 0.994 的 R2 值。本研究的结果证明需要实施计算交叉校准方程，以便将基于 DPX-L 的本地儿科参考值转换为新型 Prodigy 系统。
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