Watson Laura P E, Venables Michelle C, Murgatroyd Peter R
NIHR/Wellcome Trust Clinical Research Facility, Addenbrooke's Hospital, Cambridge, UK.
MRC-Elsie Widdowson Laboratory, Cambridge, UK.
J Clin Densitom. 2017 Oct-Dec;20(4):498-506. doi: 10.1016/j.jocd.2017.06.029. Epub 2017 Jul 27.
We describe a study to assess the precision of the GE Lunar iDXA and the agreement between the iDXA and GE Lunar Prodigy densitometers for the measurement of regional- and total-body bone and body composition in normal to obese healthy adults. We compare the whole-body fat mass by dual-energy X-ray absorptiometry (DXA) to measurements by a 4-component (4-C) model. Sixty-nine participants, aged 37 ± 12 yr, with a body mass index of 26.2 ± 5.1 kg/cm, were measured once on the Prodigy and twice on the iDXA. The 4-C model estimated fat mass from body mass, total body water by deuterium dilution, body volume by air displacement plethysmography, and bone mass by DXA. Agreements between measurements made on the 2 instruments and by the 4-C model were analyzed by Bland-Altman and linear regression analyses. Where appropriate, translational cross-calibration equations were derived. Differences between DXA software versions were investigated. iDXA precision was less than 2% of the measured value for all regional- and whole-body bone and body composition measurements with the exception of arm fat mass (2.28%). We found significant differences between iDXA and Prodigy (p < 0.05) whole-body and regional bone, fat mass (FM), and lean mass, with the exception of hip bone mass, area and density, and spine area. Compared to iDXA, Prodigy overestimated FM and underestimated lean mass. However, compared to 4-C, iDXA showed a smaller bias and narrower limits of agreement than Prodigy. No significant differences between software versions in FM estimations existed. Our results demonstrate excellent iDXA precision. However, significant differences exist between the 2 GE Lunar instruments, Prodigy and iDXA measurement values. A divergence from the reference 4-C observations remains in FM estimations made by DXA even following the recent advances in technology. Further studies are particularly warranted in individuals with large FM contents.
我们描述了一项研究,旨在评估通用电气(GE)Lunar iDXA的精度,以及iDXA与GE Lunar Prodigy骨密度仪在测量正常至肥胖健康成年人的局部和全身骨骼及身体成分方面的一致性。我们将双能X线吸收法(DXA)测量的全身脂肪量与四成分(4-C)模型的测量结果进行比较。69名年龄为37±12岁、体重指数为26.2±5.1kg/cm的参与者在Prodigy上测量了一次,在iDXA上测量了两次。4-C模型根据体重、通过氘稀释法测得的全身水含量、通过空气置换体积描记法测得的身体体积以及通过DXA测得的骨量来估算脂肪量。通过Bland-Altman分析和线性回归分析,分析了两种仪器测量结果与4-C模型测量结果之间的一致性。在适当的情况下,推导了平移交叉校准方程。研究了DXA软件版本之间的差异。除手臂脂肪量(2.28%)外,iDXA在所有局部和全身骨骼及身体成分测量中的精度均低于测量值的2%。我们发现iDXA与Prodigy在全身和局部骨骼、脂肪量(FM)和瘦体重方面存在显著差异(p<0.05),但髋部骨量、面积和密度以及脊柱面积除外。与iDXA相比,Prodigy高估了FM,低估了瘦体重。然而,与4-C相比,iDXA的偏差更小,一致性界限比Prodigy更窄。在FM估计方面,软件版本之间不存在显著差异。我们的结果表明iDXA具有出色的精度。然而,GE Lunar的两款仪器Prodigy和iDXA的测量值之间存在显著差异。即使在技术取得最新进展之后,DXA在FM估计方面与参考4-C观测结果仍存在偏差。对于FM含量较高的个体,尤其需要进一步研究。