DXA-Derived Adiposity and Lean Indices for Management of Cardiometabolic and Musculoskeletal Frailty: Data Interpretation Tricks and Reporting Tips.
Marco A Minetto, Chiara Busso, Piera Lalli and 2 others
PMID 36188779WHAT IT FOUND
DXA can estimate fat and lean mass in obesity and sarcopenia, but BMI alone may miss excess adiposity.
Calibration settings change reported values, so serial scans need the same software configuration and measured height, weight, gender, and ethnicity.
Key findings
01Total body DXA can estimate whole-body and regional fat and lean mass, and the paper recommends its use in rehabilitative management of obesity and sarcopenia.
02BMI alone cannot identify excess adiposity or establish overweight or obesity in all cases, and it may underestimate cardiometabolic risk in some patients.
03DXA calibration settings can change reported fat and lean values, and serial scans should use the same software configuration.
STILL TO COME
How it was doneWhat they found
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What it does not show
The paper is a narrative review and tutorial, not a trial or cohort study, so it does not test whether DXA assessment improves patient outcomes. It reports no original patient outcomes, falls, fractures, function, or activities of daily living results. The proposed cutoffs vary by manufacturer, population, ethnicity, and reference database, and the paper says there is no consensus on some thresholds. The calibration issue is unresolved, and the paper notes that further studies are needed to decide when NHANES BCA calibration should be used. The representative cases illustrate reporting, but they are not evidence that the recommended indices change management or results. The article addresses physiatrists and DXA reporting rather than physical therapy, occupational therapy, or speech-language pathology interventions.
Declared interests
The authors report funding from the University of Turin, Fondazione CRT, and the Italian Ministry of Education, University and Research. They declare no commercial or financial relationships that could be construed as a potential conflict of interest.
The easy way to misread this
Do not read this as evidence that DXA screening or DXA-guided care improves cardiometabolic or musculoskeletal outcomes. It is a review and tutorial, not a trial of a therapist intervention.