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Arch Osteoporos. 2018 Sep 14;13(1):97. doi: 10.1007/s11657-018-0508-7.

Combination of DXA and BIS body composition measurements is highly correlated with physical function-an approach to improve muscle mass assessment.

Author information

Department of Nutritional Sciences, University of Wisconsin-Madison, Nutritional Sciences Building, 1415 Linden Drive Suite 266, Madison, WI, 53706, USA.
Section of Healthy Longevity Researches, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
Department of Food Science and Nutrition, University of Minnesota-Twin Cities, Saint Paul, MN, USA.
University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA.
Department of Nutritional Sciences, University of Wisconsin-Madison, Nutritional Sciences Building, 1415 Linden Drive Suite 266, Madison, WI, 53706, USA.
Biotechnology Center, University of Wisconsin-Madison, Madison, WI, USA.



Fluid volume estimates may help predict functional status and thereby improve sarcopenia diagnosis.


Bioimpedance-derived fluid volume, combined with DXA, improves identification of jump power over traditional measures.


DXA-measured lean mass should be corrected for fluid distribution in older populations; this may be a surrogate of muscle quality.


Sarcopenia, the age-related loss of muscle mass and function, negatively impacts functional status, quality of life, and mortality. We aimed to determine if bioimpedance spectroscopy (BIS)-derived estimates of body water compartments can be used in conjunction with dual-energy X-ray absorptiometry (DXA) measures to aid in the prediction of functional status and thereby, ultimately, improve the diagnosis of sarcopenia.


Participants (≥ 70 years) had physical and muscle function tests, DXA, and BIS performed. Using a BMI correction method, intracellular water (ICWc), extracellular water (ECWc), and ECWc to ICWc (E/Ic) ratio was estimated from standard BIS measures. Jump power was assessed using jump mechanography.


The traditional measure used to diagnose sarcopenia, DXA-derived appendicular lean mass (ALM) corrected for height (ALM/ht2), was the least predictive measure explaining jump power variability (r2 = 0.31, p < 0.0001). The best measure for explaining jump power was a novel variable combining DXA ALM and BIS-derived E/Ic ratio (ALM/(E/Ic); r2 = 0.70, p < 0.0001). ALM/(E/Ic) and ICWc had the highest correlation with jump power and grip strength, specifically jump power (r = 0.84 and r = 0.80, respectively; p < 0.0001).


The creation of a novel variable (ALM/(E/Ic)) improved the ability of DXA to predict jump power in an older population. ALM/(E/Ic) substantially outperformed traditional lean mass measures of sarcopenia and could well be an improved diagnostic approach to predict functional status. DXA-measured ALM should be corrected for fluid distribution, i.e., ALM/(E/Ic); this correction may be considered a surrogate of muscle quality.


Bioimpedance spectroscopy; Extracellular water; Intracellular water; Muscle function; Muscle quality; Sarcopenia

[Indexed for MEDLINE]

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