Estimating dual-energy X-ray absorptiometry-derived total body skeletal muscle mass using single-slice abdominal magnetic resonance imaging in obese subjects with and without diabetes: a pilot study

• Published in: European journal of clinical nutrition Vol. 66; no. 5; pp. 628 - 632
• Main Authors: Baker, S T, Strauss, B J, Prendergast, L A, Panagiotopoulos, S, Thomas, G E, Vu, T, Proietto, J, Jerums, G
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 01.05.2012; Nature Publishing Group
• Subjects: 692/699/1702/393; 692/699/2743/137/773; 692/700; 692/700/1421/1628; Abdomen; Absorptiometry, Photon - methods; Adipose tissue; Biological and medical sciences; Body Composition; Body fat; Body Fluid Compartments - diagnostic imaging; Body mass index; Body weight loss; Cancer; Clinical Nutrition; Cohort Studies; Computed tomography; Confidence intervals; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - complications; Diagnosis; Dual energy X-ray absorptiometry; Energy; Epidemiology; Estimation; Fat-free body mass; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Hospitals; Humans; Internal Medicine; Intra-Abdominal Fat; Investigative techniques, diagnostic techniques (general aspects); Lumbar Vertebrae; Magnetic resonance imaging; Magnetic Resonance Imaging - methods; Male; Mathematical Concepts; Medical imaging; Medical sciences; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolism; Methods; Middle Aged; Muscle, Skeletal - diagnostic imaging; Muscle, Skeletal - pathology; Muscles; Musculoskeletal system; Nutrition; Obesity; Obesity - complications; Obesity - pathology; original-article; Osteoarticular system. Muscles; Overweight persons; Patients; Pilot Projects; Public Health; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Repatriation; Skeletal muscle; Tomography; Vertebrae; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Weight control; Weight loss; Australia; Victoria Australia; fat-free mass; body composition; magnetic resonance imaging; type 2 diabetes; skeletal muscle; obesity; Endocrinopathy; Type 2 diabetes; Human; Obesity; Nutrition disorder; Metabolic diseases; Striated muscle; Nuclear magnetic resonance imaging; Body composition; Abdomen; Dual energy absorptiometry; Lean body mass; Medical imagery; Nutritional status
• ISSN: 0954-3007; 1476-5640
• DOI: 10.1038/ejcn.2012.3

BACKGROUND/OBJECTIVES: Single-slice abdominal computed tomography or magnetic resonance imaging (MRI) performed to measure visceral adipose tissue in individuals with obesity and diabetes mellitus can also image skeletal muscle. The aim of this study was to validate a method developed in cancer patients using a single abdominal cross-sectional image to estimate fat-free mass (FFM) and appendicular lean tissue mass index (LTMI), a total body skeletal muscle mass surrogate, in an obese cohort of subjects with and without type 2 diabetes. SUBJECTS/METHODS: In total, 49 obese subjects (22 with diabetes) recruited into a weight loss study underwent dual-energy X-ray absorptiometry (DXA) and abdominal MRI at baseline. DXA-derived FFM and LTMI were compared with skeletal muscle area at the level of the third lumbar vertebra (L3) on MRI. RESULTS: L3 skeletal muscle area correlated with FFM ( R adj 2 =0.825; P <0.001) and LTMI ( R adj 2 =0.6; P <0.001). A simple formula, previously shown to predict LTMI in cancer patients, produced a good estimation of LTMI from L3 skeletal muscle area (95% confidence interval −3.70, 2.56%) in our obese cohort. Equations incorporating age, sex, height, weight and diabetic status improved the relationship between L3 skeletal muscle area and estimated FFM ( r =0.976, P <0.001) and LTMI ( r =0.879, P <0.001). CONCLUSION: A single-axial slice at the L3 level can be used to estimate FFM and LTMI in obese diabetic and non-diabetic subjects, allowing precise analysis of body composition using a single imaging modality in clinical research and practice.