Yonsei Med J.  2012 Mar;53(2):289-293. 10.3349/ymj.2012.53.2.289.

The Influence of Exogenous Fat and Water on Lumbar Spine Bone Mineral Density in Healthy Volunteers

• Kim KN
• Kim BT
• Kim KM
• Park SB
• Joo NS
• Je SH
• Kim YS
• Lee DJ

• KMID: 1120194
• DOI: http://doi.org/10.3349/ymj.2012.53.2.289

Abstract

PURPOSE
Changes in human body composition can affect the accuracy of spine bone mineral density (BMD) measurements. The purpose of this study was to evaluate whether fat and water in the soft tissue of the abdomen influence lumbar spine BMD measurements obtained using dual energy X-ray absorptiometry (DXA).
MATERIALS AND METHODS
Duplicate BMD measurements were carried out on healthy volunteers (10 men and 10 women) and the Hologic anthropomorphic spine phantom had on the same day before and after placement of following 3 materials in the abdominal area: lard 900 g, 1.5 cm thick; oil 1.4 liters in a vinyl bag; and water 1.2 liters in a vinyl bag.
RESULTS
In the case of human participants, following the placement of exogenous water to mimic extracellular fluid (ECF), there was a significant decrease in lumbar spine BMD (-0.012 g/cm2, p=0.006), whereas the placement of exogenous lard and oil to mimic abdominal fat produced a slight increase in lumbar spine BMD (0.006 g/cm2, p=0.301; 0.008 g/cm2, p=0.250, respectively). The average percentage of lumbar spine BMD change with and without exogenous lard, oil, and water showed increase of 0.51%, and 0.67%, and decrease of 1.02%, respectively. Using the phantom, BMD decreased with the placement of both lard (-0.002 g/cm2, p=0.699) and water (-0.006 g/cm2, p=0.153); however, there was no difference in BMD after oil placement.
CONCLUSION
These results suggest that in cases where changes in fat and ECF volume are similar, ECF exerts a greater influence than fat on DXA lumbar BMD measurements.

Keyword

Bone mineral density; lard; extracellular fluid; dual energy X-ray absorptiometry (DXA)

MeSH Terms

Absorptiometry, Photon
Adult
Bone Density/*drug effects
Dietary Fats/pharmacology
Fats/*pharmacology
Female
Humans
Lumbar Vertebrae/*drug effects/*metabolism
Male
Water/*pharmacology

Reference

1. Marshall D, Johnell O, Wedel H. Meta-analysis of how well measures of bone mineral density predict occurrence of osteoporotic fractures. BMJ. 1996. 312:1254–1259.

2. Cauley JA, Wu L, Wampler NS, Barnhart JM, Allison M, Chen Z, et al. Clinical risk factors for fractures in multi-ethnic women: the Women's Health Initiative. J Bone Miner Res. 2007. 22:1816–1826.

3. Siris ES, Chen YT, Abbott TA, Barrett-Connor E, Miller PD, Wehren LE, et al. Bone mineral density thresholds for pharmacological intervention to prevent fractures. Arch Intern Med. 2004. 164:1108–1112.

4. Labio ED, Del Rosario DB, Strasser SI, McCaughan GW, Crawford BA. Effect of ascites on bone density measurement in cirrhosis. J Clin Densitom. 2007. 10:391–394.

5. Mann ML, Thornley-Brown D, Campbell R, Bell E, Burroughs L, Nunnally N, et al. The effect of peritoneal dialysate on DXA bone densitometry results in patients with end-stage renal disease. J Clin Densitom. 2008. 11:532–536.

6. Roos BO, Hansson TH, Sköldborn H. Dual photon absorptiometry in lumbar vertebrae. Evaluation of the baseline error. Acta Radiol Oncol. 1980. 19:111–114.

7. Svendsen OL, Haarbo J, Hassager C, Christiansen C. Accuracy of measurements of body composition by dual-energy x-ray absorptiometry in vivo. Am J Clin Nutr. 1993. 57:605–608.

8. Svendsen OL, Hendel HW, Gotfredsen A, Pedersen BH, Andersen T. Are soft tissue composition of bone and non-bone pixels in spinal bone mineral measurements by DXA similar? Impact of weight loss. Clin Physiol Funct Imaging. 2002. 22:72–77.

9. Pietrobelli A, Formica C, Wang Z, Heymsfield SB. Dual-energy X-ray absorptiometry body composition model: review of physical concepts. Am J Physiol. 1996. 271:E941–E951.

10. Formica C, Atkinson MG, Nyulasi I, McKay J, Heale W, Seeman E. Body composition following hemodialysis: studies using dual-energy X-ray absorptiometry and bioelectrical impedance analysis. Osteoporos Int. 1993. 3:192–197.

11. Stenver DI, Gotfredsen A, Hilsted J, Nielsen B. Body composition in hemodialysis patients measured by dual-energy X-ray absorptiometry. Am J Nephrol. 1995. 15:105–110.

12. Svendsen OL, Hassager C, Skødt V, Christiansen C. Impact of soft tissue on in vivo accuracy of bone mineral measurements in the spine, hip, and forearm: a human cadaver study. J Bone Miner Res. 1995. 10:868–873.

13. Svendsen OL, Hassager C, Bergmann I, Christiansen C. Measurement of abdominal and intra-abdominal fat in postmenopausal women by dual energy X-ray absorptiometry and anthropometry: comparison with computerized tomography. Int J Obes Relat Metab Disord. 1993. 17:45–51.

14. Johnson J, Dawson-Hughes B. Precision and stability of dual-energy X-ray absorptiometry measurements. Calcif Tissue Int. 1991. 49:174–178.

15. Wahner HW, Dunn WL, Brown ML, Morin RL, Riggs BL. Comparison of dual-energy x-ray absorptiometry and dual photon absorptiometry for bone mineral measurements of the lumbar spine. Mayo Clin Proc. 1988. 63:1075–1084.

16. Compston JE, Laskey MA, Croucher PI, Coxon A, Kreitzman S. Effect of diet-induced weight loss on total body bone mass. Clin Sci (Lond). 1992. 82:429–432.

17. Tothill P. Dual-energy x-ray absorptiometry measurements of total-body bone mineral during weight change. J Clin Densitom. 2005. 8:31–38.