title: The Official Positions of the International Society for Clinical Densitometry: body composition analysis reporting.
abstract: Dual-energy x-ray absorptiometry (DXA) measurements of body composition increasingly are used in the evaluation of clinical disorders, but there has been little guidance on how to effectively report these measures. Uniformity in reporting of body composition measures will aid in the diagnosis of clinical disorders such as obesity, sarcopenia, and lipodystrophy. At the 2013 International Society for Clinical Densitometry Position Development Conference on body composition, the reporting section recommended that all DXA body composition reports should contain parameters of body mass index, bone mineral density, BMC, total mass, total lean mass, total fat mass, and percent fat mass. The inclusion of additional measures of adiposity and lean mass are optional, including visceral adipose tissue, appendicular lean mass index, android/gynoid percent fat ratio, trunk to leg fat mass ratio, lean mass index, and fat mass index. Within the United States, we recommend the use of the National Health and Nutrition Examination Survey 1999-2004 body composition dataset as an age-, gender-, and race-specific reference and to calibrate BMC in 4-compartment models. Z-scores and percentiles of body composition measures may be useful for clinical interpretation if methods are used to adjust for non-normality. In particular, DXA body composition measures may be useful for risk-stratification of obese and sarcopenic patients, but there needs to be validation of thresholds to define obesity and sarcopenia. To summarize, these guidelines provide evidence-based standards for the reporting and clinical application of DXA-based measures of body composition.
authors.affiliation: Department of Medicine, Houston Methodist Hospital, Houston, TX, USA. Electronic address: spetak@petak.com.
authors.forename: Steven
authors.initials: S
authors.lastname: Petak
authors.forename: Carmen G
authors.initials: CG
authors.lastname: Barbu
authors.forename: Elaine W
authors.initials: EW
authors.lastname: Yu
authors.forename: Roger
authors.initials: R
authors.lastname: Fielding
authors.forename: Kathleen
authors.initials: K
authors.lastname: Mulligan
authors.forename: Brian
authors.initials: B
authors.lastname: Sabowitz
authors.forename: Chih-Hsing
authors.initials: CH
authors.lastname: Wu
authors.forename: John A
authors.initials: JA
authors.lastname: Shepherd
mesh_terms: D015502:Absorptiometry, Photon / Q000592:standards*; D001823:Body Composition; D015519:Bone Density; D003226:Congresses as Topic; D006801:Humans; D010024:Osteoporosis / Q000000981:diagnostic imaging*; D017410:Practice Guidelines as Topic; D012955:Societies, Medical
keywords: Adipose mass; body composition; bone mineral density; lean mass; whole body