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DXA to determine body fat may better evaluate metabolic syndrome
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WASHINGTON — Using DXA to determine body fat percentage expressed as a percentile for age and sex may be a reasonable, safe and simple approach to evaluate patients’ metabolic health, according to data presented at the 25th annual meeting of The North American Menopause Society.
Results from a pilot study of 50 postmenopausal women by Steven R. Goldstein, MD, of New York University School of Medicine, and colleagues echo the findings from Wildman and colleagues published in the Archives of Internal Medicine in 2008.
“In a study using weight, fasting insulin levels, glucose and different lipids to come up with a concept of metabolic health in over 5,000 patients, Wildman discovered a number of normal-weight patients were metabolically unhealthy and a number of overweight patients were metabolically healthy,” Goldstein told Endocrine Today.
Goldstein and his team retrospectively and consecutively collected routine DXA scans indicated for bone mass and whole-body scans for body composition in their cohort of women.
The researchers converted percent body fat to individualized percentile for age and sex. Results were then compared with patients’ BMI based on height and weight; standard BMI definitions were used. Body fat between the 25th and 75th percentiles was considered normal, above the 75th percentile abnormal and below the 25th percentile lean.
“BMI was developed 170 years ago by a Belgian scientist; it is neither age- nor gender-specific,” Goldstein said. “A 5’8” male of 25 has the same BMI as a 5’8” female of 55 who weighs the same amount. It’s like looking at metabolic health through Coke-bottle glasses.”
For normal weight by BMI standard, five of 27 (18.5%) had body fat above the 75th percentile for age and another five (18.5%) were below the 25th percentile. For overweight by BMI standard, three of 16 (18.8%) had body fat between the 25th and 75th percentiles for age. All seven women with obesity were, predictably, above the 75th percentile for age, Goldstein said.
“Percentile body fat is perhaps a better surrogate of metabolic health than just BMI,” Goldstein said. “It is easy to obtain, and there is little X-ray exposure — less than flying cross country.”
Goldstein said he hopes to return to NAMS in 2015 and present a larger prospective study to answer the question.
This new utility also holds potential for DXA machine reimbursements, which have fallen so low, Goldstein said. “Perhaps finding another use for DXA would be clinically relevant; it would be very important and helpful to everybody.” – by Allegra Tiver
For more information:
Goldstein SR. Abstract S-5. Presented at The North American Menopause Society Annual Meeting; Oct. 15-18, 2014; Washington, D.C.
Wildman RP. Arch Intern Med. 2008;168:1617-1624.
Disclosure: Goldstein reports being a consultant for Cook ObGyn, JDS Therapeutics, Noven, Pfizer, Philips Ultrasound, Shionogi and Teva.