Reference standards for lean mass measures using GE dual energy x-ray absorptiometry in Caucasian adults

Body composition assessments commonly focus predominantly on fat mass, however lean mass (LM) measurements also provide useful information regarding clinical and nutritional status. LM measurements help predict health outcomes and diagnose sarcopenia, which has been associated with frailty. Dual energy x-ray absorptiometry (DXA) is an established technique used in clinical and research settings to assess body composition including total and regional LM. Currently, there are no reference values available that were derived from GE-Healthcare DXA systems directly for US adults for LM, LM index (LMI), percent LM (%LM), and appendicular lean mass index (ALMI) and it is known that whole-body and regional LM measures differ by DXA manufacturer. OBJECTIVE: To develop reference values by age and sex for LM measures using GE-Healthcare DXA systems. METHODS: A de-identified sample was obtained from Ball State University’s Clinical Exercise Physiology Laboratory and University of Wisconsin-Milwaukee’s Physical Activity & Health Research Laboratory. DXA scans of 2,076 women and 1,251 men were completed using a GE Lunar Prodigy or iDXA. Percentiles (%ile) were calculated for all variables of interest (LM, LMI, %LM, and ALMI) and a factorial ANOVA was used to assess differences for each variable between 10-year age groups and sex, as well as the interaction between age and sex. RESULTS: Men had higher mean total LM, %LM, LMI, and ALMI than women (p<0.01), across all age groups. All LM variables decreased significantly over the 5 decades in men, however in women only total LM, %LM, and ALMI decreased from the youngest to oldest age groups (p<0.01). CONCLUSION: These reference values provide for a more accurate interpretation of GE-Healthcare DXA-derived LM measurements offering clinicians and researchers with an initial resource to aid in the early detection and assessment of LM deficits.