Lateral Spine Densitometry in Obese Women |
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Authors: | E R Brooks D Heltz P Wozniak C Partington J C Lovejoy |
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Institution: | (1) Pennington Biomedical Research Center and The Department of Kinesiology, Louisiana State University, Baton Rouge, Louisiana 70808, USA, US;(2) Department of Experimental Statistics, Louisiana State University Agricultural Center, Baton Rouge, Louisiana 70803, USA, US;(3) Digital Diagnostic Center, Baton Rouge, Louisiana 70808, USA, US |
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Abstract: | The lateral (LAT) spine scan has been suggested as a more sensitive measure than posterior-anterior (PA) scanning for assessing
age-related bone loss in normal-weight postmenopausal women. The measurement error of PA and LAT bone mineral density (BMD)
using dual energy X-ray absorptiometry (DXA) has also been shown to rise with incremental increases in fat and from large
variance in fat thickness, respectively. The purpose of this cross-sectional study was to determine specific affects of obesity
on paired PA and LAT lumbar (L2–L4) BMD and Z score (BMD of patient versus age-matched reference database) correlation in 30 obese postmenopausal women (mean
BMI ± SD = 33.3 ± 4.06). The mean PA and LAT BMD ± SD were 0.946 ± 0.123 and 0.749 ± 0.134, respectively. The mean PA and
LAT Z scores were −0.17 ± 1.15 and 0.80 ± 1.7. The correlation between PA and LAT BMD was significantly lower (r = 0.55; P < 0.05) than previously reported, and PA and LAT Z score correlation was (r = 0.57; P= 0.0016). After adjusting for body mass index (BMI), percent body fat, fat mass, and truncal fat by DXA, waist:hip ratio
(WHR) and visceral and subcutaneous abdominal fat by computerized axial tomography (CT), PA and LAT Z score correlation increased
to r = 0.62; P= 0.0065. In our subjects, the mean LAT Z score was 4.6 times higher than the mean AP Z, contrary to previous observations
in normal-weight postmenopausal women. Our findings may be due to increased soft tissue composition and fat inhomogeneity
in the LAT scanning field resulting in increased X-ray attenuation in obesity.
Received: 22 July 1997 / Accepted: 26 January 1998 |
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Keywords: | : Absorptiometry — Bone density — Densitometry — DXA — Lumbar vertebrae — Obesity |
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