Comparison of high-resolution peripheral quantitative computerized tomography with dual-energy X-ray absorptiometry for measuring bone mineral density

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The objective of this study was to compare the measurement of areal bone mineral density (aBMD) by dual-energy X-ray absorptiometry (DXA) with the measurement of volumetric bone mineral density (vBMD) by high-resolution peripheral computerized tomography (HR-pQCT) in subjects with a wide range of body mass indices (BMI).


We scanned the arms and legs of 49 premenopausal women, aged 21-45 years, with BMI from 18.5 to 46.5, by HR-pQCT and found that there was a nonsignificant change in vBMD associated with increased BMI, whereas aBMD (DXA) was associated with a positive significant increase. HR-pQCT scans a slice at the extremity of the tibia and radius, whereas DXA scans the entire leg and arm.


The correlation coefficients (r) of BMD (DXA) of the legs with BMI were 0.552, P < 0.001, with %fat it was 0.378, P < 0.01 and with W it was 0.633, P < 0.001. The r of BMD (DXA) of the arms with BMI was 0.804, P < 0.001, with %fat it was 0.599, P < 0.001 and with W it was 0.831, P < 0.001, whereas the r of the average bone density (D100) of legs and arms measured by HR-pQCT with BMI, W and %fat were not significant.


Although HR-pQCT and DXA scan different parts of the bone, the high r of BMD with BMI and low r of bone density measured by HR-pQCT with BMI suggest that BMD measured by DXA is artifactually increased in the presence of obesity.

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