Dual Energy X-Ray Absorptiometry Compared with Anthropometry in Relation to Cardio-Metabolic Risk Factors in a Young Adult Population: Is the 'Gold Standard' Tarnished?

Denise L Demmer; Lawrence J Beilin; Beth Hands; Sally Burrows; Craig E Pennell; Stephen J Lye; Jennifer A Mountain; Trevor A Mori

doi:10.1371/journal.pone.0162164

Dual Energy X-Ray Absorptiometry Compared with Anthropometry in Relation to Cardio-Metabolic Risk Factors in a Young Adult Population: Is the 'Gold Standard' Tarnished?

PLoS One. 2016 Sep 13;11(9):e0162164. doi: 10.1371/journal.pone.0162164. eCollection 2016.

Authors

Denise L Demmer¹, Lawrence J Beilin¹, Beth Hands², Sally Burrows¹, Craig E Pennell³, Stephen J Lye⁴, Jennifer A Mountain⁵, Trevor A Mori¹

Affiliations

¹ School of Medicine and Pharmacology, Royal Perth Hospital Unit, The University of Western Australia, Perth, Australia.
² Institute for Health Research, The University of Notre Dame Australia, Perth, Australia.
³ School of Women's and Infants Health, The University of Western Australia, Perth, Australia.
⁴ Lunenfeld-Tanenbaum Research Institute, University of Toronto, Toronto, Canada.
⁵ School of Population Health, The University of Western Australia, Perth, Australia.

Abstract

Background and aims: Assessment of adiposity using dual energy x-ray absorptiometry (DXA) has been considered more advantageous in comparison to anthropometry for predicting cardio-metabolic risk in the older population, by virtue of its ability to distinguish total and regional fat. Nonetheless, there is increasing uncertainty regarding the relative superiority of DXA and little comparative data exist in young adults. This study aimed to identify which measure of adiposity determined by either DXA or anthropometry is optimal within a range of cardio-metabolic risk factors in young adults.

Methods and results: 1138 adults aged 20 years were assessed by DXA and standard anthropometry from the Western Australian Pregnancy Cohort (Raine) Study. Cross-sectional linear regression analyses were performed. Waist to height ratio was superior to any DXA measure with HDL-C. BMI was the superior model in relation to blood pressure than any DXA measure. Midriff fat mass (DXA) and waist circumference were comparable in relation to glucose. For all the other cardio-metabolic variables, anthropometric and DXA measures were comparable. DXA midriff fat mass compared with BMI or waist hip ratio was the superior measure for triglycerides, insulin and HOMA-IR.

Conclusion: Although midriff fat mass (measured by DXA) was the superior measure with insulin sensitivity and triglycerides, the anthropometric measures were better or equal with various DXA measures for majority of the cardio-metabolic risk factors. Our findings suggest, clinical anthropometry is generally as useful as DXA in the evaluation of the individual cardio-metabolic risk factors in young adults.

Publication types

Comparative Study

MeSH terms

Absorptiometry, Photon*
Adiposity
Anthropometry*
Body Height
Body Mass Index
Cardiovascular Diseases / etiology*
Cholesterol, HDL / blood
Cross-Sectional Studies
Female
Humans
Linear Models
Male
Risk Assessment / methods*
Risk Assessment / standards
Waist Circumference
Western Australia / epidemiology
Young Adult

Substances

Cholesterol, HDL

Grants and funding

DXA scanning was funded by Canadian Institutes for Health Research (Grant MOP 82893). The Raine Study 20 year follow up assessment was funded by project grants from the Australian National Health and Medical Research Council, the Lions Eye Institute in Western Australia, Australian Foundation for the Prevention of Blindness and the Alcon Research Institute. Core management of the Raine study is provided by the Raine Medical Research Foundation; The University of Western Australia (UWA); the Telethon Kids Institute; the UWA Faculty of Medicine, Dentistry and Health Sciences; the Women and Infants Research Foundation and Curtin University.