The effect of different measurement modalities in the association of lean mass with mortality: A systematic review and meta-analysis

Gloria Hoi-Yee Li; Grace Koon-Yee Lee; Philip Chun-Ming Au; Marcus Chan; Hang-Long Li; Bernard Man-Yung Cheung; Ian Chi-Kei Wong; Victor Ho-Fun Lee; James Mok; Benjamin Hon-Kei Yip; Kenneth King-Yip Cheng; Chih-Hsing Wu; Ching-Lung Cheung

doi:10.1016/j.afos.2021.02.004

The effect of different measurement modalities in the association of lean mass with mortality: A systematic review and meta-analysis

Osteoporos Sarcopenia. 2021 Mar;7(Suppl 1):S13-S18. doi: 10.1016/j.afos.2021.02.004. Epub 2021 Mar 12.

Affiliations

¹ Department of Pharmacology and Pharmacy, The University of Hong Kong, Pokfulam, Hong Kong.
² Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
³ Department of Medicine, The University of Hong Kong, Pokfulam, Hong Kong.
⁴ Department of Clinical Oncology, The University of Hong Kong, Pokfulam, Hong Kong.
⁵ JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Shatin, Hong Kong.
⁶ Department of Health Technology and Informatics, The Hong Kong Polytechnic University, Hung Hom, Hong Kong.
⁷ Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
⁸ Institute of Geriatrics, College of Medicine, National Cheng Kung University, Tainan, Taiwan.

Abstract

Objectives: Lean mass is commonly measured by 3 modalities, dual energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA), and computerized tomography (CT). CT is considered the most accurate, while lean mass measured by DXA and BIA often consists of non-muscle compartment, and hence considered less accurate when compared with CT. It remains unclear if the association of lean mass with mortality would differ using different measurement modalities.

Methods: A systematic review and meta-analysis of lean mass and mortality was conducted. The analysis was stratified by different measurement modalities and health conditions. Pooled hazard ratios were estimated using a random effects model.

Results: This meta-analysis included 188 studies with 98 468 participants. Reduced lean mass measured by BIA, DXA, and CT, was associated with increased risk of mortality with a hazard ratio (HR) of 1.35 (95% CI, 1.21-1.49), 1.18 (95% CI, 1.06-1.30), and 1.44 (95% CI, 1.32-1.57), respectively. Similarly, low lean mass defined by BIA-, DXA-, and CT-measurement was associated with increased risk of mortality, with an HR of 1.81 (95% CI, 1.56-2.10), 1.44 (95% CI, 1.29-1.60), and 1.78 (95% CI, 1.64-1.93).

Conclusions: Reduced and low lean mass were robustly associated with increased mortality in studies using different measurement modalities.

Keywords: BIA; CT; DXA; Lean mass; Mortality.