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Body composition assessment by dual-energy X-ray absorptiometry (DXA)

Valutazione della composizione corporea mediante la densitometria a raggi X (DXA)

Abstract

Body composition (BC) assessment is indispensable to evaluate nutritional status and thus health, both at the population and individual level, and to assess the efficacy of primary and secondary preventive nutritional strategies. Changes in BC, including the regional distribution of body fat, largely occur during pubertal transition, with marked differences between genders. They may, however, also occur in the elderly, who experience significant changes in the ratio between body fat and muscle with aging. The development and implementation of more sophisticated techniques (e.g. BC assessment at the molecular and atomic levels) could provide a major contribution to determining BC at different levels. This review discusses the application of dual-energy X-ray absorptiometry (DXA) on BC determination, given that DXA has the potential to provide overall and regional assessment of BC in terms of fat, lean mass and bone. DXA is widely used in many clinical settings primarily diagnosis osteoporosis. This article describes the use of whole-body DXA in assessing BC in patients with chronic diseases (e.g. metabolic syndrome) as well as in different sport activities to evaluate the effects of exercise.

Riassunto

La valutazione della composizione corporea, da qui in avanti denominata con il termine anglosassone di body composition (BC), è un metodo essenziale per analizzare lo stato di salute in termini nutrizionali, sia a livello di popolazione sia a livello individuale, come pure per indagare l’efficacia delle strategie nutrizionali preventive primarie e secondarie. I cambiamenti della BC, inclusa la distribuzione distrettuale del grasso corporeo, avvengono in larga parte durante il periodo puberale e si diversificano in base al sesso. Questi tuttavia possono manifestarsi anche nel soggetto anziano, per il quale il trascorrere degli anni può causare significativi cambiamenti nel rapporto tra grasso corporeo e muscolo. Per misurare la composizione corporea esistono numerose tecniche; alcune semplici, ma con margini di errore ancora elevati, altre invece costose e sofisticate (come per esempio la valutazione a livello atomico e molecolare della BC) ma più affidabili nel rilevamento dei risultati a vari livelli. Questa revisione della letteratura riguarda l’applicazione della tecnica dual-Energy X-ray absorptiometry (DXA) per la determinazione della composizione corporea, in quanto tale metodica permette di misurare sia in maniera totale che segmentale, per singoli distretti, i vari componenti quali: massa grassa, massa magra e tessuto osseo. Attualmente la DXA è principalmente usata per fare diagnosi di osteoporosi e/o per controllare la risposta alla terapia farmacologia. In questo articolo verranno descritte le altre possibili indicazioni, tra cui lo studio della BC nei pazienti con sindromi metaboliche croniche e l’applicazione in condizioni fisiologiche, quali per esempio nello sportivo, per valutare l’effetto dell’esercizio fisico sulla massa corporea.

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Correspondence to G. Guglielmi.

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Andreoli, A., Scalzo, G., Masala, S. et al. Body composition assessment by dual-energy X-ray absorptiometry (DXA). Radiol med 114, 286–300 (2009). https://doi.org/10.1007/s11547-009-0369-7

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Keywords

  • Total-body DXA
  • Body composition
  • Body fat
  • Lean body mass
  • Bone mineral density

Parole chiave

  • DXA
  • Composizione corporea
  • Massa grassa
  • Massa magra
  • Densità minerale ossea