Journal of Bone Metabolism

"Absorptiometry, photon"

Original Articles

Cross-Calibration of Bone Mineral Density and Body Composition between GE Lunar Prodigy and Hologic Horizon W Dual Energy X-Ray Absorptiometry Systems: Sujin Kim, Guen Young Lee, Jun-Il Yoo, Sang-Wook Lee, Yong-Chan Ha; J Bone Metab 2026;33(1):84-93.
Published online February 28, 2026; DOI: https://doi.org/10.11005/jbm.26.1014

Background
Dual energy X-ray absorptiometry (DXA) measurements vary among instruments from different manufacturers. This study aimed to assess the correlation between bone mineral density (BMD) and body composition measured by the GE Lunar Prodigy and Hologic Horizon W DXA systems and to develop conversion equations.
Methods
A total of 120 healthy volunteers (59 males, 61 females) aged 20 to 70 years were scanned on both DXA systems on the same day. BMD was measured at the lumbar spine (L1-L4) and bilateral femurs. Body composition parameters were measured for the whole body and regional sites. Bland-Altman analysis, Pearson correlation, and concordance correlation coefficient (CCC) were used to assess agreement. Linear regression was performed to derive conversion equations.
Results
The Hologic system measured BMD values 14% to 20% lower at the lumbar spine and 8% to 17% lower at femoral sites compared to the GE Lunar system (all P<0.0001). Lean mass values were 4% to 10% lower on the Hologic system. Very strong correlations were observed for both BMD (r=0.944-0.980) and lean mass (r=0.963-0.984). Cross-calibration equations were developed for all measurement sites.
Conclusions
Despite significant systematic differences, there was very high correlation between the two DXA systems. The conversion equations can facilitate comparison of measurements between these systems in clinical practice and research.

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Evaluation of Trabecular Bone Score and Bone Mineral Density in Patients with Primary Hyperparathyroidism under 50 Years Old: Yunkyung Jeon, Myungsoo Im, Doohwa Kim, Jihyun Kim, Kyoungjune Pak, Seong-Jang Kim, Keunyoung Kim; J Bone Metab 2026;33(1):63-72.
Published online February 28, 2026; DOI: https://doi.org/10.11005/jbm.25.885

Background
This study aimed to investigate the densitometric characteristics and qualitative bone status in patients with normocalcemic primary hyperparathyroidism (PHPT) compared with those in controls who were younger adults under 50 years.
Methods
This retrospective study included 60 controls and 31 patients with PHPT who underwent dual energy X-ray absorptiometry (DXA) of the lumbar spine (LS), femoral neck (FN), and total hip (TH). Trabecular bone score (TBS) was derived from LS DXA images. Bone mineral density (BMD) values were assessed using Z-scores, and correlations between TBS, BMD, and laboratory parameters were examined.
Results
The median ages of the control and PHPT groups were 41 and 42 years, respectively. The proportion of individuals classified as “below the expected range for age” based on Z-scores differed significantly between groups only when considering any site collectively. Median TBS was significantly lower in PHPT patients than in controls, even when BMD values at LS, FN, and TH fell within similar diagnostic categories. In controls, TBS and BMD demonstrated very low correlation coefficients. In contrast, PHPT patients showed a stronger correlation between TBS and femoral BMD, whereas the association between TBS and LS BMD was largely absent. Among laboratory markers, only serum intact parathyroid hormone was significantly negatively correlated with TBS.
Conclusions
Young adults with PHPT exhibit impaired bone quality despite relatively preserved BMD, suggesting early microarchitectural deterioration. These findings support the combined use of LS and femoral BMD with TBS for more accurate assessment of skeletal health in PHPT.

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Determinants of Bone Mineral Density in Postmenopausal Women: The Role of Lean and Fat Mass by Dual Energy X-Ray Absorptiometry Assessment: Luis A. Ramírez Stieben, Lucas R. Brun, Silvana Di Gregorio, Luis Miguel Del Río Barquero, María Lorena Brance; J Bone Metab 2025;32(4):306-314.
Published online November 30, 2025; DOI: https://doi.org/10.11005/jbm.25.881

Background
Bone mineral density (BMD) is a key predictor of fracture risk in postmenopausal women. Evidence on the influence of fat and lean mass (LM) on BMD remains contradictory. This study aimed to assess the associations between BMD at different sites (whole-body, upper, and lower limbs) and anthropometric and body composition variables measured by dual energy X-ray absorptiometry (DXA) in postmenopausal women.
Methods
A cross-sectional study was conducted on 308 healthy postmenopausal women. Anthropometric data and whole-body DXA scans were used to measure BMD, total fat mass (FM), LM, appendicular LM index (ALMI), and abdominal fat. Pearson or Spearman correlation analyses were used according to variable distribution, and a correlation matrix along with variance inflation factor analyses was used to reduce 18 variables to a final set of 5. Multiple linear regression models were built for BMD at each site.
Results
Age was negatively correlated with BMD at all sites. Total LM and ALMI demonstrated positive correlations with BMD, whereas body mass index (BMI) and abdominal fat exhibited weaker positive associations. In multivariable analyses, age was negatively associated with whole-body BMD, while total LM was positively associated. For lower-limb BMD, age and total LM were significant predictors, with BMI showing a positive but weaker association. For upper-limb BMD, total LM, and ALMI were all positively associated. The models demonstrated satisfactory fit (adjusted R², 0.341-0.438; global P<0.0001).
Conclusions
Age and total LM were independently and consistently associated with BMD in postmenopausal women, whereas FM and BMI had a limited impact.

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Validation of Dual Energy X-Ray Absorptiometry and Nuclear Magnetic Resonance in the Analysis of Body Composition in Mice: Kyung-Wan Baek, Ji-Seok Kim, Jin Sung Park, So-Jeong Kim, Yong-Chan Ha, Ok-Yi Jeong, Jun-Il Yoo; J Bone Metab 2020;27(4):291-299.
Published online November 30, 2020; DOI: https://doi.org/10.11005/jbm.2020.27.4.291

Background
As an instrument for measuring body composition in experimental animals, dual energy X-ray absorptiometry (DXA) is ideal for accuracy, cost, and measurement efficiency. However, there is too little insight into the effectiveness of the various aspects of applying DXA to experimental animals. We investigated whether to compare and verify the precision and accuracy of DXA and nuclear magnetic resonance (NMR) animal body composition analyzers.
Methods
We used 30 Institution of Cancer Research mice in the study. First, in order to evaluate the reproducibility of DXA and NMR, we did repeated measurements by repositioning each mouse in anesthesia and euthanasia states. Subsequently, the accuracy of each device was evaluated by comparing the weight measured before the experiment, the weight of the tissue extracted from the mice after the experiment, and the measured DXA and NMR. In addition, when measuring the body composition of animals, we compared the time and the measurable body composition parameters and summarized the advantages and disadvantages of the 2 devices.
Results
Compared to NMR, DXA had the advantage of a fast measurement of bone composition and rapid image analysis. In addition, DXA showed a higher correlation (>95%) with fat mass, lean mass baseline than did NMR (>85%).
Conclusions
In conclusion, DXA was confirmed to have higher precision and measurement accuracy than did NMR. Therefore, DXA is an effective method for evaluating the body composition of experimental animals.

Citations

Citations to this article as recorded by

1. Small animal DXA instrument comparison and validation
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Alarm Services as a Useful Tool for Diagnosis and Management of Osteoporosis in Patients with Hip Fractures: A Prospective Observational Multicenter Study: Hyun-Soo Ok, Woo-Sung Kim, Yong-Chan Ha, Jae-Young Lim, Chan-Woo Jung, Young-Kyun Lee, Kyung-Hoi Koo; J Bone Metab 2020;27(1):65-70.
Published online February 29, 2020; DOI: https://doi.org/10.11005/jbm.2020.27.1.65

Background

Alarm services in the Order Communication System improve awareness for related physicians including orthopaedic surgeons, internal medicine doctors, and other relevent doctors. This prospective observational multicenter study was to compare the diagnostic and treatment rates of osteoporosis between an alarm service group and a no alarm service group.

Methods

From January 2017 to december 2017, The subjects included patients aged 50 years or older with hip fractures from 16 hospital-based multicenter cohorts. Among the 16 hospitals, 5 university hospitals established an alarm service for osteoporosis management (i.e., Alarm group) and 11 university hospitals did not set-up alarm services (i.e., Control group). The rate of dual energy X-ray absorptiometry (DXA) test and the initiation rate of antiosteoporosis medications between the 2 groups were compared at enrollment and at 6 months follow-up.

Results

During the study period, 1,405 patients were enrolled. The DXA examination rate and initiation rate of osteoporosis treatment between the Alarm group and the Control group were 484 patients (89.8%) vs. 642 patients (74.1%) (P<0.001) and 355 patients (65.9%) versus 294 patients (33.9%) (P<0.001), respectively. At 6 months follow-up, the rate of anti-osteoporosis management between the 2 groups decreased (57.8% vs. 29.4%).

Conclusions

This prospective multicenter study demonstrates that alarm services can improve awareness of physicians, and it resulted in a significantly higher rate of examination of DXA and initiation of anti-osteoporosis medication in the Alram group. Therefore, alarm service is a simple and effective tool to increase anti-osteoporosis management as part of the fractuure liaison service in South Korea.

Citations

Citations to this article as recorded by

1. Approaches to organization of Fracture Liaison Services at the regional level with the involvement of primary care physicians
L. P. Evstigneeva, V. G. Kondakova, A. V. Dubowskoj, K. G. Avramenkova
Osteoporosis and Bone Diseases.2023; 25(4): 21. CrossRef
2. Fracture Liaison Service in Korea: 2022 Position Statement of the Korean Society for Bone and Mineral Research
Jae-Young Lim, Young Yul Kim, Jin-Woo Kim, Seongbin Hong, Kyunghoon Min, Jaewon Beom, Byung-Ho Yoon, Sang Yoon Lee, Sung Hye Kong, Jun-Il Yoo, Myung Sook Park, Jae-Hwi Nho, Sangbong Ko, Min Wook Joo, Dong Hwan Kim, Chan Ho Park, Tae-Young Kim, Seil Sohn,
Journal of Bone Metabolism.2023; 30(1): 31. CrossRef
3. Osteoporosis Feature Selection and Risk Prediction Model by Machine Learning Using a Cross-Sectional Database
Yonghan Cha, Sung Hyo Seo, Jung-Taek Kim, Jin-Woo Kim, Sang-Yeob Lee, Jun-Il Yoo
Journal of Bone Metabolism.2023; 30(3): 263. CrossRef
4. The Potential Economic Benefits of an Alarm Service in Order Communication Systems in Korea: a Cost-Effectiveness Analysis of Less-Intensive Fracture Liaison Services Based on a Prospective Cohort Study
Suhyun Jang, Young-Kyun Lee, Yong-Chan Ha, Sunmee Jang
Calcified Tissue International.2022; 111(4): 380. CrossRef

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Effects of Thyrotropin Suppression on Bone Health in Menopausal Women with Total Thyroidectomy: Eun Heui Kim, Yun Kyung Jeon, Kyoungjune Pak, In-Joo Kim, Seong-Jang Kim, Seunghyeon Shin, Bo Hyun Kim, Sang Soo Kim, Byung-Joo Lee, Jeong-Gyu Lee, Tae Sik Goh, Keunyoung Kim; J Bone Metab 2019;26(1):31-38.
Published online February 28, 2019; DOI: https://doi.org/10.11005/jbm.2019.26.1.31

Background

This study examined the change in the trabecular bone score (TBS), areal bone mineral density (aBMD), and osteoporosis in postmenopausal women who underwent thyrotropin (TSH)-suppressive therapy for treating papillary thyroid cancer after a total thyroidectomy procedure.

Methods

We evaluated 36 postmenopausal women who received a total thyroidectomy for papillary thyroid cancer and were undergoing TSH suppressive therapy with levothyroxine. Postmenopausal women (n=94) matched for age and body mass index were recruited as healthy controls. The aBMD and TBS of the lumbar spine were compared between dual energy X-ray absorptiometry (DXA) at baseline and at follow-up after an average of 4.92 years.

Results

There was no significant difference in the rate of diagnoses of osteoporosis, osteopenia, or normal bone status between the 2 groups during the baseline DXA evaluation. However, the TBS was significantly lower whereas aBMD did not show significant difference at the time of baseline DXA measurement (1st DXA, 1.343±0.098 vs. 1.372±0.06317, P<0.001; 2nd DXA, 1.342±0.095 vs. 1.370±0.062, P<0.001). The TBS and aBMD did not differ significantly between the initial and follow-up DXA images in both groups of TSH suppressive patients and controls.

Conclusions

The average value of TBS and aBMD did not significantly change during the follow-up period. The TSH suppressive therapy was revealed as not a significant factor for the progressive deterioration of bone status during long term follow-up.

Citations

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