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Maternal and pediatric nutrition

Predicting skeletal muscle mass from dual-energy X-ray absorptiometry in Japanese prepubertal children



We aimed to develop regression-based prediction equations for estimating total and regional skeletal muscle mass (SMM) from measurements of lean soft tissue mass (LSTM) using dual-energy X-ray absorptiometry (DXA) and investigate the validity of these equations.


In total, 144 healthy Japanese prepubertal children aged 6–12 years were divided into 2 groups: the model development group (62 boys and 38 girls) and the validation group (26 boys and 18 girls). Contiguous MRI images with a 1-cm slice thickness were obtained from the first cervical vertebra to the ankle joints as reference data. The SMM was calculated from the summation of the digitized cross-sectional areas. Total and regional LSTM was measured using DXA.


Strong significant correlations were observed between the site-matched SMM (total, arms, trunk and legs) measured by MRI and the LSTM obtained by DXA in the model development group for both boys and girls (R2adj=0.86–0.97, P<0.01, standard error of the estimate (SEE)=0.08–0.44 kg). When these SMM prediction equations were applied to the validation group, the measured total (boys 9.47±2.21 kg; girls 8.18±2.62 kg) and regional SMM were very similar to the predicted values for both boys (total SMM 9.40±2.39 kg) and girls (total SMM 8.17±2.57 kg). The results of the Bland–Altman analysis for the validation group did not indicate any bias for either boys or girls with the exception of the arm region for the girls.


These results suggest that the DXA-derived prediction equations are precise and accurate for the estimation of total and regional SMM in Japanese prepubertal boys and girls.

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We sincerely thank the subjects who participated in this study and their guardians. This study was supported in part by JSPS KAKENHI Grant Number 18800054, 22700623 and 24680069.

Author contributions

TM designed and conducted the research, analysed the data and wrote the paper. MO, YH, ST and SS conducted the research, analysed the data, reviewed and revised the manuscript, and approved the final manuscript as submitted.

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Correspondence to T Midorikawa.

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Midorikawa, T., Ohta, M., Hikihara, Y. et al. Predicting skeletal muscle mass from dual-energy X-ray absorptiometry in Japanese prepubertal children. Eur J Clin Nutr 71, 1218–1222 (2017).

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