# Association of X-ray Absorptiometry Body Composition Measurements with Basic Anthropometrics and Mortality Hazard

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## Abstract

**:**

## 1. Introduction

## 2. Methods

#### 2.1. NHANES

#### 2.2. Indices and Standardization

#### 2.3. Statistical Modeling of Association with Mortality

## 3. Results

#### 3.1. Sample Characteristics and Correlations

#### 3.2. Associations with Mortality Hazard

## 4. Discussion

## 5. Conclusions

## Author Contributions

## Funding

## Institutional Review Board Statement

## Informed Consent Statement

## Data Availability Statement

## Conflicts of Interest

## References

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**Figure 1.**Correlation coefficients for anthropometrics and DEXA-derived body composition indices (Z scores relative to age- and sex-specific means) among NHANES 1999–2006 adults. Red squares denote positive correlations and blue negative ones; larger size indicates larger correlation magnitude. The upper right half of the correlation matrix shows correlations of the unadjusted indices, while for the lower left half, the body composition indices were adjusted to a standard height, weight, and waist circumference using power law scaling. NHANES = National Health and Nutrition Examination Survey; DEXA = dual-energy X-ray absorptiometry; BMI = body mass index; WC = waist circumference; ABSI = a body shape index; FMI = fat mass index; FFMI = fat-free mass index; TFMI = trunk fat mass index; TFFMI = trunk fat-free mass index; LFMI = limb fat mass index; LFFMI = limb fat-free mass index.

**Figure 2.**Estimated mortality hazard ratios in NHANES 1999–2006 as nonlinear (penalized spline) functions of (

**a**) BMI, (

**b**) ABSI, (

**c**) FMI (red) and FFMI (blue), (

**d**) TFFMI. Dashed lines indicate 95% confidence intervals. NHANES = National Health and Nutrition Examination Survey; BMI = body mass index; ABSI = a body shape index; FMI = fat mass index; FFMI = fat-free mass index; TFFMI = trunk fat-free mass index.

**Figure 3.**Estimated mortality hazard ratios in NHANES 1999–2006 as nonlinear (penalized spline) functions of adjusted (

**a**) TFFMI, (

**b**) LFFMI in models that also include as predictors BMI and ABSI. Dashed lines indicate 95% confidence intervals. NHANES = National Health and Nutrition Examination Survey; BMI = body mass index; ABSI = a body shape index; FMI = fat mass index; TFFMI = trunk fat-free mass index; LFFMI = limb fat-free mass index.

Valid DEXA Scans | All Adults | |
---|---|---|

Number | 14,064 | 19,959 |

Deaths | 2140 | 3478 |

% female | 48 | 52 |

Ethnicity | Mexican: 25% | 24% |

Other Hispanic: 4% | 4% | |

White: 47% | 47% | |

Black: 20% | 21% | |

Other: 4% | 4% | |

Age (y) | 43 ± 19 | 46 ± 20 |

Height (cm) | 168 ± 10 | 167 ± 10 |

Weight (kg) | 76 ± 17 | 79 ± 20 |

BMI ($\mathrm{kg}\phantom{\rule{0.277778em}{0ex}}{\mathrm{m}}^{-2}$) | 27.1 ± 5.1 | 28.1 ± 6.3 |

WC (cm) | 94 ± 14 | 96 ± 16 |

ABSI (${10}^{-2}\phantom{\rule{0.277778em}{0ex}}{\mathrm{m}}^{11/6}\phantom{\rule{0.277778em}{0ex}}{\mathrm{kg}}^{-2/3}$) | 8.04 ± 0.52 | 8.10 ± 0.54 |

FMI ($\mathrm{kg}\phantom{\rule{0.277778em}{0ex}}{\mathrm{m}}^{-2}$) | 9.2 ± 3.8 [8.6 ± 2.0] | |

FFMI ($\mathrm{kg}\phantom{\rule{0.277778em}{0ex}}{\mathrm{m}}^{-2}$) | 18.1 ± 2.8 [17.9 ± 1.8] | |

TFMI ($\mathrm{kg}\phantom{\rule{0.277778em}{0ex}}{\mathrm{m}}^{-2}$) | 4.5 ± 2.1 [4.1 ± 0.9] | |

TFFMI ($\mathrm{kg}\phantom{\rule{0.277778em}{0ex}}{\mathrm{m}}^{-2}$) | 8.8 ± 1.3 [8.8 ± 0.9] | |

LFMI ($\mathrm{kg}\phantom{\rule{0.277778em}{0ex}}{\mathrm{m}}^{-2}$) | 4.3 ± 1.9 [4.1 ± 1.3] | |

LFFMI ($\mathrm{kg}\phantom{\rule{0.277778em}{0ex}}{\mathrm{m}}^{-2}$) | 8.0 ± 1.5 [7.8 ± 1.0] |

**Table 2.**Regression coefficients for body composition indices from DEXA versus simple anthropometric indices.

Index | Height | BMI | ABSI | ${\mathit{R}}^{2}$ |
---|---|---|---|---|

FMI | −0.362 | 1.830 | 1.246 | 0.930 |

FFMI | 0.140 | 0.611 | −0.364 | 0.912 |

TFMI | −0.867 | 2.183 | 2.354 | 0.918 |

TFFMI | 0.013 | 0.600 | −0.011 | 0.863 |

LFMI | 0.202 | 1.666 | 0.423 | 0.882 |

LFFMI | 0.491 | 0.672 | −0.764 | 0.879 |

Predictor | $\mathbf{\Delta}$ | ${\mathit{R}}^{2}$ | C |
---|---|---|---|

Baseline | 0 | 0.031 | 0.567 |

BMI | 79.3 | 0.056 | 0.581 |

ABSI | 115.1 | 0.064 | 0.602 |

FMI | 72.0 | 0.055 | 0.582 |

FFMI | 46.8 | 0.047 | 0.585 |

TFMI | 47.6 | 0.047 | 0.579 |

TFFMI | 31.1 | 0.043 | 0.583 |

LFMI | 80.3 | 0.057 | 0.586 |

LFFMI | 99.7 | 0.061 | 0.598 |

**Table 4.**The association of each body composition measure with mortality hazard when considered alongside simple anthropometrics.

Predictor | $\mathbf{\Delta}$ | ${\mathit{R}}^{2}$ | C |
---|---|---|---|

BMI + ABSI | 195.2 | 0.088 | 0.615 |

+FMI | 200.6 | 0.096 | 0.618 |

+FFMI | 207.5 | 0.097 | 0.620 |

+TFMI | 202.0 | 0.094 | 0.618 |

+TFFMI | 255.6 | 0.110 | 0.627 |

+LFMI | 200.9 | 0.097 | 0.620 |

+LFFMI | 222.4 | 0.100 | 0.619 |

+TFFMI + LFFMI | 317.6 | 0.130 | 0.635 |

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**MDPI and ACS Style**

Krakauer, N.Y.; Krakauer, J.C.
Association of X-ray Absorptiometry Body Composition Measurements with Basic Anthropometrics and Mortality Hazard. *Int. J. Environ. Res. Public Health* **2021**, *18*, 7927.
https://doi.org/10.3390/ijerph18157927

**AMA Style**

Krakauer NY, Krakauer JC.
Association of X-ray Absorptiometry Body Composition Measurements with Basic Anthropometrics and Mortality Hazard. *International Journal of Environmental Research and Public Health*. 2021; 18(15):7927.
https://doi.org/10.3390/ijerph18157927

**Chicago/Turabian Style**

Krakauer, Nir Y., and Jesse C. Krakauer.
2021. "Association of X-ray Absorptiometry Body Composition Measurements with Basic Anthropometrics and Mortality Hazard" *International Journal of Environmental Research and Public Health* 18, no. 15: 7927.
https://doi.org/10.3390/ijerph18157927