Comparison of the ability between dual‐energy X‐ray absorptiometry and bioelectrical impedance analysis for diagnosing low skeletal muscle mass and sarcopenia in patients with chronic liver disease

Abstract Background and Aim Sarcopenia and osteoporosis adversely impact the clinical outcomes of patients with chronic liver disease (CLD). The Japan Society of Hepatology (JSH) sarcopenia criteria utilize bioelectrical impedance analysis (BIA) for assessing muscle mass rather than dual‐energy X‐ray absorptiometry (DXA), which can simultaneously diagnose these comorbidities. We investigated the correlations and interchangeability between the appendicular skeletal muscle mass index (ASMI) values determined using BIA and DXA and evaluated the diagnostic ability of DXA for sarcopenia and osteosarcopenia in patients with CLD. Methods This cross‐sectional study included 173 patients with CLD. Sarcopenia was defined as low ASMI BIA according to the JSH and Asian Working Group for Sarcopenia (AWGS) criteria (ASMI BIA cutoff ) or low ASMI DXA according to the AWGS criteria (ASMI DXA cutoff ) and low handgrip strength. For women, a provisional cutoff value was set for ASMI DXA using the ASMI BIA cutoff (ASMI DXA‐altered cutoff ). Results We found that ASMI BIA and ASMI DXA were significantly correlated ( r = 0.921; P < 0.001). The Bland–Altman plots demonstrated substantial agreement between ASMI BIA and ASMI DXA , with a mean difference of 0.0116 kg/m 2 . The prevalence rates of sarcopenia and osteosarcopenia diagnosed using the ASMI BIA cutoff were 26.0% and 17.3%, respectively. The kappa coefficients for the prevalence of sarcopenia and osteosarcopenia were 0.759 and 0.775 between ASMI BIA cutoff and ASMI DXA cutoff and 0.780 and 0.806 between ASMI BIA cutoff and ASMI DXA‐altered cutoff , respectively. Conclusions The utilization of DXA can facilitate the comprehensive assessment and management of musculoskeletal comorbidities in patients with CLD.