OBJECTIVES: Sarcopenia is one of the physiological change associated with aging, which is defined as a loss of muscle mass, muscle strength and physical functions. As the elderly population has increased substantially, the prevalence of sarcopenia is increasing. This study aims to evaluate the effectiveness of body composition analysis using dual-energy x-ray absorptiometry (DEXA) for diagnosing sarcopenia.

METHODS: We conducted a literature review to assess the effectiveness of DEXA in body composition analysis for diagnosing sarcopenia. We collected guidelines from the Guidelines International Network, the Korean Medical Guideline Information Center, and six clinical society websites, as well as conducted additional manual searches.

RESULTS: We reviewed 13 guidelines and articles on expert consensus from eight professional groups, including the European Working Group on Sarcopenia in Older People, International Conference on Sarcopenia and Frailty Research, European Society of Clinical Nutrition and Metabolism, Foundation for the National Institutes of Health, Asian Working Group for Sarcopenia, Sarcopenia study group of Korean Geriatrics Society, International Society for Clinical Densitometry, and International Working Group on Sarcopenia.

All the professional groups recommended evaluating three factors—muscle mass, muscle strength, and physical performance—for the diagnosis of sarcopenia; the decrease in muscle mass should be measured using DEXA, and appendicular skeletal muscle mass (ASM) or appendicular lean mass (ALM) should be measured by the indicators adjusted for height or BMI.

The thresholds for muscle mass reduction were 6.43 - 7.26 kg/m² for men and 5.34 - 6.0 kg/m² for women in the case of height-adjusted ASM, 0.786 m² for men and 0.512 m² for women with BMI-adjusted ALM, and 7.23 kg/m² for men and 5.67 kg/m² for women with height-adjusted ALM.

CONCLUSIONS: Guidelines and articles published in eight professional groups in worldwide recommend the use of DEXA for for the diagnosis of sarcopenia. Therefore, DEXA is useful for diagnosing sarcopenia in patients with suspected sarcopenia.