Lunar prodigy advance

Body composition analysis was assessed by dual energy X-ray absorptiometry (DXA) (GE Healthcare Lunar Prodigy Advance, GE Medical Systems, Milan, Italy), which is said to be the gold standard for body composition measurements in obese patients. Subjects were instructed to avoid excess physical effort in the 24 h before the analysis. The DXA measurement was performed in the morning, after a night's rest, fasting. Subjects were instructed in detail regarding the measurement procedure. During the procedure, patients wore cotton T-shirts, shorts, and socks with no metal, rubber, and plastic objects, and laid on the DXA table supine and motionlessly. The same trained operator positioned the subjects, performed the DXA scans, and executed the analysis according to the operator's manual, using the standard analysis protocol. The standard scan mode (for moderately obese subjects) or the thick scan mode (for extremely obese subjects), with absorbed radiation doses of 0.4 μGy and 0.8 μGy, respectively, were used. The intrasubject and intersubject coefficients of variation (CV% = 100 × standard deviations [SD]/mean) ranged from 1% to 5%. The coefficient of variation for the bone mass measurements was <1%. Anthropometric and DXA measurements are described in detail in our previous studies.^{[16 (link),30 (link),31 (link)]}

Anthropometric measurements were taken with subjects wearing light clothing and no shoes. BMI was calculated as weight divided by the square of height (kg/m²). Obesity was defined as BMI ≥ 30 kg/m². Waist circumference (cm) was measured at the level of the iliac crest at the end of normal expiration. Hip circumference was measured at the maximum protuberance of the buttocks.
Body composition analysis was assessed using dual-energy X-ray absorptiometry (DXA; GE Healthcare Lunar Prodigy Advance, GE Medical Systems, Milan, Italy). Subjects were given complete instructions on the body composition analysis procedure and were instructed not to make any intense physical effort in the 24 h prior to body composition measurement. Total body fat mass (TBFM) was determined using standard scan mode (in the case of normal body weight and moderately obese subjects) or thick scan mode (in the case of extremely obese subjects); the absorbed doses of radiation were 0.4 and 0.8 μGy, respectively. Total body skeletal muscle mass (TBSMM) was calculated from appendicular lean soft tissue (ALST)—evaluated using DXA and the skeletal-muscle-prediction model created by Kim et al. [14 (link)]: $TBSMM=\left(1.13\times ALST\right)-\left(0.02 \times age \right)+\left(0.61 \times sex \right)+0.97$ (sex = 0 for female).

Visceral adiposity index (VAI) was calculated using the formula developed by Amato et al. [15 (link)]: $\mathrm{Females}:\mathrm{VAI}=\left(\frac{\mathrm{waist} \mathrm{circumference}}{36.58+\left(1.89 \times \mathrm{BMI}\right)}\right)\times \left(\frac{\mathrm{TG}}{0.81}\right)\times \left(\frac{1.52}{\mathrm{HDL}}\right)$
Total-body skeletal muscle mass was calculated using the skeletal muscle-prediction model created by Kim et al. [16 (link)]. The total-body skeletal muscle mass model is based on appendicular lean soft tissue (ALST), evaluated using dual-energy X-ray absorptiometry (DXA) and sex (0 = female; 1 = male).
Total-body skeletal muscle mass = (1.13 × ALST) − (0.02 × age) + (0.61 × sex) + 0.97
Body composition was analyzed using dual-energy X-ray absorptiometry (DXA; GE Healthcare Lunar Prodigy Advance, GE Medical Systems, Milan, Italy).