A Brief Review of the Literature for Published Dual-Energy X-Ray Absorptiometry Protocols for Athletes

Abstract

Context: Dual-energy x-ray absorptiometry (DXA) is widely known for its utility in diagnosing a patient with osteopenia or osteoporosis; however, its utility in evaluation of body composition and potential athletic performance was previously routinely overlooked. In recent years, athletic programs have begun employing this equipment during athlete screening. However, it is currently unknown how athletic programs are utilizing this information to guide an athlete’s training and health. Objective: To explore the literature to identify what is known regarding sports performance and athlete health based on body composition recordings. Data Sources: PubMed and Google Scholar databases were searched for this brief review. Study Selection: A focus was placed on articles within the past 10 years that discussed DXA protocols within athletic populations; 14 articles were included in this brief literature review. Study Design: Brief literature review. Level of Evidence: Level 5. Data Extraction: One member of the research team searched the literature and retrieved articles with the purpose of analyzing and/or explaining DXA imaging in body composition analysis of active persons (primarily athletes). Results: Quality assurance scans with a phantom calibration block as well as athlete prescreening condition and activity standardization was routinely recommended. However, only 1 study reported a specific DXA protocol for athletes, and only 1 study described guidelines for how to report DXA results in athletic populations, suggesting it is plausible yet difficult due to the small changes detectable. Conclusion: Due to the limited literature as well as a lack of reference values for specific athletic populations, the authors of this review recommend using the current Nana et al ( Int J Sport Nutr Exerc Metab 2015;25:198-215) DXA protocol for performing DXA scans in the athletic population as well as current Hind et al ( J Clin Densitom 2018;21:429-443) guidelines for distributing the information.