Can forearm bone mineral density be measured with dxa in the supine position? A study in Chinese population

The purpose of our study was to confirm that forearm bone mineral density (BMD) results obtained with the patient in the supine position are equivalent to results obtained with patient in the sitting position. The subjects were a Chinese sample of 82 healthy adults (35 males and 47 females; age: 22.5-59.8 yr; body mass index: 17.6-32.4). Forearm BMD was measured by dual-energy X-ray absorptiometry, with the forearm positioned in the sitting and supine positions. Repeated measurements were available for some subjects, and the average of the repeats for those subjects were used in the analysis. The standard enCORE software (GE Lunar, Madison, WI) adjustment for supine position was applied to the BMD values obtained in the supine position for 33% radius, ultradistal (UD) radius, and radius total regions of interest (ROIs) to give sitting-equivalent values. The supine sitting-equivalent results were regressed on the sitting values through the origin. There were statistically significant differences in the UD and total-radius forearm results between supine sitting-equivalent BMD and sitting BMD. The correlation coefficients of UD and total radius were 0.967 and 0.976, respectively. There was no significant difference between supine sitting-equivalent BMD and sitting BMD in the 33% radius forearm BMD. The correlation coefficient of 33% radius was 0.956. For Chinese subjects, there was no significant difference in BMD for the 33% radius, the only ROI recommended for diagnosis by ISCD. Forearm scans could be accomplished with the patient suitably positioned for the routine lumbar spine and proximal femur scans.