{
  "abstract": "DXA and HR-pQCT are used for bone assessment but also image adjacent soft tissue. This pilot study examined association between HR-pQCT-measured leg muscle cross-sectional area (CSA) and density vs DXA-derived lean mass, and explored associations with muscle strength, power, and physical performance in adults with obesity. Patients eligible for bariatric surgery (BMI ≥ 30 kg/m²; ages ≥30) received baseline HR-pQCT (XtremeCT II) and DXA (Hologic) scans. HR-pQCT scans of the non-dominant leg were acquired at 30% of tibial length and processed using a custom Python script for muscle segmentation, followed by manual editing. Whole-body DXA scans were analyzed to extract lean mass for the total leg and subregions analogous to the HR-pQCT. Functional measures included gait speed (400-m walk), muscle power (12-step stair climb), and knee extensor strength (isokinetic dynamometer). Pearson correlations assessed relationships between imaging modalities and functional measures. Among 28 adults (ages: 47.7 ± 8.6; BMI: 43.8 ± 4.6 kg/m²), HR-pQCT muscle CSA and density averaged 36.0 ± 4.8 cm² and 60.1 ± 8.1 HU, respectively. DXA lean mass was 2.23 ± 0.40 kg for the total leg and 0.107 ± 0.019 kg for the 30% site. HR-pQCT muscle CSA correlated moderately with DXA lean mass (r = 0.57-0.69, p = .0017-<.0001), whereas HR-pQCT muscle density showed negligible correlations with DXA lean mass (r = -0.01-0.04, p = .84-0.96). Significant positive correlations were observed for DXA total leg lean mass with absolute muscle power (r = 0.40) and HR-pQCT muscle CSA with knee strength (r = 0.41; both p < .05). In adults with obesity, HR-pQCT and DXA may provide complementary measures of leg muscle quantity, with moderate association for CSA and lean mass, but limited associations with muscle density. Body weight and whole-body lean mass showed stronger correlations with stair climb power (r = 0.42-0.70) than localized leg muscle measures (r = 0.17-0.40). Muscle density and muscle quantity may capture different aspects of musculoskeletal health, warranting further investigation in larger samples.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Endocrinology, Esbjerg and Grindsted Hospital, University Hospital of Southern Denmark, 6700 Esbjerg, Denmark.",
    "Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense M, Denmark.",
    "Department of Regional Health Research, University of Southern Denmark, 5230 Odense M, Denmark.",
    "Department of Biomedical Engineering, Wake Forest University School of Medicine, Winston-Salem, NC 27101, United States.",
    "Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC 27109, United States.",
    "Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC 27157, United States.",
    "Department of Statistical Sciences, Wake Forest University, Winston-Salem, NC 27109, United States.",
    "Weight Management Center, Atrium Health Wake Forest Baptist, Winston-Salem, NC 27104, United States.",
    "Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC 27157, United States.",
    "McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada.",
    "Department of Biomedical Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB T2N 4Z6, Canada.",
    "Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada.",
    "Department of Internal Medicine, Section of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, United States."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 16,
  "authors": [
    {
      "affs": [
        0,
        1,
        2
      ],
      "name": "Søren Gam",
      "orcid": "0000-0002-2461-2824"
    },
    {
      "affs": [
        3
      ],
      "name": "Joshua R Stapleton",
      "orcid": "0000-0002-6501-1806"
    },
    {
      "affs": [
        4
      ],
      "name": "Vivian Jing",
      "orcid": "0009-0005-3036-4387"
    },
    {
      "affs": [
        3
      ],
      "name": "Eric Zeng",
      "orcid": "0009-0004-9335-0225"
    },
    {
      "affs": [
        3
      ],
      "name": "S Delanie Lynch",
      "orcid": "0000-0003-4074-4410"
    },
    {
      "affs": [
        3
      ],
      "name": "Nina Z Heilmann",
      "orcid": "0000-0003-3195-7713"
    },
    {
      "affs": [
        3
      ],
      "name": "Kristin Cattell",
      "orcid": "0009-0001-9092-0454"
    },
    {
      "affs": [
        4
      ],
      "name": "Lori S Cogdill",
      "orcid": "0009-0009-1392-4302"
    },
    {
      "affs": [
        4
      ],
      "name": "Catherine MacLean",
      "orcid": "0009-0001-6396-8698"
    },
    {
      "affs": [
        4
      ],
      "name": "Sherri A Ford",
      "orcid": "0000-0002-3162-2174"
    },
    {
      "affs": [
        5
      ],
      "name": "Marjorie J Howard",
      "orcid": "0000-0003-1799-2563"
    },
    {
      "affs": [
        6
      ],
      "name": "Daniel P Beavers",
      "orcid": "0000-0002-4286-9463"
    },
    {
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        7,
        8
      ],
      "name": "Jamy D Ard",
      "orcid": "0000-0002-1643-6795"
    },
    {
      "affs": [
        9,
        10,
        11
      ],
      "name": "Steven K Boyd",
      "orcid": "0000-0002-2930-5997"
    },
    {
      "affs": [
        3
      ],
      "name": "Ashley A Weaver",
      "orcid": "0000-0002-4383-0106"
    },
    {
      "affs": [
        4,
        12
      ],
      "name": "Kristen M Beavers",
      "orcid": "0000-0002-7786-4195"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/a06wdktfe04xe.bib",
  "cited_by": 0,
  "doi": "10.1093/jbmrpl/ziag158",
  "fulltext_url": "https://europepmc.org/articles/PMC13644820",
  "id": "a06wdktfe04xe",
  "issns": [
    "2473-4039"
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  "landing_url": "https://europepmc.org/article/MED/42847042",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
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      "openalex",
      "2737|Body Composition Measurement Techniques"
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  "pdf_url": "https://europepmc.org/articles/PMC13644820?pdf=render",
  "pmcid": "PMC13644820",
  "pmid": "42847042",
  "published": "2026-09-22",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/a06wdktfe04xe.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:18:10Z",
      "native_id": "MED:42847042",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42847042"
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  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2737|Body Composition Measurement Techniques",
      "subfield": "physiology"
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  ],
  "title": "Leg muscle assessment by HR-pQCT and DXA: associations between imaging measures and muscle function in adults with obesity-a pilot study.",
  "title_text": "Leg muscle assessment by HR-pQCT and DXA: associations between imaging measures and muscle function in adults with obesity-a pilot study.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:18:10Z",
  "url": "https://research.draconitic.com/paper/a06wdktfe04xe",
  "venue": "JBMR plus",
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