WITH INCIDENCE of osteoporosis and obesity, both caused due to endocrinal problems, increasing it has become imperative for the medical fraternity to know the exact extent of damage in terms of correct weight of bones, muscle and fat and not just rely on height and weight to know the bone mass density.
Considered as the gold standard technology, the DEXA (Dual Energy X-ray Absorptiometry) machine helps endocrinologists in two important diagnoses, one to know exact bone density for detecting osteoporosis and the other to ascertain body composition for detailed obesity analysis, according to endocrinologists Dr Sunil Jain of Diabetes, Thyroid, Hormone Research Institute at New Palasia, who has installed the first ever DEXA machine at his clinic recently.
Osteoporosis is a condition, which affects women after menopause and men after 60 years of age, involves gradual loss of calcium in the body resulting in thinner and fragile bones, which are likely to fracture due to slightest pressure while a person is known to be obese if his Body Mass Index (BMI) – measure of body fat based on height and weight – is more than 30.
The DEXA machine has a scanner, which goes over the patient’s body. With almost no radiation, which is its greatest advantage, the machine sends two very thin beams of x-ray (basically photon rays). The two rays – one each mapping the muscle (soft tissue) and the bone — give feedback to two softwares, which give exact picture of the patientt’s bone density and the body composition.
“This is what has helped us a lot. Now we know exactly how much of bone, fat and muscle are present in any person. Earlier, with ultra sound methods, where we could not know these, it was more or less an assumption that with age, the person must have got osteoporosis or a woman in this age group, like after menopause, must be having lesser bone mass index,” according to Dr Jain.
“Longetivity in India is increasing so diagnosis in time would always prevent the onset of osteoporosis, particularly for those above 50 years,” he adds. The machine analysis gives very clear indication about osteopenia i.e. early stage of bone loss or significant osteoporosis.
Based on this there are five modalities of treatment, says Dr Jain. “Of these five modalities, four can stop further bone loss thus preventing deterioration while the fifth is an injectible dose, which actually increases the bone mass,” according to Dr Jain.
An added advantage is that the machine is not just a diagnostic tool but also can be used as a monitoring tool. In case of obesity, merely knowing weight and height does not give actual picture, but the machine gives the exact bone weight, fat quantity and the muscle, so a targeted approach – so many grams of fat is extra – is possible in obesity management, says the endocrinologist, who did his DM from PGI Chandigarh, a premier institute for endocrinology.
“It is important to know that when a patient needs weight loss, it has necessarily to be fat loss and not the muscle. Otherwise, crash diet courses strip you of your muscle, which tends to increase weight with vengeance after the diet programme stops,” he points out and adds, “The DEXA figures give us a real time picture of body composition in terms of fat, bone and muscle and accordingly the patient can be monitored for fat reduction only.”
The whole procedure hardly takes 15-20 minutes and the results are there in front of the patient to see so that he can be convinced to alter his lifestyle. Apart from the medication, a slight change in diet is recommended but it’s a healthy lifestyle that counts in the long run.