Changes in fat and skeletal muscle with exercise training in obese adolescents: comparison of whole-body MRI and dual energy X-ray absorptiometry

OBJECTIVE We examined skeletal muscle (SM) and fat distribution using whole-body MRI in response to aerobic (AE) versus resistance exercise (RE) training in obese adolescents and whether DXA provides similar estimates of fat and SM change as MRI. DESIGN AND METHODS Thirty-nine obese boys (12-18 years) were randomly assigned to one of three 3-month interventions: AE (n = 14), RE (n = 14), or a control (n = 11). RESULTS At baseline, MRI-measured total fat was significantly greater than DXA-measured total fat [△ = 3.1 kg (95% CI: -0.4 to 7.4 kg, P < 0.05)], wherein underestimation by dual energy X-ray absorptiometry (DXA) was greatest in those with the highest total fat. Overall, the changes in total fat were not significantly different between MRI and DXA [△ = -0.4 kg (95% CI: -3.5 to 2.6 kg, P > 0.05)], but DXA tended to overestimate MRI fat losses in those with larger fat losses. MRI-measured SM and DXA-measured lean body mass were significantly correlated, but as expected the absolute values were different at baseline [△ = -28.4 kg (95% CI: -35.4 to -21.3 kg, P < 0.05)]. Further, DXA overestimated MRI gains in SM in those with larger SM gains. CONCLUSIONS Although DXA and MRI-measured total and regional measures tended to be correlated at baseline and changes with exercise, there were substantial differences in the absolute values derived using DXA versus MRI. Further, there were systemic biases in the estimation between the methods wherein DXA tended to overestimate fat losses and SM gains compared to MRI. Thus, the changes in body composition observed are influenced by the method employed.