ArticleEuropean geriatric medicine2026
DXA-BIA discordance in low muscle mass and sarcopenia among older Korean adults under the AWGS 2025 criteria.
Article in European geriatric medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeTo compare dual-energy X-ray absorptiometry (DXA)- and bioelectrical impedance analysis (BIA)-based classifications of low muscle mass and sarcopenia under the Asian Working Group for Sarcopenia (AWGS) 2025 criteria.
methodsWe analyzed nationally representative 2024 Korea National Health and Nutrition Examination Survey data from 1178 adults aged ≥65 years with both DXA and BIA measurements (survey-weighted mean age, 72.1 years; 54.3% women). Sarcopenia analyses included 1121 participants with handgrip-strength data, including 131 with low handgrip strength. Low muscle mass was defined using modality-specific height-adjusted, body mass index (BMI)-adjusted, and combined height-or-BMI criteria. Survey weights were used for prevalence estimates, whereas agreement statistics were unweighted.
resultsUnder the combined criterion, low-muscle-mass prevalence was 83.0% by DXA and 55.5% by BIA; observed agreement was 65.4%, and Cohen's kappa was 0.246. Observed agreement was highest for the BMI-adjusted criterion (50.6% vs 41.1%; agreement, 79.8%; kappa, 0.598) and lowest for the height-adjusted criterion (70.8% vs 28.8%; agreement, 56.5%; kappa, 0.258). Among participants with low handgrip strength, combined low-muscle-mass prevalence was 93.1% by DXA and 80.3% by BIA, with 18 DXA-positive/BIA-negative and 4 DXA-negative/BIA-positive classifications. Sarcopenia prevalence was 10.0% by DXA and 8.7% by BIA (kappa, 0.895); 990 participants with normal handgrip strength were concordantly non-sarcopenic.
conclusionDXA and BIA yielded method-dependent low-muscle-mass classifications under AWGS 2025. Similar overall sarcopenia prevalence largely reflected the shared handgrip-strength requirement, whereas discordance persisted among participants with low handgrip strength.
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