Estimation of lean body weight in older community-dwelling men

Mitchell, Sarah J., Kirkpatrick, Carl M. J., Le Couteur, David G., Naganathan, Vasi, Sambrook, Philip N., Seibel, Markus J., Blyth, Fiona M., Waite, Louise M., Handelsman, David J., Cumming, Robert G. and Hilmer, Sarah N. (2010) Estimation of lean body weight in older community-dwelling men. British Journal of Clinical Pharmacology, 69 2: 118-127. doi:10.1111/j.1365-2125.2009.03586.x

Author Mitchell, Sarah J.
Kirkpatrick, Carl M. J.
Le Couteur, David G.
Naganathan, Vasi
Sambrook, Philip N.
Seibel, Markus J.
Blyth, Fiona M.
Waite, Louise M.
Handelsman, David J.
Cumming, Robert G.
Hilmer, Sarah N.
Title Estimation of lean body weight in older community-dwelling men
Journal name British Journal of Clinical Pharmacology   Check publisher's open access policy
ISSN 0306-5251
Publication date 2010-02
Year available 2009
Sub-type Article (original research)
DOI 10.1111/j.1365-2125.2009.03586.x
Volume 69
Issue 2
Start page 118
End page 127
Total pages 10
Editor Begg, E. J.
Ritter, J. M.
Lennard, M. S.
Place of publication Oxford, U.K.
Publisher Wiley-Blackwell Publishing
Collection year 2010
Language eng
Subject C1
110308 Geriatrics and Gerontology
111502 Clinical Pharmacology and Therapeutics
920199 Clinical Health (Organs, Diseases and Abnormal Conditions) not elsewhere classified
Formatted abstract

• Lean mass decreases with age while total body fat increases, leading to changes in the pharmacokinetics and pharmacodynamics of drugs.

• Dual-energy X-ray absorptiometry (DXA) is a useful reference method to measure lean body weight but may not be readily utilized clinically.

• Limited methods for measurement of lean body weight using easily obtainable participant characteristics, such as height and weight, have been validated for use in people aged ≥65 years.


• This study has shown that lean body weight can be estimated using three different equations from easily obtainable participant characteristics with results comparable to DXA-derived estimates.

• These equations may be useful tools to estimate lean body weight in situations where DXA is not practical.


Lean body weight (LBW) decreases with age while total body fat increases, altering drug pharmacokinetics. The aim of this study was to evaluate the ability of the LBW equation to predict dual-energy X-ray absorptiometry (DXA)-derived fat free mass (FFMDXA) in older community-dwelling males compared with that of two existing FFM equations: the Heitmann and Deurenberg equations.


Data were obtained from 1655 older men enrolled in the Concord Health and Ageing in Men Project. The predictive performance of the LBW and FFM equations to predict FFMDXA accurately was assessed graphically using Bland–Altman plots and quantitatively for precision and bias using the method of Sheiner and Beal in all participants and in frailty and body mass index (BMI) subgroups.


The LBW and Heitmann equations consistently overestimated FFMDXA for all frailty and BMI subgroups with a mean difference [95% confidence interval (CI)] of 5.5 kg (−0.65, 11.63 kg) and 3.34 kg (−2.84, 9.64 kg), respectively. The Deurenberg equation overestimated FFMDXA for overweight participants but underestimated FFMDXA for not-frail participants, with a mean difference (95% CI) of 1 kg (−7.23, 5.25 kg) for all participants.


LBW and FFM estimated using these equations give results comparable to DXA-derived FFM. The LBW and Heitmann equations provide a more consistent estimate of FFMDXA in all frailty and BMI groups despite the Deurenberg equation having the smallest mean difference. Further studies to determine whether the LBW equation is a clinically useful substitute for weight when determining drug dose in older people appear warranted.
© 2010 The Authors
Keyword Community dwelling
Lean body weight
Older men
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: 2010 Higher Education Research Data Collection
2010 Higher Education Research Data Collection
School of Pharmacy Publications
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Citation counts: TR Web of Science Citation Count  Cited 10 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 11 times in Scopus Article | Citations
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Created: Sun, 07 Feb 2010, 00:08:07 EST