Journal homepage: https://medicinskiglasnik.ba Med Glas (Zenica) 2025;22(1) https://doi.org/10.17392/1870-22-01 | Submitted: 07. Aug. 2024. Revised: 20 Nov. 2024. Accepted: 21 Nov. 2024. This article is an open-access article licensed under CC-BY-NC-ND 4.0 license (https://creativecommons.org/licenses/by-nc-nd/4.0/) ORIGINAL ARTICLE Impact of age and body mass index on dual-energy X-ray absorptiometry scan results in postmenopausal women Halil Ćorović 1* , Nusret Salkica 1 , Naida Omerović Ćorović 2 , Šejla Cerić 1 , Selma Agić-Bilalagić 1 , Amra Skopljak- Beganović 1 , Enis Tinjak 1 1 Clinical Centre University of Sarajevo, Sarajevo, Bosnia and Herzegovina; 2 University of Sarajevo, Faculty of Pharmacy, Sarajevo, Bosnia and Herzegovina ABSTRACT Aim To analyse the impact of age and body mass index (BMI) on dual-energy X-ray absorptiometry (DXA) scan results in postmenopausal women. Methods The study included 100 postmenopausal women who underwent the DXA procedure, out of which 50 had a normal BMI and 50 were overweight/obese. Data that were examined included age, BMI, T-score of the lumbar region and the femoral neck, as well as bone mineral density (BMD). Correlation results were presented as Pearson’s correlation coefficient (r). Results The T2-score and BMD2 were significantly lower in older patients compared to younger ones (p=0.008 and p=0.007, respectively). Post hoc test results showed that the T2-score and BMD2 were significantly lower in patients ≥71 years of age compared to patients ≤59 years of age (p=0.006 and p=0.005, respectively). Also, T1- and T2-scores, as well as BMD1 and BMD2, were significantly higher in overweight/obese patients (p<0.001 and p=0.003; p<0.001 and p=0.002, respectively). The correlation between BMI and the T1-score was moderate (r=0.429), between BMI and the T2-score weak (r=0.348), between BMI and BMD1 moderate (r=0.431), and between BMI and BMD2 weak (r=0.344). Conclusion Our study showed that both age and BMI are important factors affecting DXA procedures and should be taken into account with each postmenopausal woman individually in everyday practice. Keywords: body weight, densitometry, postmenopause INTRODUCTION Accurate body composition assessment is essential for evaluat- ing health status and disease risk across diverse populations. Dual-energy X-ray absorptiometry (DXA) has emerged as a precise tool for quantifying fat mass, lean mass, and bone min- eral density (BMD), offering crucial insights for clinical deci- sion-making and research (1). However, interpreting DXA scans is complex and influenced by various factors, including the age and body mass index (BMI). This index, calculated from an individual’s height and weight, serves as a widely used proxy for body fatness and significantly impacts DXA meas- urements, highlighting variations in fat distribution and lean mass composition with increasing BMI (2). These variations underscore the importance of considering BMI when interpret- ing DXA scans, especially in clinical settings where accurate body composition assessment informs management strategies for obesity-related conditions and overall health (3). Bones naturally become thin with age. The level of calcium and other minerals decreases as people age, resulting in lower bone weight and density, and thus increased fragility. Greater bone thickness is a protective factor related to osteoporosis development (4). Several prospective studies have indicated that underweight (BMI ≤18.5) women lose more bone density and have a higher risk of osteoporotic fractures compared to those of average weight (5–7). While BMI impacts osteoporosis development, BMD could be the primary risk factor for osteo- porosis and fractures. This hypothesis was tested and the results suggested that BMD rather than BMI mediates fracture risk (8). Other radiological procedures could be applied to post- menopausal women for these purposes, such as vertebral frac- ture assessment, trabecular bone score, and quantitative com- puted tomography, but DXA is still a standard procedure and has a fundamental place in routine analyses (9). Unfortunately, this problem has not been sufficiently well examined in Bosnia and Herzegovina (B&H), although there is no objective obstacle to it, because DXA is a routine procedure in clinical centres in B&H, and the most frequent patients are women, many of whom are postmenopausal. The aim of this study was to analyse the impact of age and BMI on DXA scan results in postmenopausal women. The authors decided to conduct this study in order to deep- en the understanding of how these factors affect the interpreta- tion of DXA scans in clinical and research settings, especially when it comes to quantifying BMD. The obtained data will serve *Corresponding author: Halil Ćorović Phone: +387 33 298 310 E-mail: halil.corovic@live.com ORCID: https://orcid.org/0000-0003-1197-9085