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T L Holt

Publications and source records attributed to T L Holt.

20 records · Page 2Linked to original sources

Clinical applicability of bioelectric impedance to measure body composition in health and disease.

The applicability of bioelectric impedance analysis (BIA) as a measure of body composition in children and young adults in both health and disease was studied in 155 subjects (5 mo to 54 yr of age) who were healthy (n = 21), had cystic fibrosis (n = 16), or had end-stage liver disease with variable clinical ascites or edema (n = 62). BIA and phase angle measured at a frequency of 50 kHz between the wrist and contralateral ankle by use of a tetrapolar measuring technique was compared with fat-free mass (FFM) estimated from skin-fold (SK) thickness measurements (n = 57), and body cell mass (grams potassium) measured by total-body potassium (TBK) counting. In a subgroup of subjects with end-stage liver disease, BIA was compared with total-body water measured by deuterium dilution (n = 21). High levels of correlation were found in healthy subjects, cystic fibrosis patients, and patients with end-stage liver disease when impedance (height2/resistance) was used to predict TBK (r = 0.96, 0.96, 0.98, respectively), and SK was used to predict FFMs (r = 0.96, 0.99, 0.90, respectively), by linear regression analysis. However, less satisfactory relationships were found when the methods were more appropriately analyzed with an estimated limits of agreement procedure (1 SD = 8.5, 5.0, 27.7% [TBK] and 9.4, 6.7, 23.0% [FFMs], respectively). A poor level of technique agreement (1 SD = 14%) was found when this method was compared with total-body water measured by isotope dilution in patients with liver disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Nutritional growth retardation is associated with defective lung growth in cystic fibrosis: a preventable determinant of progressive pulmonary dysfunction.

Evidence for a relationship between nutritional growth retardation in cystic fibrosis (CF) and progressive pulmonary dysfunction was evaluated by a prospective longitudinal study of changes in nutritional growth parameters, in relation to changes in pulmonary function data, in 61 moderately affected CF patients, aged 5-17 yr, during the equilibrated phase of lung growth. Age, sex, initial and serial weight and height Z scores, body cell mass (BCM) by total-body potassium (TBK) analysis, and changes in forced expiratory volume in 1 s (FEV1) and forced vital capacity (FVC), excluding data during pulmonary exacerbations, were analyzed by multiple regression analyses. The only significant predictor of change in FVC (best-fit model) was change in BCM, expressed as TBK (g/yr), TBK for age (percentage predicted), and TBK for height (percentage predicted) (p < 0.01). Standard anthropometric variables were not predictive. No reliable predictive model emerged for changes in FEV1. Relative decline in TBK for age was strongly predictive of decline in FVC (percentage predicted) accounting for 23% of this change. Patients with normal growth of the BCM had significantly less decline in FVC than those with retarded growth of the BCM (a fall of 2.5 vs. 6.8%/yr, p < 0.01). Impaired growth of the metabolically active BCM appears to be associated with progressive lung dysfunction in CF, possibly mediated by impaired lung growth. Achieving optimal nutrition and growth may minimize the progressive decline in pulmonary function commonly seen in this disease.

Adolescent↗