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Body composition and water compartment measurements in boys with Duchenne muscular dystrophy.

OBJECTIVE: Duchenne muscular dystrophy (DMD) patients have a lower percentage of total body water and higher extracellular water to intracellular water (ECW/ICW) ratio compared with normal subjects. However, it is not known whether this is due to increased fat mass or a decreased amount of ICW in muscle cells in DMD patients. The purpose of this study was to (1) determine the effect of increased fat mass and decreased lean mass on the ECW to ICW ratio in DMD patients and to (2) determine the validity of multifrequency bioelectrical impedance analysis (MFBIA) in assessing body composition in DMD patients. DESIGN: This study has a quasi-experimental, comparative design using nonequivalent groups. A total of 46 boys ranging from 6 to 13 yrs of age participated in this study. There were 12 nonobese able-bodied controls, 19 obese able-bodied children (obese), and 15 boys with DMD. Body composition was measured by dual-energy x-ray absorptiometry (DEXA). Body composition and body water compartment analysis were assessed by MFBIA. All measurements obtained using MFBIA were compared with those obtained using DEXA for validation. RESULTS: Both MFBIA and DEXA measures were strongly correlated in control (r = 0.99), obese (r = 0.92), and DMD subjects (r = 0.95). However, lean tissue mass measured by DEXA in the DMD subjects was only slightly higher (19.2 +/- 1.1 vs. 18.2 +/- 1.2, P < 0.02) than as measured by MFBIA. Mean percentage of body fat measured by DEXA in the DMD subjects (30.4 +/- 3.1%) was significantly lower than as measured by MFBIA (38.7 +/- 2.2%). The mean percentage of body fat measured by DEXA in the control group (23.2 +/- 1.8%) was significantly (P < 0.001) lower than as measured by MFBIA (28.6 +/- 1.6%). The mean percentage of body fat measured by DEXA in obese able-bodied controls (40.8 +/- 0.9%) was not significantly different from that measured by MFBIA (40.4 +/- 1.5%). Compared with the obese and control subjects, DMD subjects showed reduced ICW and ECW, with an increased ECW/ICW ratio, as expected. However, the percentage of fat for the DMD group was not different from the obese group. CONCLUSIONS: DMD patients have elevated ECW/ICW ratios compared with obese subjects and nonobese controls. However, obese subjects and nonobese controls had similar ECW/ICW ratios, despite the increased fat tissue mass in obese subjects. This suggests that the elevated ECW/ICW ratios in DMD subjects are not due to increased fat mass but rather some other mechanism, likely impaired cellular homeostasis due to muscle membrane instability. Although MFBIA slightly underestimates lean tissue mass in boys with DMD, it has a potential role as an inexpensive and easy to use measurement tool to measure changes in muscle mass in the clinical setting.

Absorptiometry, Photon↗

Effects of tibolone on body composition in postmenopausal women: a 1-year follow up study.

OBJECTIVE: We investigated the effects of 1-year tibolone treatment on body weight, body composition and indices of android obesity in postmenopausal women. METHODS: Forty-four postmenopausal women participated in this open-label controlled study; mean age was 51.8+/-2.21 years and all women were menopausal for 3.8+/-1.40 years. Twenty-two of them started taking 2.5 mg tibolone (TIB) daily for 1 year, whereas the remaining 22 served as age-matched controls. All subjects underwent a structured interview, physical examination, body composition measurements performed by dual-energy X-ray absorptiometry (DXA) - Hologic QDR 4500 A, as well as bioelectrical body impedance analysis (BI) - Tanita TBF-215, Japan. RESULTS: The TIB group did not significantly increase their weight (+0.4 kg), while the non-treated controls increased their mean weight by 1.4 kg (p=0.046). In the TIB group, DXA showed a non-significant body fat decrease by a mean of 0.5 kg and a non-significant lean mass increase by 0.8 kg, while in the control group, fat mass increased by 1.7 kg (p=0.032) and lean mass did not change. BI revealed that the TIB group had lost some fat ( approximately 0.6 kg, n.s.) and put some free-fat mass ( approximately 1.0 kg, p=0.048) without changes in total body water. The control group put on some fat ( approximately 1.1 kg, p=0.042) and lost some body water ( approximately 0.4 kg, n.s.). CONCLUSION: Results from both methods of measuring body composition show a similar trend: a decrease in fat mass and an increase in lean mass in TIB treated subjects. From the body composition perspective, tibolone may be regarded as a preferential alternative to conventional hormonal therapy (HT) in postmenopausal women.

Absorptiometry, Photon↗

Determination of body composition using air displacement plethysmography, anthropometry and bio-electrical impedance in rural elderly Mexican men and women.

BACKGROUND AND AIMS: Air displacement plethysmography with the BOD-POD is a new densitometry technique, and has been found to be an accurate method to measure body composition. The aim of this study was to assess body composition in a group of free living healthy subjects 60 years of age or older from a rural area of Northwest Mexico, and to evaluate body composition by anthropometry and bioelectrical impedance (BIA) using equations reported for other elderly populations. METHODS: Body composition was evaluated in 21 women and 26 men with the BOD-POD, by anthropometry, and BIA and compared to different equations using the Bland- Altman procedure. RESULTS: Body fat in elderly women and men was 42.7 and 30.2 % respectively. In women, Segal's equation using BIA 1, based on standing height, showed no significant differences with the BOD-POD. There was satisfactory agreement between Segal's equation and BOD-POD. In men similar results was found with Deurenberg's equation using B1A 2 based on recumbent length. CONCLUSIONS: Segal's and Deurenberg's equations were accurate and precise for the estimation of body fat in the elderly of this study. The use of these equations could improve the estimation of body composition for similar elderly subjects. Further studies are recommended with a larger size samples to include elderly subjects from other Latin American countries.

Aged↗

Relation between maternal body composition and birth weight.

In order to establish the relationship between maternal body composition indicators (fat-free mass, fat mass, total body water) and birth weight, a cross-sectional study was designed, based on 196 pairs of mothers and live singleton newborns with gestational age of 37 weeks or more. Immediately after delivery, the mothers were interviewed to obtain information about different birth weight predictors. An analysis of maternal body composition through bioelectric impedance was held. Multiple linear regression was used to measure the effect of each variable on birth weight. The birth weight mean was 3,251 +/- 514 g. Maternal height was 160.44 +/- 6.3 cm, total net weight gain was 5.85 +/- 5.15 kg, fat mass consisted of 15.84 +/- 6.72 kg, and fat-free mass was 50.42 +/- 7.65 kg; total body water was 34.82 +/- 5.61 liters. The model which included total body water and all predictors found to be associated with birth weight in the bivariate analysis (maternal age, gestational age, gender, placenta weight, and placenta weight squared) was found to be the best in explaining the variability of birth weight (R(2) = 45.26%). Fat mass was an important predictor only in the subgroup of women within the low tertile of body mass index. In conclusion, fat-free mass and total body water explained a major proportion of the variability of birth weight in comparison with the mother's weight gain during the pregnancy period, which has already been considered an important predictor of birth weight.

Adipose Tissue↗

Measuring body composition in overweight individuals by dual energy x-ray absorptiometry.

BACKGROUND: Dual energy x-ray absorptiometry (DXA) is widely used for body composition measurements in normal-weight and overweight/obese individuals. The limitations of bone densitometers have been frequently addressed. However, the possible errors in assessing body composition in overweight individuals due to incorrect positioning or limitations of DXA to accurately assess both bone mineral density and body composition in obese individuals have not received much attention and are the focus of this report. DISCUSSION: We discuss proper ways of measuring overweight individuals and point to some studies where that might not have been the case. It appears that currently, the most prudent approach to assess body composition of large individuals who cannot fit under the scanning area would be to estimate regional fat, namely the regions of thigh and/or abdomen. Additionally, using two-half body scans, although time consuming, may provide a relatively accurate measurement of total body fat, however, more studies using this technique are needed to validate it. SUMMARY: Researchers using bone densitometers for body composition measurements need to have an understanding of its limitations in overweight individuals and address them appropriately when interpreting their results. Studies on accuracy and precision in measurements of both bone and soft tissue composition in overweight individuals using available densitometers are needed.

Journal Article↗

Body composition of a young, multiethnic female population.

The study objective was to establish the range of body-composition values for a multiethnic female population (aged 3-18 y) by using dual-energy X-ray absorptiometry (DXA). Results for 313 females in three ethnic groups [European American (white), n = 141; African American (black), n = 104; and Mexican American (Hispanic), n = 68] are reported. Changes in the bone mineral content (BMC), lean tissue mass (LTM), fat mass, and percentage fat are presented as functions of age. Analysis of variance with age, weight, and height as covariates was used to evaluate differences among the three ethnic groups. BMC and LTM were higher in the black than the white females, but no significant difference in BMC or LTM was evident between the white and Hispanic groups. The relation between the BMC and LTM compartments was linear (r = 0.963, P < 0.0005) and independent of age or ethnic classification. The Hispanic and black females had higher percentage fat values than the white group. When adjusted for body size, the Hispanic females continued to have significantly higher fat mass and percentage fat than the white females in this study. Ethnic-specific equations for body composition as a function of age, weight, and height are given. In addition, the results for the white females in the present study were compared with DXA-derived body-composition data for reference populations in other countries. We conclude that reference values of total body composition for young females need to be ethnic-specific.

Adolescent↗

The effects of two doses of replacement growth hormone on the biochemical, body composition and psychological profiles of growth hormone-deficient adults.

This study examined the effects of growth hormone (GH) replacement on the insulin-like growth factor-I (IGF-I), body composition and psychological profiles of GH-deficient adults. We assessed whether two doses of GH produced different effects on these variables and whether patients who, at the end of the study chose to remain on long-term GH replacement responded differently to those who chose to abandon therapy. Forty-two adults (aged 42.9 +/- 1.9 years (mean +/- S.E.M.)) with documented GH deficiency entered two studies (24 in study 1, 18 in study 2). Biochemical, body composition and psychological profiles were assessed at baseline, and after 6 months and 1 year. Psychological assessments were performed using well-established, independent, validated 'Quality of Life' questionnaires (Nottingham Health Profile (NHP) and the Psychological General Well-Being Schedule (PGWB)). The study protocols differed only in the doses of growth hormone (0.024 mg/kg per day and 0.012 mg/kg per day respectively). Comparison between studies and between patients eventually continuing and abandoning GH therapy was performed. GH replacement was associated with significant changes in IGF-I levels (P < 0.001), body composition (P < 0.01) and self-perceived well-being (NHP, P < 0.01; PGWB, P < 0.01). The higher dose of GH produced a greater IGF-I response than the lower dosage (44.6 +/- 7.3 vs 26.2 +/- 3.6 nmol/l, P < 0.05), but no better psychological response (NHP, P = 0.22; PGWB, P = 0.23). Those deciding to continue replacement therapy did not respond differently to those choosing to abandon therapy with respect to IGF-I (P = 0.72), body composition (P = 0.38) and psychological assessment (NHP, P = 0.29; PGWB, P = 0.24). GH replacement in GH-deficient adults was associated with significant improvements in self-perceived well-being as well as changes in body composition and other variables. This improvement was similar at two different doses of replacement GH. Those patients electing to continue on long-term replacement did not achieve a demonstrably different psychological, body composition or biochemical benefit to those patients deciding to discontinue replacement.

Adolescent↗

Four-component model for the assessment of body composition in humans: comparison with alternative methods, and evaluation of the density and hydration of fat-free mass.

1. Body composition was assessed in 28 healthy subjects (body mass index 20-28 kg/m2) by dual-energy X-ray absorptiometry, deuterium dilution, densitometry, 40K counting and four prediction methods (skinfold thickness, bioelectrical impedance, near-i.r. interactance and body mass index). Three- and four-component models of body composition were constructed from combinations of the reference methods. The results of all methods were compared. Precision was evaluated by analysis of propagation of errors. The density and hydration fraction of the fat-free mass were determined. 2. From the precision of the basic measurements, the propagation of errors for the estimation of fat (+/- SD) by the four-component model was found to be +/- 0.54 kg, by the three-component model, +/- 0.49 kg, by deuterium dilution, +/- 0.62 kg, and by densitometry, +/- 0.78 kg. Precision for the measurement of the density and hydration fraction of fat-free mass was +/- 0.0020 kg/l and +/- 0.0066, respectively. 3. The agreement between reference methods was generally better than between reference and alternative methods. Dual-energy X-ray absorptiometry predicted three- and four-component model body composition slightly less well than densitometry or deuterium dilution (both of which greatly influence these multi-component models). 4. The hydration fraction of fat-free mass was calculated to be 0.7382 +/- 0.0213 (range 0.6941-0.7837) and the density of fat-free mass was 1.1015 +/- 0.0073 kg/l (range 1.0795-1.1110 kg/l), with no significant difference between men and women for either. 5. The results suggest that the three- and four-component models are not compromised by errors arising from individual techniques.(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗

[Serial changes in body composition in patients with chronic renal failure on peritoneal dialysis].

Nutritional status is one of the most important factors affecting mortality and morbidity in chronic dialysis patients. There are, however, few data on serial body composition changes in these patients. To investigate serial changes in body composition in patients on peritoneal dialysis, we measured intracellular fluid volume(ICF), extracellular fluid volume(ECF), body protein volume(BPV), body fat volume(BFV) and bone mineral content(BMC) using multifrequency bioelectrical impedance analysis (MF-BIA). MF-BIA was performed in 35 patients, consisting of 21 men and 14 women with a mean age of 51.3 +/- 10.9 years, before and after one year of observation. At the baseline in male patients, ICF was 37.0 +/- 3.4%, ECF 19.7 +/- 1.6%, BPV 20.7 +/- 1.7%, BFV 18.1 +/- 6.6% and BMC 4.5 +/- 0.4% of body weight, and in female patients ICF was 34.4 +/- 2.6%, ECF 17.8 +/- 1.9% BPV 19.0 +/- 1.6%, BFV 24.4 +/- 6.2% and BMC 4.5 +/- 0.4% of body weight. In the group of patients whose body weight increased more than 3 kilograms(n = 9), the increase rate of BFV was 32.3 +/- 20.2%, significantly higher than that of the other segments(p < 0.001). On the other hand, in the group of patients whose body weight decreased more than 3 kilograms(n = 5), each segment showed the same extent of decrease and there was no significant difference in the decrease rates among each segment. In the group of patients whose body weight was stable(n = 21), changes in each body composition segment were extremely small. It could be concluded that the body weight increase is due mainly to increase in BFV and body weight decrease results from a concurrent decrease in each body composition segment in peritoneal dialysis patients.

Adult↗

Association between bone mineral density (DXA), body structure, and body composition in middle-aged men.

The association between bone mass, body structure, and body composition was explored in 156 men, 40 years of AGE. Bone mineral density (total body, lumbar spine, left arm, and left leg) was obtained by dual-energy X-ray absorptiometry (DXA; Hologic QDR 4500A). Body structure was determined from a battery of anthropometric dimensions with a principal components analysis. Body composition was estimated with DXA. From the 24 anthropometric dimensions, three components were extracted and identified as muscle, fat, and skeletal length. Significant correlations between the muscle component and all BMD measurements (r = 0.28-0.44) were obtained. Except for BMD of the left arm, which correlated significantly, but negatively, with the fat component (r = -0.16), no significant relations were found between the fat component and BMD. There were significant correlations between lean mass, fat mass, and BMD measurements. The correlations were higher between lean mass and BMD (r = 0.22-0.44) than between fat mass and BMD (r = 0.08-0.24). The multiple regression analysis revealed that except for BMD of the left arm only lean mass or the muscle component, and not fat mass or the fat component, were independent predictors of BMD. It is concluded that the principal anthropometric determinant of BMD in middle-aged men is lean mass or muscle.

Absorptiometry, Photon↗

[Therapeutic assessment of childhood obesity with body composition measured by bioelectrical impedance analysis].

This study was conducted to assess the changes in body composition, such as body fat mass (F) and lean body mass (LBM), after the treatment of obesity with a low calorie balanced diet (LCBD) in out patient clinics. Body composition was measured by a bioelectrical impedance analysis (RJL Systems, Detroit, Michigan, USA). 67 patients with over 30% of obesity index (OI), 36 males and 31 females, aged 3-15 years old were studied. 41% of the males and 13% of the females showed an increasing trend of OI after a temporary improvement of obesity (P < 0.001) during a one year treatment period. F and LBM, however, did not change significantly, irrespective of the OI increment (P < 0.001), which was due to the increase of LBM. These observations indicated that the effects of treatment with LCBD for obesity should be assessed by the changes in F and LBM.

Adolescent↗

Maternal body composition at term gestation and birth weight: is there a link?

To assess the relative influence of maternal body composition at late gestation on birth weight, we examined maternal body composition near term (36.50+/-2.67 weeks gestation) in a group of 29 women, aged 20-39 years. The women came to the laboratory after an overnight fast. After anthropometric measurements, bioelectrical impedance analysis (BIA) was performed, determining resistance (R) and reactance (Xc), with a Tefal scale at 50 kHz. Fat mass (FM, kg) and fat-free mass (FFM, kg) were determined with the total body water (TBW) equation of Siri. The correlation between BIA parameters and birth weights was examined by linear regression analysis. All subjects delivered between 37 and 41 weeks' gestation. The mean+/-SD values of the studied parameters were: Xc=490.00+/-77.34 ohm, R=55.71+/-8.71 ohm, FM=24.18+/-6.51 kg, FFM=45.82+/-2.65 kg, maternal weight gain=9.51+/-6.43 kg, birth weight=3.43+/-0.36 kg. A direct significant correlation was found between FFM, maternal weight gain, and birth weight. It is known that in late pregnancy, maternal weight gain over gestation is linked to birth weight. We observed that FFM was the most important maternal body component associated with the newborn weight at term gestation, and we believe that this finding might be elucidated by fluid retention. In fact, resistance seemed to be inversely related to birth weight and we do not overlook the link between resistance and TBW. The implementation of our study could shed more light on the influence of maternal body composition on birth weight.

Adult↗

Validity of body composition assessment methods for older men with cardiac disease.

PURPOSE: This study was designed to determine which of several body composition assessment methods was most accurate for patients with cardiac disease for the purpose of outcome measurement. METHODS: Six body composition assessment methods were administered to each of 24 men with cardiac disease. Methods included circumference measurement, skinfold measurement, near-infrared interactance via the Futrex-5000, bioelectrical impedance via the BioAnalogics ElectroLipoGraph and Tanita TBF-150, and hydrostatic weighing, the criterion measure. RESULTS: A repeated measures analysis of variance indicated no significant (P > .05) difference between circumference and skinfold measurements compared to hydrostatic weighing. Near-infrared interactance presented the best standard error of estimates (3.5%) and the best correlation (r = .84) with hydrostatic weighing; however, the constant error was 3.76%. Bioelectrical impedance measured by the ElectroLipoGraph and TBF-150 instruments significantly underestimated percent body fat by 8.81% and 4.8%, respectively. CONCLUSIONS: In this study of middle-aged to older men with cardiac disease, the best method for determining body fat was circumferences. This technique was accurate, easy to administer, inexpensive, and had a lower error potential than the other techniques. Skinfold measurements were also closely related to hydrostatic weighing, but should be performed only by experienced practitioners because there is a greater potential for tester error in certain patients. In the future, near-infrared interactance measurements may be a viable technique for body composition assessment in patients with cardiac disease. However, algorithms specific to the population of patients with cardiac disease being tested must be developed before this technique can be routinely recommended for body composition assessment. Bioelectrical impedance assessment by either method is not recommended for patients with cardiac disease, as it consistently underestimated percent body fat when compared to hydrostatic weighing in this population.

Adipose Tissue↗

Nutritional assessment and measurement of body composition in preterm infants.

To compose an optimal nutrition for preterm infants, it is necessary to assess their body composition and metabolism. Much information on body composition has become known by carcass analysis of stillborn (pre)term infants, but these data do not inform us about the rapid alterations in body composition of surviving preterm infants during the first weeks of life. Many noninvasive nutritional assessment techniques have been developed with special adaptation to preterm infants. With these techniques it is now possible to have an accurate assessment of TBW, extracellular water; total body fat; fat-free mass; bone mineral content; energy expenditure (metabolic rate); and energy substrate turnover. Most of these techniques unfortunately show relatively large intraindividual variations and, in most cases, it is only possible to study and compare groups of preterm infants. Studies of individual patients over a certain period of time are still rather inaccurate.

Body Composition↗

Bioelectrical impedance analysis for body composition: clinical evaluation in general surgical patients.

Body composition was measured in 112 surgical patients and eight normal subjects by bioelectrical impedance analysis (BIA), and the results compared with our standard five-compartment method utilizing in vivo neutron activation analysis and tritium dilution space to measure fat-free mass and total body water. In a population with a mean fat-free mass of 49.2 kg by the latter method, BIA underestimated fat-free mass by 1.3 kg, with a standard deviation (SD) of 4.0 kg. Total body water was overestimated by 0.5 liter, with SD of 0.47 liter, when compared to a mean tritium dilution space of 36.7 liter. Changes in total body water which occurred over a treatment period of at least 1 week were also measured by the two methods. The change as measured by isotopic dilution could be estimated from the change as measured by BIA with a standard error of 2.25 liter. Although the results suggest that BIA should not be used as a research tool, it is concluded that in clinical practice, when nutrient requirements are being estimated, fat-free mass measured by BIA may have a useful place.

Adolescent↗

Body composition of patients with spinal cord injury.

Body composition of 10 control subjects and 37 spinal cord injured (SCI) patients was measured by dilution of 3H2O and Na2 35SO4. SCI patients were classified into four groups by ascending level of lesion, low and high paraplegics and low and high quadriplegics. The studies show diminishing total body water, intracellular water, lean body mass and body cell mass and increasing fat mass with higher spinal lesions. No differences in body weight or extracellular water were observed so that the ratio of extracellular water/total body water was increased as the level of injury increased.

Adult↗

Body composition and androgen pattern in the early period of postmenopause.

Body composition is related to age, genetic factors, and hormonal patterns throughout life, Peak bone mass seems to be an important protective factor against osteoporosis, although diet and life-style (smoking, physical activity) are able to influence bone mass. While it is well known that estrogens exert a protective action against bone loss in postmenopausal women, the role of androgens is still not clear. Twenty-five women in the early postmenopausal period (age: 52.8 +/- 5.1 years) were measured by dual-energy x-ray absorptiometry (DXA) to assess the relationship between body composition (fat mass and lean mass), bone mineral content (BMC), bone mineral density (BMD) and androgen pattern. Waist/hip ratio was used to divide the study population in three groups: gynecoid (gluteo-femural fat distribution), android abdominal fat distribution), and intermediate. In all subjects an inverse significant correlations between estradiol and fat mass was found. In the abdominal fat distribution group significant correlations between estradiol and weight (inversely correlated), androstenedione and BMD, learn mass an BMC were found. The data show the important role of androgens (androstenedione, particularly) and lean body mass on the BMD and BMC, respectively, in the early period of postmenopause.

Absorptiometry, Photon↗

Body composition analyses in normal weight obese women.

The purpose of this study was to identify new indexes of body composition that characterize the normal weight obese (NWO) women. We measured body composition by dual energy x-ray absorptiometry (DXA) and resting metabolic rate (RMR) by indirect calorimetry in a cohort of seventy-five healthy Italian women, subdivided into three groups (nonobese/controls, NWO, preobese-obese women). Despite a normal body mass index (BMI), the NWO women have a higher body fat mass percentage (FAT %) (38.99 +/- 6.03) associated to a significant (p = 0.02) lower amount of lean mass of legs (12.24 +/- 1.31) and lean mass of left leg (6.07 +/- 0.64) with respect to the control group. The NWO group showed a significant (p = 0.043) lower RMR (1201.25 +/- 349.02) in comparison with nonobese and preobese-obese women. To classify NWO individuals among general population, we identified three significant body composition indexes: abdominal index, leg index and trunk index. The NWO women showed significant increased value in the three indexes (p < 0.001). Our results suggest that, despite a normal BMI, the NWO women displayed a cluster of anthropometric characteristics (body fat mass percentage, leg indexes) not different to obese women ones. An appropriate diet-therapy and physical activity may be protecting NWO individuals from diabetes and cardiovascular diseases associated to preobese-obese women.

Abdominal Fat↗