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Body composition derived from whole body counting of potassium in growth hormone-deficient adults: a possible low intracellular potassium concentration.

The validity of total body potassium (TBK) measurement in estimating fat mass and fat-free mass (FFM) in GHD adults was assessed by comparison with the reference technique of dual energy x-ray absorptiometry (DEXA). The TBK and FFM values determined by DEXA were used to calculate the potassium concentration per kg FFM in GH-deficient (GHD) adults and compared with standard values for normal subjects of 59.6 mmol for females and 66.4 mmol for males. There were considerable differences between predicted and measured TBK values for both males (3972 vs. 3577 mmol; P < 0.001) and females (2526 vs. 2277 mmol; P < 0.001). Similarly, the estimation of FFM and fat mass by TBK measurement was significantly inaccurate for both sexes compared to values determined by DEXA. These discrepancies may be accounted for by the lower calculated potassium concentrations compared with standard values for both males (56.2 vs. 66.4 mmol; P < 0.001) and females (53.1 vs. 59.6 mmol; P < 0.001). These observations suggest that caution should be exercised in the interpretation of TBK in GHD adults, and the reduced potassium concentrations would alleviate inaccuracies in the estimation of body composition. Secondly, the decreased intracellular potassium concentration of GHD adults may account for the decreased muscle strength and ease of fatigueability seen in GHD adults.

Absorptiometry, Photon↗

Comparison of body composition measured by total body potassium and infrared interactance.

OBJECTIVE: The purpose of this study was to find how closely a near infrared instrument (IRI), Futrex 5000, would compare to whole body counting (WBC) of potassium-40 (40K) in assessing body composition. DESIGN: We measured lean body mass (LBM) and percent total body fat (PCF) in 177 males and 27 females by total body potassium (TBK) and by infrared interactance (IRI). TBK was assessed by 2 pi whole body counter (WBC) and IRI by Futrex (F) instrument. These subjects were measured for TBK and for IRI within 1 week of each other. RESULT: A large mean difference (p < or = 0.001) was found between the results using the two instruments: IRI data for LBM were higher and PCF lower compared to TBK. CONCLUSION: As shown by repeated TBK measurements over a 22-year period in these same volunteers, this technique is reliable. The IRI assessments did not come to a close fit with TBK.

Adult↗

Comparison of abilities of various interpretations of bio-electrical impedance to predict reference method body composition assessment.

Body composition was assessed in 28 normal men and women using three established reference methods (deuterium dilution for total body water, and densitometry and dual-energy X-ray absorptiometry for body fat and fat-free mass), the four- and three-component models based on these methods, and eight different predictions of the same whole-body bio-electrical impedance measurement. The comparative value of each prediction was assessed using bias and 95% limits of agreement against all reference methods. The magnitude of bias between each interpretation of whole body impedance and each reference method estimate was found to vary considerably, but in general this was consistent over the range studied. However, with few exceptions, magnitudes of the limits of agreement were considerable. For example, a majority of values of 95% limits of agreement in predicting total body water reached bias+/-3 kg or above, and all values in predicting fat (% body weight) for all subjects reached bias+/-6%, and for most purposes these could well be unacceptable. Although in absolute terms bias and limits of agreement for fat-free mass were the same as for body fat, estimates of fat-free mass were relatively more acceptable because fat-free mass was (as is the usual case) the larger of these two body components.

Journal Article↗

Effect of regular physical training on age-associated alteration of body composition in men.

Body composition changes with increasing age in men, in that lean body mass decreases whereas fat mass increases. Whether this altered body composition is related to decreasing physical activity or to the known age-associated decrease in growth hormone secretion is uncertain. To address this question, three groups of healthy men (n = 14 in each group), matched for weight, height and body mass index, were investigated using dual-energy X-ray absorptiometry, indirect calorimetry and estimate of daily growth hormone secretion [i.e. plasma insulin-like growth factor I (IGF-I-) levels]. Group 1 comprised young untrained subjects aged 31.0 +/- 2.1 years (mean +/- SEM) taking no regular physical exercise; group 2 consisted of old untrained men aged 68.6 +/- 1.2 years; and group 3 consisted of healthy old men aged 67.4 +/- 1.2 years undergoing regular physical training for more than 10 years with a training distance of at least 30 km per week. Subjects in group 3 had for the past three years taken part in the 'Grand Prix of Berne', a 16.5-km race run at a speed of 4.7 +/- 0.6 min km-1 (most recent race). Fat mass was more than 4 kg higher in old untrained men (P < 0.01, ANOVA) than in the other groups (young untrained men, 12.0 +/- 0.9 kg; old untrained men, 16.1 +/- 1.0 kg; old trained men, 11.0 +/- 0.8 kg), whereas body fat distribution (i.e. the ratio of upper to lower body fat mass) was similar between the three groups. The lean mass of old untrained men was more than 3.5 kg lower (P < 0.02, ANOVA) than in the other two groups (young untrained men, 56.4 +/- 1.0 kg; old untrained men, 52.4 +/- 1.0 kg; old trained men, 56.0 +/- 1.0 kg), mostly because of a loss of skeletal muscle mass in the arms and legs (young untrained men, 24.0 +/- 0.5 kg; old untrained men 20.8 +/- 0.5 kg; old trained men, 23.6 +/- 0.7 kg; P < 0.01, ANOVA). Resting metabolic rate per kilogram lean mass decreased with increasing age independently of physical activity (r = -0.42, P < 0.005). Fuel metabolism was determined by indirect calorimetry at rest. Protein oxidation was similar in the three groups. Old untrained men had higher (P < 0.001) carbohydrate oxidation (young untrained men, 13.2 +/- 1.0 kcal kg-1 lean mass; old untrained men, 15.2 +/- 1.3 kcal Kg-1; old trained men, 7.8 +/- 0.8 kcal kg-1), but lower (P < 0.05, ANOVA) fat oxidation (young untrained men, 10.1 +/- 1.2 kcal kg-1 lean mass; old untrained men, 6.5 +/- 1.0 kcal kg-1; old trained men, 13.7 +/- 1.0 kcal kg-1) than the other two groups. Mean plasma IGF-I level in old trained men was higher than in old untrained men (P < 0.05), but was still lower than that observed in young untrained men (P < 0.005) (young untrained men, 236 +/- 24 ng mL-1; old untrained men, 119 +/- 13 ng mL-1; old trained men, 166 +/- 14 ng mL-1). In summary, regular physical training in older men seems to prevent the changes in body composition and fuel metabolism normally associated with ageing. Whether regular physical training in formerly untrained old subjects would result in similar changes awaits further study.

Absorptiometry, Photon↗

Dual X-ray absorptiometry assessment of body composition in children with altered body posture.

Many children have contractures and/or deformities that preclude positioning in a fully supine position. The purpose of this study was to evaluate the effects of "poor" positioning on the assessment of body composition with dual X-ray absorptiometry (DXA) in thirty-seven normal child volunteers ages 3-16 yr. Multiple whole-body DXA scans of each child were performed: duplicate scans in the correct fully supine position, two scans while simulating different positions typical of children with contractures, and a scan while positioned in the full lateral position as a "worst-case" scenario. Also evaluated were the precision of duplicate measures in the altered positions, the effect of knee flexion contractures, and the impact of metallic orthopedic fixation devices. Errors in body composition assessment did occur from "poor" positioning. In those positions simulating children with contractures, the mean errors were 4-6% for measures of bone mineral content, 1-3% for lean body mass, and 5-11% for fat mass. Measures in the correct fully supine position and the contracted positions were highly correlated. The errors obtained by altering position were small. If errors of this magnitude are of significance, then corrective equations could be utilized to improve accuracy. Precise and reasonably accurate measures of body composition can be obtained with DXA in children with disabilities and deformities that preclude fully supine positioning.

Absorptiometry, Photon↗

Comparison of measurements of body composition by total body potassium, bioimpedance analysis, and dual-energy X-ray absorptiometry in hypopituitary adults before and during growth hormone treatment.

We compared fat-free mass (FFM) and percentage body fat mass (BFM) values derived from total body potassium (TBK), bioelectrical impedance analysis (BIA), and dualenergy X-ray absorptiometry (DXA) in hypopituitary adults before and after 6 mo treatment with growth hormone. Before growth hormone treatment, FFM values from the three methods correlated strongly. FFM values from TBK were lower than FFM values derived from BIA and DXA (mean +/- SD: 53.7 +/- 14.3 compared with 49.1 +/- 9.2 kg, P < 0.0001; DXA compared with TBK: 54.7 +/- 16.4 and 49.2 +/- 9.7 kg, P < 0.0002). BFM values from TBK were significantly higher than the BIA-derived (P < 0.002) but not different from the DXA-derived values. There was no difference in FFM and BFM values derived from DXA and BIA methods. The differences between BIA and TBK methods and between DXA and TBK methods were observed in the obese but not in the nonobese subjects. The increase in FFM derived from BIA with growth hormone was greater than that derived from TBK ([median(range)]; BIA: +5.2(-0.1, +13.8) compared with TBK: +0.9(-4.8, +8.6) kg, P < 0.001, but the changes with placebo were not different. The changes in FFM and BFM derived from DXA was growth hormone and placebo were not significantly different from those derived by using TBK or BIA. We conclude that FFM and BFM values derived from TBK, BIA, and DXA correlate highly and that TBK-derived values for FFM are lower than those derived from BIA and DXA in obese patients.

Absorptiometry, Photon↗

[Changed body composition by increased total body fat content in experimentally hypothyroid rats].

Total body fat content was determined in growing normal male Wistar rats and hypothyroidized animals 7 weeks after feeding with Methimazol (group MMI-HT), Methyl-thiouracil (group MTU-HT), and performance of radiothyroidectomy by 131-iodine (group R-HT), respectively. At the end of experiments there was an extreme hypothyroid state in all treated groups, verified by external signs, growth kinetics, serum cholesterol estimation and evaluation of the iodothyrosine pattern of the thyroid glands. Changed body composition resulted in all HT-groups from significant increase of total body fat content. The relation of constituents fat : protein : water of 1 : 2 : 6 in the KT-group was changed into 1 : 1 : 3 in the HT-groups. No differences were found between the different HT-groups. Our findings are in good agreement with altered metabolism of plasma lipids described by other authors showing the existence of a highly disturbed lipid metabolism in thyroid hormone deficiency.

Animals↗

Influence of diet composition on nitrogen balance and body composition in meal-eating and nibbling rats.

A series of experiments was conducted to evaluate the influence of meal frequency on nitrogen balance and body composition of rats. Rats were either fed 2 hours per 24 or 48 hours (meal-eaters), or pair-fed to meal-eaters with an automated feeding machine (nibblers). Rats weighing approximately 250 g initially, were fed 10%, 20%, or 30% casein, high-carbohydrate diets or a 20% casein high-fat diet for 7 to 8 weeks. Meal-eaters gained essentially the same amount of body weight as the nibblers. Meal-feeding once per 24 or 48 hours did not adversely influence nitrogen balance or the body composition of the rats. In one experiment, smaller rats, weighing approximately 150 g initially, were utilized. Meal-eaters again, retained as much nitrogen as nibblers, and contained less body fat than the nibblers. In these studies, meal-eating did not cause a depression in nitrogen retention or an increase in body fat deposition in rats.

Animals↗

Nutritional assessment with body composition measurements.

The measurement of body composition by multiple isotope dilution provides an accurate and precise measure of both the nutritional state and the response to nutritional support. A multiple isotope dilution technique has been developed that permits measurement of the three major components of body composition: body fat, extracellular mass (ECM), and body cell mass (BCM). Normal body composition was defined by data obtained in 25 healthy volunteers. Malnutrition is characterized by a loss of BCM and an expansion of the ECM, and as a result the lean body mass is not significantly different from normal. The loss of body weight with malnutrition therefore often reflects the loss of body fat. The utility of body composition measurements was demonstrated by determining the effect of total parenteral nutrition on body composition to determine the relationship between caloric intake and the change in the BCM. A statistically significant relationship was developed which demonstrated that a caloric intake in the range of 30-40 cal/kg/day is required for maintenance. To restore a depleted or malnourished BCM requires a caloric intake in excess of that required for maintenance. The measurement of body composition by multiple isotope dilution is complex and time consuming, and requires specialized laboratory facilities and specially trained personnel. As a result, these measurements are not suited for routine patient management, but should rather be reserved for research purposes.

Adipose Tissue↗

Body composition in adolescents: estimation by total body electrical conductivity.

This comparative study, conducted on 28 boys and girls of widely varying fatness, was designed to validate a new whole-body composition method [total body electrical conductivity (TOBEC)], based on bioelectrical properties of the human body. A significant correlation [r = 0.911; standard error of the estimate (SEE) = 5.3 kg] was demonstrated between the transformed TOBEC scores (TOBEC0.5 X Ht) and lean body mass (LBM) determined by hydrodensitometry and corrected for individual variations in hydration (LBMd + W). TOBEC determinations also correlated well with 1) total body water determined by deuterium oxide dilution (r = 0.877; SEE = 4.5 liters), 2) total body potassium determined by means of a 4 pi whole-body counter (r = 0.860; SEE = 430.7 meq), 3) LBM derived from skinfold thicknesses (r = 0.850; SEE = 5.8 kg). The residuals of the regression between LBMd + W and TOBEC scores did not show any significant correlation with either the potassium or the water content of the LBM. The results indicate that TOBEC is a simple, rapid, reliable, and noninvasive technique for delineating changes in body composition that occur in children during growth.

Adolescent↗

Population differences in body composition in relation to the body mass index.

This paper examines the relationships between body mass index (BMI) and body composition in different population groups where low BMIs might be expected to occur and assesses the extent to which BMIs are influenced by size and shape. The relationship between BMI and fat as a percentage of body weight is approximately linear although theoretically a curvilinear relationship is to be expected. However, by allowing for a variable composition of weight differences, an approximately linear theoretical relationship is obtained. There are few direct data (e.g. from densitometry, hydrometry etc.) on body composition in the groups in question and to examine the relationships indirect data were used. The regression coefficients of fat-free mass on BMI for 285 samples of Africans, people of Asian origin, Indo-Mediterraneans and Pacific people were not significantly different in the various groups of each sex; % fat on BMI was similarly related in four groups of women. Intercept terms were all significantly different. Using the sitting height-to-stature ratio (SH/S) as an index of body shape in 158 groups, the regression coefficient of BMI on SH/S was 0.90 kg/m2 per 0.01 SH/S. Mean SH/S lies between 0.50 and 0.55 in most populations so that shape could affect BMI by 5 kg/m2 and influence markedly the interpretation of BMI. However, allowing for SH/S is not straightforward as there is as much variation within as between groups. In conclusion, low BMI approximates to low weight, fat mass and fat-free mass. There are differences in the relationships of BMI to body composition but over the range 20-25 kg/m2 these may not be important in epidemiological studies. To interpret BMI in terms of body composition in more detail it is necessary to take into account sex, age, shape and ethnicity.

Adipose Tissue↗