Abstract
Dual-energy X-ray absorptiometry (DXA) has been considered a reference method for measuring body fat percentage (BF%) in children and adolescents with an excess of adiposity. However, given that the DXA technique is impractical for routine field use, there is a need to investigate other methods that can accurately determine BF%. We studied the accuracy of bioelectrical impedance analysis (BIA) technology, including foot-to-foot and hand-to-foot impedance, and Slaughter skinfold-thickness equations in the measurement of BF%, compared with DXA, in a population of Latin American children and adolescents with an excess of adiposity. A total of 127 children and adolescents (11–17 years of age; 70% girls) from the HEPAFIT (Exercise Training and Hepatic Metabolism in Overweight/Obese Adolescent) study were included in the present work. BF% was measured on the same day using two BIA analysers (Seca® 206, Allers Hamburg, Germany and Model Tanita® BC-418®, TANITA Corporation, Sportlife Tokyo, Japan), skinfold measurements (Slaughter equation), and DXA (Hologic Horizon DXA System®, Quirugil, Bogotá, Columbia). Agreement between measurements was analysed using t-tests, Bland–Altman plots, and Lin’s concordance correlation coefficient (ρc). There was a significant correlation between DXA and the other BF% measurement methods (r > 0.430). According to paired t-tests, in both sexes, BF% assessed by BIA analysers or Slaughter equations differ from BF% assessed by DXA (p < 0.001). The lower and upper limits of the differences compared with DXA were 6.3–22.9, 2.2–2.8, and −3.2–21.3 (95% CI) in boys and 2.3–14.8, 2.4–20.1, and 3.9–18.3 (95% CI) in girls for Seca® mBCA, Tanita® BC 420MA, and Slaughter equations, respectively. Concordance was poor between DXA and the other methods of measuring BF% (ρc < 0.5). BIA analysers and Slaughter equations underestimated BF% measurements compared to DXA, so they are not interchangeable methods for assessing BF% in Latin American children and adolescents with excess of adiposity.
Highlights
Overweight and obesity in children and adolescents have emerged as serious public health concerns in both developed and developing countries [1]
Boys were found to have significantly lower values of BF% as measured by Dual-energy X-ray absorptiometry (DXA), Seca® mBCA 514, and Tanita® BC 420MA compared to girls (p < 0.001 for all)
The main findings of this study show that bioelectrical impedance analysis (BIA) analysers and Slaughter skinfold-thickness equations provide less accurate measurements of BF% compared to DXA in children and adolescents with excess of adiposity
Summary
Overweight and obesity in children and adolescents have emerged as serious public health concerns in both developed and developing countries [1]. Body fat percentage (BF%) has been proposed as a risk factor for metabolic and cardiovascular disorders [6] and, there is a growing interest in the accurate measurement of BF%, rather than the conventional body mass index (BMI), as it might provide clinically useful insight. DXA has been considered a reference method for measuring BF% in children and adolescents with excess of adiposity [8] thanks to the long-term precision of the values it yields (the coefficient of variation, CV, of repeated measurements is 2%) [9]. Considering that DXA is impractical for routine field use, it would be convenient to develop other methods of accurately measuring BF% in children and adolescents with excess of adiposity
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