Abstract

BackgroundClinical application of body composition (BC) measurements for individual children has been limited by lack of appropriate reference data.Objectives(1) To compare fat mass (FM) and fat free mass (FFM) standard deviation scores (SDS) generated using new body composition reference data and obtained using simple measurement methods in healthy children and patients with those obtained using the reference 4-component (4-C) model; (2) To determine the extent to which scores from simple methods agree with those from the 4-C model in identification of abnormal body composition.DesignFM SDS were calculated for 4-C model, dual-energy X-ray absorptiometry (DXA; GE Lunar Prodigy), BMI and skinfold thicknesses (SFT); and FFM SDS for 4CM, DXA and bioelectrical impedance analysis (BIA; height2/Z)) in 927 subjects aged 3.8–22.0 y (211 healthy, 716 patients).ResultsDXA was the most accurate method for both FM and FFM SDS in healthy subjects and patients (mean bias (limits of agreement) FM SDS 0.03 (±0.62); FFM SDS −0.04 (±0.72)), and provided best agreement with the 4-C model in identifying abnormal BC (SDS ≤−2 or ≥2). BMI and SFTs were reasonable predictors of abnormal FM SDS, but poor in providing an absolute value. BIA was comparable to DXA for FFM SDS and in identifying abnormal subjects.ConclusionsDXA may be used both for research and clinically to determine FM and FFM SDS. BIA may be used to assess FFM SDS in place of DXA. BMI and SFTs can be used to measure adiposity for groups but not individuals. The performance of simpler techniques in monitoring longitudinal BC changes requires investigation. Ultimately, the most appropriate method should be determined by its predictive value for clinical outcome.

Highlights

  • The measurement of body composition, both in clinical practice and in epidemiological studies, is an area of increasing interest

  • The most appropriate method should be determined by its predictive value for clinical outcome

  • The use of body composition measurements in children and adolescents, in a clinical context for individual patients, has been hampered by the lack of reference data necessary to standardise measurements for age, gender and size [1]. We recently addressed this limitation, providing paediatric reference data using the gold standard 4-component (4-C) model plus a variety of simpler techniques; these data allow body composition measurements from individual children to be expressed as a standard deviation score (SDS) normalised for age and gender, analogous to the use of weight, height or BMI SDS [2]

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Summary

Introduction

The measurement of body composition, both in clinical practice and in epidemiological studies, is an area of increasing interest. The use of body composition measurements in children and adolescents, in a clinical context for individual patients, has been hampered by the lack of reference data necessary to standardise measurements for age, gender and size [1]. A variety of simpler methods can be used to measure or predict fat mass (FM) and fat free mass (FFM) [3] but it is not clear to what extent these different techniques are interchangeable. This is an important issue since it is unlikely that a single technique will be suitable or available for all patients under all circumstances. Clinical application of body composition (BC) measurements for individual children has been limited by lack of appropriate reference data

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