Campanozzi Angelo, Dabbas Myriam, Ruiz Jean Charles, Ricour Claude, Goulet Olivier
Pediatric Gastroenterology, Hepatology and Nutrition, Hôpital Necker-Enfants Malades, University of Paris 5 Renè Descartes, 149, Rue de Sevres, Paris, France.
Eur J Pediatr. 2008 May;167(5):533-40. doi: 10.1007/s00431-007-0546-4. Epub 2007 Jul 6.
Multiple skinfold anthropometry (MSA) and bioelectrical impedance analysis (BIA) are useful as clinically non-invasive, inexpensive and portable techniques, although it is not clear if they can be used interchangeably in the same patient to routinely assess her/his body composition. In order to compare BIA, MSA and DXA in the estimation of lean body mass (LBM) of a pediatric obese population, 103 obese [body mass index (BMI) > 97th percentile] children (median age: 11 years; range: 5.4-16.7 years) underwent nutritional evaluation. After an overnight fast, the subjects' anthropometric measurements were performed by the same investigator: body weight (BW), height, skinfold thickness (four sites); fat body mass (FBM) using Brook or Durnin equations and dual X-ray absorptiometry (DXA). BIA was performed using a bioelectrical impedance analyzer (Analicor-Eugedia, 50 kHz) and Houtkooper's equation to calculate LBM. Linear regression analysis was performed to evaluate the relationship between the prediction of LBM by MSA, DXA and BIA. The differences between the three techniques were analysed using Student's t-test for paired observations and the Bland and Altmann method. A considerable lack of agreement was observed between DXA- and BIA-LBM (delta = -4.37 kg LBM; delta-2sigma = -11.6 kg LBM; delta+2sigma = +2.8 kg LBM); between DXA- and MSA-LBM (delta = -1.72 kg LBM; delta-2sigma = -8.2 kg LBM; delta+2sigma = +4.8 kg LBM) and between BIA- and MSA-LBM (delta = -2.65 kg LBM; delta-2sigma = -10.5 kg LBM; delta+2sigma = +5.2 kg LBM).
In obese children, DXA, BIA and MSA should not be used interchangeably in the assessment of LBM because of an unacceptable lack of agreement between them. The discrepancies between methods increase with the degree of obesity.
多重皮褶厚度人体测量法（MSA）和生物电阻抗分析（BIA）作为临床非侵入性、廉价且便携的技术很有用，不过尚不清楚它们能否在同一患者中互换使用以常规评估其身体成分。为了比较BIA、MSA和双能X线吸收法（DXA）在评估小儿肥胖人群瘦体重（LBM）方面的效果，103名肥胖儿童（体重指数[BMI]＞第97百分位数）（中位年龄：11岁；范围：5.4 - 16.7岁）接受了营养评估。经过一夜禁食后，由同一名研究人员对受试者进行人体测量：体重（BW）、身高、皮褶厚度（四个部位）；使用布鲁克或杜宁公式及双能X线吸收法（DXA）测量脂肪量（FBM）。使用生物电阻抗分析仪（Analicor - Eugedia，50 kHz）和胡特库珀公式进行BIA以计算LBM。进行线性回归分析以评估MSA、DXA和BIA对LBM预测值之间的关系。使用配对观察的学生t检验和布兰德 - 奥特曼方法分析三种技术之间的差异。观察到DXA与BIA - LBM之间存在相当大的不一致（Δ = -4.37 kg LBM；Δ - 2σ = -11.6 kg LBM；Δ + 2σ = +2.8 kg LBM）；DXA与MSA - LBM之间（Δ = -1.72 kg LBM；Δ - 2σ = -8.2 kg LBM；Δ + 2σ = +4.8 kg LBM）以及BIA与MSA - LBM之间（Δ = -2.65 kg LBM；Δ - 2σ = -10.5 kg LBM；Δ + 2σ = +5.2 kg LBM）。
在肥胖儿童中，由于DXA、BIA和MSA之间存在不可接受的不一致性，因此在评估LBM时不应互换使用。方法之间的差异随着肥胖程度的增加而增大。
