Douglass Janet, Graves Patricia, Gordon Susan
1 Division of Tropical Health and Medicine, James Cook University , Townsville, Queensland, Australia .
2 Division of Tropical Health and Medicine, James Cook University , Cairns, Queensland, Australia .
Lymphat Res Biol. 2018 Jun;16(3):309-316. doi: 10.1089/lrb.2017.0057. Epub 2017 Dec 11.
Expected values for tissue tonometry and bioimpedance spectroscopy (BIS) in the lower extremity of young people have not been established. These measures are commonly used to assess tissue changes in adult, breast cancer-related lymphedema of the arm. In tropical regions, identification of tissue changes in the lower limbs related to lymphatic filariasis is required; hence expected values and factors contributing to variation in tissue tonometry and BIS in two tropical populations were investigated.
A convenience sample of healthy volunteers aged 8-21 in Myanmar and Australia was recruited. Tissue compressibility at the calf and anterior and posterior thigh was measured using three tonometry devices and free fluid in each leg was assessed using BIS. Data were collected about possible modifiers: leg dominance, age, gender, body mass index (BMI), hydration, and menstrual cycle. Paired t-test and linear regression compared the objective measures with possible modifiers within each population. Statistical significance was set at p < 0.05 with a 95% confidence interval. In Myanmar, increases in free fluid, tissue compressibility, and limb circumference were associated with being older, female, underweight, or in the second half of the menstrual cycle. In young Australians, increases in tissue compressibility and limb circumference were associated with being older or in the second half of the menstrual cycle.
When assessing tissue compressibility and free fluid in young people using tonometry and gender, BIS, limb dominance and BMI should be considered in a local context and attempts should be made to minimize the potential influences of hydration and the female menstrual cycle.
年轻人下肢组织张力测量和生物电阻抗光谱法(BIS)的预期值尚未确定。这些测量方法通常用于评估成人手臂与乳腺癌相关的淋巴水肿中的组织变化。在热带地区,需要识别与淋巴丝虫病相关的下肢组织变化;因此,对两个热带人群中组织张力测量和BIS变化的预期值及影响因素进行了研究。
招募了缅甸和澳大利亚8至21岁的健康志愿者作为便利样本。使用三种张力测量设备测量小腿、大腿前侧和后侧的组织可压缩性,并使用BIS评估每条腿中的游离液体。收集了有关可能的影响因素的数据:腿的优势侧、年龄、性别、体重指数(BMI)、水合作用和月经周期。配对t检验和线性回归比较了各人群中客观测量值与可能的影响因素。统计学显著性设定为p < 0.05,置信区间为95%。在缅甸,游离液体、组织可压缩性和肢体周长的增加与年龄较大、女性、体重过轻或月经周期后半期有关。在年轻的澳大利亚人中,组织可压缩性和肢体周长的增加与年龄较大或月经周期后半期有关。
在使用张力测量法和BIS评估年轻人的组织可压缩性和游离液体时,应结合当地情况考虑性别、肢体优势侧和BMI,并应尽量减少水合作用和女性月经周期的潜在影响。