Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, Alberta, Canada.
Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil.
Obes Rev. 2020 Aug;21(8):e13041. doi: 10.1111/obr.13041. Epub 2020 May 6.
Accurate measurement of body composition is required to improve health outcomes in children and adolescents with overweight or obesity. This systematic review aimed to summarize the reliability and validity of field and laboratory body composition techniques employed in pediatric obesity studies to facilitate technique selection for research and clinical practice implementation. A systematic search in MEDLINE (via PubMed), EMBASE, CINAHL, and SPORTDiscus from inception up to December 2019 was conducted, using a combination of the following concepts: body composition, pediatric overweight/obesity, and reliability/validity. The search strategy resulted in 66 eligible articles reporting reliability (19.7%), agreement between body composition techniques cross sectionally (80.3%), and/or diagnostic test accuracy (10.6%) in children and adolescents with overweight or obesity (mean age range = 7.0-16.5 years). Skinfolds, air-displacement plethysmography (ADP), dual-energy X-ray absorptiometry (DXA), and ultrasound presented as reliable techniques. DXA, ADP, and isotope dilution showed similar and the best agreement with reference standards. Compared with these laboratory techniques, the validity of estimating body composition by anthropometric equations, skinfolds, and BIA was inferior. In conclusion, the assessment of body composition by laboratory techniques cannot be replaced by field techniques due to introduction of measurement errors, which potentially conceal actual changes in body components.
准确测量身体成分对于改善超重或肥胖儿童和青少年的健康结果至关重要。本系统综述旨在总结用于儿科肥胖研究的现场和实验室身体成分技术的可靠性和有效性，以促进技术选择用于研究和临床实践实施。系统检索了 MEDLINE（通过 PubMed）、EMBASE、CINAHL 和 SPORTDiscus 从成立到 2019 年 12 月的文献，使用了以下概念的组合：身体成分、儿科超重/肥胖、可靠性/有效性。搜索策略产生了 66 篇符合条件的文章，报告了在超重或肥胖儿童和青少年中（平均年龄范围为 7.0-16.5 岁）的可靠性（19.7%）、身体成分技术的横断面一致性（80.3%）和/或诊断测试准确性（10.6%）。皮褶厚度、空气置换体描记法（ADP）、双能 X 射线吸收法（DXA）和超声被认为是可靠的技术。DXA、ADP 和同位素稀释法与参考标准具有相似且最佳的一致性。与这些实验室技术相比，通过人体测量方程、皮褶和 BIA 估计身体成分的有效性较差。总之，由于测量误差的引入，实验室技术对身体成分的评估不能被现场技术所取代，这可能掩盖了身体成分的实际变化。
