title: Methodological agreement between two-compartment body-composition methods in children.
abstract: Increases in childhood obesity have emphasized the importance of accurate and accessible body composition assessment, especially in monitoring prevention and treatment efforts. Previous pediatric studies, comparing measures from air-displacement plethysmography (ADP) to dual-energy X-ray absorptiometry (DXA) and anthropometry (ANTH, skinfold measures), were performed in small numbers of children or in children across large age and body-size ranges. The objectives of this study were: 1) to compare body fat percentage (%BF), fat mass (FM), and fat-free mass (FFM) from ADP with DXA and ANTH, to determine the agreement between techniques; 2) to identify factors that influence agreement or lack of agreement; and 3) to determine if the agreement is constant over a range of body fatness. Healthy children (n = 125), 7-10 years old, participating in a longitudinal pediatric bone health study, were evaluated. Body composition was assessed by ADP, DXA, and ANTH to determine %BF, FM, and FFM. ADP underestimated %BF compared to DXA and ANTH by 5.0% and 1.4%, respectively. Agreement between techniques was influenced by body fatness, height, age, and gender (all P < 0.05). Relatively good agreement was observed between ADP and both DXA and ANTH for FM and FFM. In conclusion, the underestimation of %BF by ADP compared to DXA may be of a magnitude that is clinically significant, especially when using %BF in children to confirm a diagnosis of obesity. Further development of body-composition techniques for young children need to account for variability in age, gender, and level of fatness.
authors.affiliation: Division of Gastroenterology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania 19104, USA.
authors.forename: Anne M
authors.initials: AM
authors.lastname: Buison
authors.forename: Richard F
authors.initials: RF
authors.lastname: Ittenbach
authors.forename: Virginia A
authors.initials: VA
authors.lastname: Stallings
authors.forename: Babette S
authors.initials: BS
authors.lastname: Zemel
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000465:Algorithms; D000886:Anthropometry / Q000379:methods*; D001823:Body Composition; D015992:Body Mass Index; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D008962:Models, Theoretical; D010993:Plethysmography, Whole Body / Q000379:methods*; D012680:Sensitivity and Specificity