title: Evaluation of methods to assess reduced body fat in patients with anorexia nervosa.
abstract: OBJECTIVE
  To evaluate skinfold anthropometry and dual-energy x-ray absorptiometry (DXA) to estimate percentage of body fat (%BF) in adolescent patients with anorexia nervosa (AN).
  
  
  METHODS
  We examined 80 female AN patients (age 15.6 ± 1.4 years) and 31 healthy, normal weight sex- and age-matched controls with DXA and skinfold anthropometry to estimate %BF. Reference values for %BF of the same participants were obtained from a 4-compartment (4C) model, which was based on measurements of total body protein (with in vivo neutron activation), total body water (with deuterium dilution), and mineral content (with DXA). We compared the different methods to assess %BF with Bland-Altman analysis of agreement.
  
  
  RESULTS
  In the AN group, average %BF was well predicted with DXA and skinfold measurements in combination with the Deurenberg equation based on 2 skinfolds (DXA 13.9 ± 6.2 %BF; skinfold 14.5 ± 4.3 vs 14.1 ± 6.8 %BF by the 4C model). In the control group, average %BF was closely predicted by skinfold measurements in combination with the Slaughter formula (26.1 ± 4.5 vs 25.2 ± 5.2 %BF by the 4C model) but was overestimated with DXA (31.3 ± 5.8 %BF). When compared with the 4C model, all methods under investigation showed considerable limits of agreement when predicting %BF in any given individual.
  
  
  CONCLUSIONS
  In our group of patients with AN, the Deurenberg skinfold model and DXA were similar in performance; however, DXA overestimated %BF in healthy subjects.
authors.affiliation: The Department of Adolescent Medicine, The Children's Hospital at Westmead and Westmead Hospital, University of Sydney, Australia. verena.haas@charite.de
authors.forename: Verena
authors.initials: V
authors.lastname: Haas
authors.forename: Dorothea
authors.initials: D
authors.lastname: Stark
authors.forename: Michael
authors.initials: M
authors.lastname: Kohn
authors.forename: Manfred J
authors.initials: MJ
authors.lastname: Müller
authors.forename: Simon
authors.initials: S
authors.lastname: Clarke
authors.forename: Caron
authors.initials: C
authors.lastname: Blumenthal
authors.forename: Julie
authors.initials: J
authors.lastname: Briody
authors.forename: Sloane
authors.initials: S
authors.lastname: Madden
authors.forename: Kevin J
authors.initials: KJ
authors.lastname: Gaskin
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue / Q000378:metabolism*; D000293:Adolescent; D000328:Adult; D000856:Anorexia Nervosa / Q000378:metabolism*; D000886:Anthropometry / Q000379:methods*; D001823:Body Composition; D001834:Body Water / Q000378:metabolism; D016022:Case-Control Studies; D002648:Child; D005260:Female; D006801:Humans; D008903:Minerals / Q000378:metabolism; D008954:Models, Biological; D011506:Proteins / Q000378:metabolism; D012016:Reference Values; D015203:Reproducibility of Results; D012885:Skinfold Thickness; D055815:Young Adult
chemical_list: D008903:Minerals; D011506:Proteins