Hydrogen background in total body nitrogen estimations

Total body protein in healthy adolescent girls: validation of estimates derived from simpler measures with neutron activation analysis

BACKGROUND

Little recent and accurate information about body protein content in healthy adolescent girls is available.

OBJECTIVE

The objective was to assess the total body nitrogen (TBN) and total body protein (TBPr) contents of fat-free mass (P:FFM) in a group of healthy adolescent girls and to validate previously published TBN prediction equations.

DESIGN

TBN was measured with in vivo neutron activation analysis (TBNNAA). Bone mineral density and FFM were measured with dual-energy X-ray absorptiometry (FFMDXA), total body water and FFM were measured with bioimpedance analysis, and FFM was assessed by measuring skinfold thicknesses in 51 girls with a mean (+/- SD) age of 14.7 +/- 0.7 y. The validity of the TBN prediction equations was assessed with Bland-Altman analysis.

RESULTS

TBNNAA in our adolescent group was higher (1.49 kg) than values reported in earlier studies of women (1.25 and 1.31 kg), and P:FFM was slightly higher (23%) than that documented in adults (19-21%). Previously published TBN equations showed either systematic bias or wide limits of agreement.

CONCLUSION

A predictive equation derived from the present study population based on FFMDXA improves the prediction of TBN for groups of young girls but may not be helpful for individuals in clinical settings.

Body composition in adolescents with anorexia nervosa

BACKGROUND

Malnourished patients with anorexia nervosa have altered body composition characterized by depletion of fat and fat-free mass.

OBJECTIVES

The objectives of this study were to assess the body composition of adolescents with anorexia nervosa compared with that of control subjects and to investigate the relation between simple anthropometric measures and reference techniques for measuring body composition.

DESIGN

Twenty-three adolescent females with anorexia nervosa aged 15.46 +/- 1.34 y (x +/- SD) were studied. Body composition was measured by anthropometry, dual-energy X-ray absorptiometry (DXA) (for body fat), and prompt gamma in vivo neutron activation analysis [for total body nitrogen (TBN)]. Twenty-five female subjects provided the control DXA data. TBN measurements were compared with prediction equations based on sex, height, age, and weight.

RESULTS

Anorexia nervosa patients had significantly lower weight (40.2 +/- 4.6 kg), body mass index (in kg/m(2): 15.3 +/- 1.2), percentage of body fat (DXA) (13.8 +/- 5.8%), percentage of TBN predicted for age (73 +/- 10%), trunk fat (2.1 +/- 1.0 kg), leg fat (2.6 +/- 1.1 kg), and trunk-to-leg fat ratio than did control subjects (P < 0.05). In anorexia nervosa patients, significant correlations were found between triceps skinfold thickness and percentage of body fat (r = 0.83), body mass index and percentage of body fat (r = 0.46), and body weight and TBN (r = 0.84, P < 0.05).

CONCLUSIONS

Hospitalized adolescent females with anorexia nervosa are depleted of total body fat and protein. We identified 3 simple anthropometric measures (triceps skinfold thickness, BMI, and body weight) that can be used to assess body composition and nutritional status in malnourished adolescents with anorexia nervosa.

Assessment of background hydrogen by the Monte Carlo computer code MCNP-4A during measurements of total body nitrogen

The use of a hydrogen internal standard to enable the estimation of absolute mass during measurement of total body nitrogen by in vivo neutron activation is an established technique. Central to the technique is a determination of the H prompt gamma ray counts arising from the subject. In practice, interference counts from other sources--e.g., neutron shielding--are included. This study reports use of the Monte Carlo computer code, MCNP-4A, to investigate the interference counts arising from shielding both with and without a phantom containing a urea solution. Over a range of phantom size (depth 5 to 30 cm, width 20 to 40 cm), the counts arising from shielding increased by between 4% and 32% compared with the counts without a phantom. For any given depth, the counts increased approximately linearly with width. For any given width, there was little increase for depths exceeding 15 centimeters. The shielding counts comprised between 15% and 26% of those arising from the urea phantom. These results, although specific to the Swansea apparatus, suggest that extraneous hydrogen counts can be considerable and depend strongly on the subject's size.