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Mumford J, Kohn M, Briody J, Miskovic-Wheatley J, Madden S, Clarke S, Biggin A, Schindeler A, Munns C. Long-term Outcomes of Adolescent Anorexia Nervosa on Bone. J Adolesc Health 2019; 64:305-310. [PMID: 30819332 DOI: 10.1016/j.jadohealth.2018.07.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Revised: 07/25/2018] [Accepted: 07/25/2018] [Indexed: 01/08/2023]
Abstract
PURPOSE Anorexia nervosa (AN) is a chronic and life-threatening eating disorder that can have a considerable negative impact on the growing skeleton. We hypothesized that the long-term impact on bone health may persist even after normalization of body weight. METHODS 41 females (mean age 21.2 ± 2.9 years) with a history of adolescent-onset AN attended a follow-up bone health assessment at 5 years (T5, n = 28) or 10 years (T10, n = 13) after their first AN-related hospital admission. Assessment included dual-energy x-ray absorptiometry measurements of the total body, lumbar spine, and proximal femur, peripheral quantitative computed tomography at the radius and tibia, anthropometric measurements, serum biochemistry, fracture history, and a patient questionnaire. RESULTS A recovery in body weight and BMI was seen for both the T5 and T10 cohorts (BMI at intake 16.6, BMI at T5-T10 21.2-21.3). Dual-energy x-ray absorptiometry body composition indicated a recovery of fat mass and lean tissue mass. Total BMD was unaffected, but reductions were seen at the femoral neck and arms. Peripheral quantitative computed tomography showed reduced trabecular and cortical bone in the radius, and cortical thinning in the tibia. AN patients showed a statistically significant reduction in measures of radiographic bone health at follow up, although not to a degree that necessitated clinical intervention. Serum insulin-like growth factor 1 was also positively correlated with total BMD and BMC measures. While fracture risk was not increased, a subset of participants (8%) showed multiple (>4) fractures. CONCLUSION A longitudinal study of adolescent AN showed persisting negative effects on bone health.
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Affiliation(s)
- Jessica Mumford
- Eating Disorder Service, Sydney Children's Hospital Network, Westmead, New South Wales, Australia; School of Rural Medicine, University of New England, Armidale, New South Wales, Australia
| | - Michael Kohn
- Eating Disorder Service, Sydney Children's Hospital Network, Westmead, New South Wales, Australia; Adolescent and Young Adult Medicine, Westmead Hospital, Westmead, New South Wales, Australia
| | - Julie Briody
- Nuclear Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Jane Miskovic-Wheatley
- Eating Disorder Service, Sydney Children's Hospital Network, Westmead, New South Wales, Australia
| | - Sloane Madden
- Eating Disorder Service, Sydney Children's Hospital Network, Westmead, New South Wales, Australia
| | - Simon Clarke
- Adolescent and Young Adult Medicine, Westmead Hospital, Westmead, New South Wales, Australia; The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Andrew Biggin
- Department of Endocrinology, The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Children's Hospital Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Aaron Schindeler
- Orthopaedic Research Unit, The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Discipline of Paediatrics & Child Health, University of Sydney, Sydney, New South Wales, Australia
| | - Craig Munns
- Department of Endocrinology, The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Discipline of Paediatrics & Child Health, University of Sydney, Sydney, New South Wales, Australia.
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Haas V, Kent D, Kohn MR, Madden S, Clarke S, Briody J, Fischer F, Müller MJ, Gaskin K. Incomplete total body protein recovery in adolescent patients with anorexia nervosa. Am J Clin Nutr 2018; 107:303-312. [PMID: 29566191 DOI: 10.1093/ajcn/nqx061] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 12/04/2017] [Indexed: 12/27/2022] Open
Abstract
Background Bone health and growth during adolescence require adequate total body protein (TBPr). Renutrition for patients with anorexia nervosa (AN) should aim to normalize body composition and to recover both fat mass and TBPr. Objective We intended to analyze predictors of protein status, including exercise status, in adolescents with AN and to investigate whether weight gain would replenish body protein deficits. Methods We assessed TBPr in a longitudinal, observational study as height-adjusted nitrogen index (NI) using in vivo neutron activation analysis in 103 adolescents with AN [mean ± SD age, 15.6 ± 1.4 y; body mass index (BMI, in kg/m2), 16.5 ± 1.6] at the commencement of inpatient refeeding (T0), in 56 of these patients 7 mo thereafter as outpatients (T1), and in age-matched controls (C; n = 51, 15.5 ± 2.1 y, BMI 20.7 ± 1.9). Lean tissue and fat mass were assessed by dual-energy X-ray absorptiometry. BMI, BMI standard deviation score, and lean tissue mass were tested as predictors of protein status using receiver operating characteristic analysis. Results At T0, NI was decreased in AN (AN, 0.88 ± 0.10 compared with C, 1.00 ± 0.08, P < 0.001). In 34%, the patients showed protein depletion. Patients classified as ``exercisers'' had a higher NI than did ``nonexercisers'' (0.89 ± 0.11 compared with 0.85 ± 0.08, P = 0.045). BMI, BMI standard deviation score, and lean tissue mass did not show potential as predictors of protein status. Despite increases in weight (+6.9 ± 4.5 kg), and BMI (+2.5 ± 1.7), protein status did not improve (TBPr T0, 8.0 ± 1.1 kg; T1, 8.1 ± 1.0 kg, P = 0.495). In an AN subgroup at 7 mo matched with controls in age (AN, 16.5 ± 1.1 y; C, 16.2 ± 1.8 y) and BMI (AN, 20.5 ± 1.4; C, 20.7 ± 1.3), protein status was still not normalized in AN (NI: AN, 0.89 ± 0.09 compared with C, 1.00 ± 0.07, P < 0.001). Conclusions Adolescents recovering from AN remained protein depleted at 7 mo after baseline assessment, even though they were weight restored.
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Affiliation(s)
- Verena Haas
- Department of Child and Adolescent Psychiatry, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Dorothea Kent
- James Fairfax Institute of Pediatric Nutrition, Department of Adolescent and Young Adult Medicine, Westmead Hospital and Centre for Research into Adolescents' Health, and Departments of Psychological and Nuclear Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Michael R Kohn
- Department of Adolescent and Young Adult Medicine, Westmead Hospital and Centre for Research into Adolescents' Health, and Departments of Psychological and Nuclear Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Sloane Madden
- Psychological and Nuclear Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Simon Clarke
- Department of Adolescent and Young Adult Medicine, Westmead Hospital and Centre for Research into Adolescents' Health, and Departments of Psychological and Nuclear Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Julie Briody
- Nuclear Medicine, The Children's Hospital at Westmead, Sydney, Australia
| | - Felix Fischer
- Department of Psychosomatic Medicine, Center for Internal Medicine and Dermatology, Charité-Universitätsmedizin Berlin, Germany
| | - Manfred J Müller
- Institut für Humanernährung und Lebensmittelkunde, Christian-Albrechts-Universität zu Kiel, Germany
| | - Kevin Gaskin
- James Fairfax Institute of Pediatric Nutrition, Department of Adolescent and Young Adult Medicine, Westmead Hospital and Centre for Research into Adolescents' Health, and Departments of Psychological and Nuclear Medicine, The Children's Hospital at Westmead, Sydney, Australia
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Brantlov S, Jødal L, Lange A, Rittig S, Ward LC. Standardisation of bioelectrical impedance analysis for the estimation of body composition in healthy paediatric populations: a systematic review. J Med Eng Technol 2017; 41:460-479. [DOI: 10.1080/03091902.2017.1333165] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Steven Brantlov
- Department of Procurement & Clinical Engineering, Aarhus University Hospital, Aarhus, Denmark
| | - Lars Jødal
- Department of Nuclear Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Aksel Lange
- Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Søren Rittig
- Department of Paediatrics, Aarhus University Hospital, Aarhus, Denmark
| | - Leigh C. Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
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Chula de Castro JA, Lima TRD, Silva DAS. Body composition estimation in children and adolescents by bioelectrical impedance analysis: A systematic review. J Bodyw Mov Ther 2017; 22:134-146. [PMID: 29332738 DOI: 10.1016/j.jbmt.2017.04.010] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Revised: 04/06/2017] [Accepted: 04/25/2017] [Indexed: 02/07/2023]
Abstract
BACKGROUND Bioelectrical impedance analysis (BIA) has commonly been used to assess the body composition of children and adolescents. BIA validation studies have found distinct correlation values with reference methods. OBJECTIVES To assess the reproducibility, correlation and mean differences in body composition estimated by BIA and reference methods, we systematically reviewed the literature in the pediatric population. METHOD The search for articles was conducted in March 2016 and was limited to articles published from 2005 to 2015 in the PubMed, Embase, EBSCO, Web of Science, Scopus and SciELO databases. Two reviewers independently performed data selection and extraction of studies that investigated the BIA validity, responsiveness, reliability and/or measurement error (reproducibility) to estimate body composition in children and adolescents with an average age ≤ 18 years. RESULTS The search produced 48 articles. Almost perfect reproducibility was found in the body fat percentage estimated by BIA, and there was almost perfect correlation between the BIA ratings and reference methods for fat mass and fat-free mass. Regarding component estimates, BIA underestimated the fat mass in both sexes. CONCLUSIONS The body fat percentage estimated by BIA exhibited almost perfect reproducibility. The fat mass and fat-free mass estimated by BIA correlated almost perfectly with the reference methods in both sexes. BIA underestimated the fat mass in both sexes.
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Affiliation(s)
- João Antônio Chula de Castro
- Universidade Federal de Santa Catarina, Centro de Desportos, Núcleo de Pesquisa em Cineantropometria e Desempenho Humano, Florianópolis, Santa Catarina, Brazil.
| | - Tiago Rodrigues de Lima
- Universidade Federal de Santa Catarina, Centro de Desportos, Núcleo de Pesquisa em Cineantropometria e Desempenho Humano, Florianópolis, Santa Catarina, Brazil
| | - Diego Augusto Santos Silva
- Universidade Federal de Santa Catarina, Centro de Desportos, Núcleo de Pesquisa em Cineantropometria e Desempenho Humano, Florianópolis, Santa Catarina, Brazil
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Madden S, Miskovic-Wheatley J, Clarke S, Touyz S, Hay P, Kohn MR. Outcomes of a rapid refeeding protocol in Adolescent Anorexia Nervosa. J Eat Disord 2015; 3:8. [PMID: 25830024 PMCID: PMC4379764 DOI: 10.1186/s40337-015-0047-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 02/28/2015] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND The impact of severe malnutrition and medical instability in adolescent Anorexia Nervosa (AN) on immediate health and long-term development underscores the need for safe and efficient methods of refeeding. Current refeeding guidelines in AN advocate low initial caloric intake with slow increases in energy intake to avoid refeeding syndrome. This study demonstrates the potential for more rapid refeeding to promote initial weight recovery and correct medical instability in adolescent AN. METHODS Seventy-eight adolescents with AN (12-18 years), hospitalised in two specialist paediatric eating disorder units, for medical instability (bradycardia, hypotension, hypothermia, orthostatic instability and/or cardiac arrhythmia) were followed during a 2.5 week admission. Patients were refed using a standardised protocol commencing with 24-72 hours of continuous nasogastric feeds (ceased with daytime medical stability) and routine oral phosphate supplementation, followed by nocturnal feeds and a meal plan of 1200-2400 kcal/day aiming for a total caloric intake of 2400-3000 kcal/day. Along with indicators of medical stability, weight, phosphate and glucose levels were recorded. RESULTS All patients gained weight in week one (M = 2.79 kg, SD = 1.27 kg) and at subsequent measurement points with an average gain of 5.12 kg (SD = 2.96) at 2.5 weeks. No patient developed hypophosphatemia, hypoglycaemia, or stigmata of the refeeding syndrome. CONCLUSIONS The refeeding protocol resulted in immediate weight gain and was well tolerated with no indicators of refeeding syndrome. There were no significant differences in outcomes between the treatment sites, suggesting the protocol is replicable. TRIAL REGISTRATION Australian Clinical Trials Register number: ACTRN012607000009415.
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Affiliation(s)
- Sloane Madden
- Eating Disorder Service, The Sydney Children's Hospitals Network, Westmead Campus, Locked Bag 4001, Westmead, 2145, NSW Australia ; Discipline of Psychiatry, Faculty of Medicine, The University of Sydney, Sydney, Australia ; Westmead Clinical School, The Sydney Children's Hospitals Network, Westmead Campus, Sydney, Australia
| | - Jane Miskovic-Wheatley
- Eating Disorder Service, The Sydney Children's Hospitals Network, Westmead Campus, Locked Bag 4001, Westmead, 2145, NSW Australia ; Westmead Clinical School, The Sydney Children's Hospitals Network, Westmead Campus, Sydney, Australia
| | - Simon Clarke
- Discipline of Paediatrics, Faculty of Medicine, University of Sydney, Sydney, Australia ; Centre for Research into AdolescentS' Health (CRASH), University of Sydney, Sydney, Australia
| | - Stephen Touyz
- Clinical Psychology Unit, University of Sydney, Sydney, Australia
| | - Phillipa Hay
- School of Medicine, University of Western Sydney, Sydney, Australia
| | - Michael R Kohn
- Eating Disorder Service, The Sydney Children's Hospitals Network, Westmead Campus, Locked Bag 4001, Westmead, 2145, NSW Australia ; Westmead Clinical School, The Sydney Children's Hospitals Network, Westmead Campus, Sydney, Australia ; Discipline of Paediatrics, Faculty of Medicine, University of Sydney, Sydney, Australia ; Centre for Research into AdolescentS' Health (CRASH), University of Sydney, Sydney, Australia
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El Ghoch M, Milanese C, Calugi S, Müller MJ, Pourhassan M, Ruocco A, Dalle Grave R. Regional fat distribution in adolescent and adult females with anorexia nervosa: A longitudinal study. Clin Nutr 2014; 34:1224-32. [PMID: 25559944 DOI: 10.1016/j.clnu.2014.12.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 12/05/2014] [Accepted: 12/14/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND & AIMS No study has yet compared body fat distribution before and after weight restoration in adolescent and adult patients with anorexia nervosa (AN) treated according to the same protocol. The study was set up to measure body fat distribution before and after short-term weight restoration in adolescent and adult patients with AN treated according to the same protocol in a specialist inpatient unit. METHODS We recruited 33 consecutive adolescent female patients with AN, and 33 controls matched by age and post-treatment BMI centile, as well as 33 adult female patients with AN, and 33 controls matched by age and post-treatment BMI. Dual-energy X-ray absorptiometry (DXA) was used to assess body composition before and after short-term weight restoration (BMI ≥ 18.5 kg/m²). RESULTS Compared with controls, both adolescents and adults with AN showed that a greater amount of fat was lost from the extremities than the trunk before weight restoration, and that there was a central adiposity phenotype after short-term weight restoration. There were no significant differences in body fat distribution between adolescents and adults with AN before or after short-term weight restoration. CONCLUSIONS Adolescent and adult females with AN have similar body fat distribution both before and after short-term weight restoration, and show a central adiposity phenotype after short-term weight restoration. The clinical implications of this finding are as yet unknown. Clinical Trials Registry- Regional Fat Distribution in Adolescent Girls and Adults with Anorexia Nervosa (ISRCTN73572502).
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Affiliation(s)
- Marwan El Ghoch
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, Verona, Italy.
| | - Chiara Milanese
- Department of Neurological and Movement Sciences, University of Verona, Italy
| | - Simona Calugi
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, Verona, Italy
| | - Manfred J Müller
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Maryam Pourhassan
- Institute of Human Nutrition and Food Science, Christian-Albrechts University, Kiel, Germany
| | - Antonella Ruocco
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, Verona, Italy
| | - Riccardo Dalle Grave
- Department of Eating and Weight Disorders, Villa Garda Hospital, Via Montebaldo, 89, 37016 Garda, Verona, Italy
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Nutritional care in children with cystic fibrosis: are our patients becoming better? Eur J Clin Nutr 2013; 67:558-64. [PMID: 23462946 DOI: 10.1038/ejcn.2013.20] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Over the last 30 years, major advances have occurred in our understanding of the disorder cystic fibrosis (CF) with the discoveries of the underlying chloride transport defect and the 'CF gene', the CF transmembrane conductance regulator gene. Equally important from a clinical and patient perspective are the improvements in median survival from less than 10 to 20 years prior to 1980, approaching 30 years during the 1980s and over 45 years more recently. Improved antibiotic regimens and lung clearance therapy contributed to the enhanced survival, but a key factor accredited as adding a further 10 years to the median survival was improving and then maintaining normal growth and nutrition. In the main, the latter were achieved by adherence to a 'high-fat high-energy' diet rather than the advocated virtually universal policy of the 'low fat', which was associated with wasting and linear growth failure. The high-fat diet in conjunction with better control of malabsorption due to microspheric pancreatic enzyme replacement therapy, attention to adequate fat-soluble vitamin supplementation and newborn screening has ensured that at least 80-90% of children with CF will achieve better health and survival through their adult years.
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Haas V, Stark D, Kohn M, Müller MJ, Clarke S, Blumenthal C, Briody J, Madden S, Gaskin KJ. Evaluation of Methods to Assess Reduced Body Fat in Patients with Anorexia Nervosa. J Am Coll Nutr 2013; 32:2-10. [DOI: 10.1080/07315724.2013.767619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Pories WJ, Dohm LG, Mansfield CJ. Beyond the BMI: the search for better guidelines for bariatric surgery. Obesity (Silver Spring) 2010; 18:865-71. [PMID: 20150899 DOI: 10.1038/oby.2010.8] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The application of the BMI of > or =35 as the major prerequisite for access to bariatric surgery is no longer appropriate because the index, now incorporated in the requirements of Medicare, Medicaid and most private carriers, does not reflect the degree or distribution of adiposity, it discriminates unfairly on the basis of gender, race, age, fitness, and body fat composition. Further, with increasing evidence that bariatric surgery can also induce full and durable remission of such comorbidities as type 2 diabetes even in patients with BMIs <30, new guidelines must be pursued.
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Affiliation(s)
- Walter J Pories
- Department of Surgery, Brody School of Medicine, East Carolina University, Greenville, North Carolina, USA.
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Haas VK, Kohn MR, Clarke SD, Allen JR, Madden S, Müller MJ, Gaskin KJ. Body composition changes in female adolescents with anorexia nervosa. Am J Clin Nutr 2009; 89:1005-10. [PMID: 19211813 DOI: 10.3945/ajcn.2008.26958] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Body weight provides limited information about nutritional status of patients with anorexia nervosa (AN). OBJECTIVES Our objectives were to determine body composition (BC) changes, to find clinical predictors and endocrine correlates of total body protein (TBPr) depletion, and to compare results on fat mass (FM) obtained with anthropometry (skinfold measurements) and dual-energy X-ray absorptiometry (DXA) in patients with AN. DESIGN Body weight, body mass index (BMI; in kg/m(2)), BC (with DXA and skinfold measurements), and TBPr [with in vivo neutron activation analysis (IVNAA)] was assessed in 50 AN patients (15.2 y) and 40 healthy sex- and age-matched controls. In 47 AN patients and 22 controls, hormone concentrations were measured. RESULTS In AN patients, body weight (44.4 +/- 5.5 kg), BMI (16.7 +/- 1.6), and FM(DXA) (7.0 +/- 3.4 kg) were lower than in controls. Lean tissue mass by DXA (LTM(DXA)) was similar in AN patients and controls (35.7 +/- 4.3 compared with 35.8 +/- 4.5 kg), but TBPr was 87% of that of controls (8.1 +/- 1.0 compared with 9.2 +/- 1.2 kg; P < 0.001). Cortisol was high, testosterone was unchanged, and estradiol and insulin-like growth factor I were low. Severe protein depletion measured by IVNAA seen in 17 AN patients could not be identified with simpler methods. All except 1 of 26 AN patients with a BMI > 16.5 had normal TBPr. The difference in individual percentage of body fat measured with DXA and skinfold measurements came up to 9%. CONCLUSION The severe protein depletion in 34% of AN patients was not accurately identified by LTM(DXA) or simpler methods, but a BMI > 16.5 indicated normal TBPr. Future studies need to compare DXA and skinfold measurements with a reference technique to assess FM in AN patients.
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Affiliation(s)
- Verena K Haas
- Department of Gastroenterology, Charité University Hospital, Berlin, Germany.
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Duren DL, Sherwood RJ, Czerwinski SA, Lee M, Choh AC, Siervogel RM, Cameron Chumlea W. Body composition methods: comparisons and interpretation. J Diabetes Sci Technol 2008; 2:1139-46. [PMID: 19885303 PMCID: PMC2769821 DOI: 10.1177/193229680800200623] [Citation(s) in RCA: 198] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
The incidence of obesity in the United States and other developed countries is epidemic. Because the prevalence of comorbidities to obesity, such as type 2 diabetes, has also increased, it is clear there is a great need to monitor and treat obesity and its comorbidities. Body composition assessments vary in precision and in the target tissue of interest. The most common assessments are anthropometric and include weight, stature, abdominal circumference, and skinfold measurements. More complex methods include bioelectrical impedance, dual-energy X-ray absorptiometry, body density, and total body water estimates. There is no single universally recommended method for body composition assessment in the obese, but each modality has benefits and drawbacks. We present here the most common methods and provide guidelines by way of examples to assist the clinician/researcher in choosing methods appropriate to their situation.
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Affiliation(s)
- Dana L Duren
- Department of Community Health, Boonshoft School of Medicine, Wright State University, Dayton, Ohio 45420, USA.
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