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Svensson K, Gennings C, Lindh C, Kiviranta H, Rantakokko P, Wikström S, Bornehag CG. EDC mixtures during pregnancy and body fat at 7 years of age in a Swedish cohort, the SELMA study. ENVIRONMENTAL RESEARCH 2024; 248:118293. [PMID: 38281561 DOI: 10.1016/j.envres.2024.118293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/19/2024] [Accepted: 01/21/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND Some endocrine disrupting chemicals (EDC), are "obesogens" and have been associated with overweight and obesity in children. Daily exposure to different classes of EDCs demands for research with mixtures approach. OBJECTIVES This study evaluates the association, considering sex-specific effects, between prenatal exposure to EDC mixture and children's body fat at seven years of age. METHODS A total of 26 EDCs were assessed in prenatal urine and serum samples from first trimester in pregnancy from 737 mother-child pairs participating in the Swedish Environmental Longitudinal, Mother and child, Asthma and allergy (SELMA) study. An indicator for children's "overall body fat" was calculated, using principal component analysis (PCA), based on BMI, percent body fat, waist, and skinfolds measured at seven years of age. Weighted quantile sum (WQS) regression was used to assess associations between EDC mixture and children's body fat. RESULTS Principal component (PC1) represented 83.6 % of the variance, suitable as indicator for children's "overall body fat", with positive loadings of 0.40-0.42 for each body fat measure. A significant interaction term, WQS*sex, confirmed associations in the opposite direction for boys and girls. Higher prenatal exposure to EDC mixture was borderline significant with more "overall body fat" for boys (Mean β = 0.20; 95 % CI: -0.13, 0.53) and less for girls (Mean β = -0.23; 95 % CI: -0.58, 0.13). Also, higher prenatal exposure to EDC mixture was borderline significant with more percent body fat (standardized score) for boys (Mean β = 0.09; 95 % CI: -0.04, 0.21) and less for girls (Mean β = -0.10 (-0.26, 0.05). The chemicals of concern included bisphenols, phthalates, PFAS, PAH, and pesticides with different patterns for boys and girls. DISCUSSION Borderline significant associations were found between prenatal exposure to a mixture of EDCs and children's body fat. The associations in opposite directions suggests that prenatal exposure to EDCs may present sex-specific effects on children's body fat.
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Affiliation(s)
| | - Chris Gennings
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Christian Lindh
- Division of Occupational and Environmental Medicine, Lund University, Lund, Sweden
| | - Hannu Kiviranta
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Panu Rantakokko
- Environmental Health Unit, Finnish Institute for Health and Welfare, Kuopio, Finland
| | - Sverre Wikström
- Department of Health Sciences, Karlstad University, Karlstad, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden; Centre for Clinical Research, County Council of Värmland, Sweden
| | - Carl-Gustaf Bornehag
- Department of Health Sciences, Karlstad University, Karlstad, Sweden; Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Yamauchi Y, Masutomi H, Ishihara K, Hartanto T, Lee CG, Fukuda S. The differential effect of two cereal foods on gut environment: a randomized, controlled, double-blind, parallel-group study. Front Nutr 2024; 10:1254712. [PMID: 38455871 PMCID: PMC10917986 DOI: 10.3389/fnut.2023.1254712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/11/2023] [Indexed: 03/09/2024] Open
Abstract
Background and aims Cereal-based foods such as fruit granola (FG) and corn flakes (CF) form part of a fiber-rich diet. Dietary fiber has a good effect on human health. However, changes in gut microbiota and intestinal immunity have not been investigated. We conducted a randomized, double-blind, placebo-controlled trial to investigate the effects of FG and CF intake on gut microbiota, metabolome, and the immune system. Methods Subjects continuously consume CF or FG for 4 weeks. Stool samples, and questionnaires on defecation were collected before, 2 weeks after, and 4 weeks after intake. Gut microbiota was analyzed using 16S rRNA gene amplicon sequencing. Fecal metabolomes were analyzed using GC/MS and CE-TOF/MS. Fecal IgA was analyzed using ELISA. Results The defecation frequency after cereal based food intake was improved. The different cereal-based foods had different effects on gut microbiome. The increase in intestinal IgA levels was positively correlated with the relative abundance of Dialister and the Lachnospiraceae ND3007 group in CF and FG group, respectively. SCFAs showed a positive correlation with Prevotella 9 in the FG group. Conclusion This study showed that the supplement in dietary fiber contained in CF and FG improves bowel movements. CF and FG each had different effects on gut microbes, metabolites and different relationships between fecal IgA or SCFAs and gut microbiota.
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Affiliation(s)
| | | | | | | | | | - Shinji Fukuda
- Metagen Inc., Tsuruoka, Japan
- Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan
- Gut Environmental Design Group, Kanagawa Institute of Industrial Science and Technology, Kanagawa, Japan
- Transborder Medical Research Center, University of Tsukuba, Tsukuba, Japan
- Laboratory for Regenerative Microbiology, Juntendo University Graduate School of Medicine, Tokyo, Japan
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Kalčíková P, Přidalová M. The Influence of Somatic Maturity on Anthropometrics and Body Composition in Youth Soccer Players. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1732. [PMID: 38002823 PMCID: PMC10670197 DOI: 10.3390/children10111732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 10/21/2023] [Accepted: 10/24/2023] [Indexed: 11/26/2023]
Abstract
The primary aim of this investigation was to compare players' anthropometric (AP) and body composition (BC) characteristics between distinct maturity bands (pre-PHV, circa-PHV, post-PHV) in youth elite soccer. This study considered 320 male soccer players (mean age 13.8 y). Participants were from U14 (n = 157) and U15 (n = 163) age categories. The Khamis-Roche method was applied to calculate the percentage of predicted adult height (PAH) at the time of assessment based on which the players were further divided into maturity bands (pre-PHV ≤ 87%, circa-PHV = 88-95%, post-PHV > 95%). The findings indicated that most of the players were in the circa-PHV stage at the time of investigation. Measurements included height and weight. The estimates of BC parameters were derived using bioelectrical impedance (BIA) analysis. These various AP and BC attributes displayed significant differences among the maturity bands (F = 139.344-7.925; p < 0.001; large effect sizes) except in body fat mass (BFM) (F = 2.998; p = 0.051; small effect size). The current somatic maturity stage of the athletes should be considered when evaluating BC results, otherwise there is a risk of misinterpretation.
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Affiliation(s)
- Pavlína Kalčíková
- Department of Natural Sciences in Kinanthropology, Faculty of Physical Culture, Palacký University Olomouc, Křížkovského 511/8, CZ-779 00 Olomouc, Czech Republic;
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Ohara K, Nakamura H, Kouda K, Fujita Y, Mase T, Momoi K, Nishiyama T. Similarities and discrepancies between commercially available bioelectrical impedance analysis system and dual-energy X-ray absorptiometry for body composition assessment in 10-14-year-old children. Sci Rep 2023; 13:17420. [PMID: 37833453 PMCID: PMC10576075 DOI: 10.1038/s41598-023-44217-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
A variety of easy-to-use commercial bioelectrical impedance appliances are available. The aim of this study was to examine the usefulness of a commercially available body composition meter using bioelectrical impedance analysis (BIA) by comparing its measurement results with those obtained from dual-energy X-ray absorptiometry (DXA). The participants were 443 children aged from 10 to 14 years (226 boys and 217 girls). Fat mass, fat-free mass, lean body mass, percentage of body fat, and bone mineral contents were evaluated for all participants using BIA and DXA. The agreement in the anthropometric data obtained from both devices was analyzed using correlation analysis, intraclass correlation coefficient (ICC), Lin's concordance correlation coefficient (CCC), Bland-Altman plots, and ordinary least products regression analysis. Equivalence between both devices was tested by two one-sided t-test. All measured indicators showed strong linear correlations between the two measurement systems (r, 0.853-1.000). Fat mass, fat-free mass, and lean body mass showed absolute concordance (ICC, 0.902-0.972; Lin's CCC, 0.902-0.972). BIA overestimated bone mineral content (62.7-66.5%) and underestimated percentage of body fat (- 8.9 to - 0.8%), lean body mass (- 3.5 to - 1.8%), and body mass (- 0.8 to - 0.5%). For fat mass and fat-free mass, the overestimate or underestimate varied according to the sex and statistical analysis test. Bland-Altman analysis and ordinary least products analysis showed fixed bias and proportional bias in all indicators. Results according to quartiles of body mass index showed poor agreement for fat mass and percentage of body fat in both boys and girls in the lowest body mass index quartile. The present results revealed strong linear correlations between BIA and DXA, which confirmed the validity of the present single-frequency BIA-derived parameters. Our results suggest that BIA cannot provide the exact same values as DXA for some body composition parameters, but that performance is sufficient for longitudinal use within an individual for daily health management and monitoring.
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Affiliation(s)
- Kumiko Ohara
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, Hyogo, 657-8501, Japan
| | - Harunobu Nakamura
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan.
- Graduate School of Human Development and Environment, Kobe University, 3-11 Tsurukabuto, Nada, Kobe, Hyogo, 657-8501, Japan.
| | - Katsuyasu Kouda
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan
| | - Yuki Fujita
- Center for Medical Education, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Tomoki Mase
- Faculty of Human Development and Education, Kyoto Women's University, 35 Imagumanokitahiyoshi-cho, Higashiyama, Kyoto, Kyoto, 605-8501, Japan
| | - Katsumasa Momoi
- Faculty of Human Development and Education, Kyoto Women's University, 35 Imagumanokitahiyoshi-cho, Higashiyama, Kyoto, Kyoto, 605-8501, Japan
| | - Toshimasa Nishiyama
- Department of Hygiene and Public Health, Kansai Medical University, 2-5-1 Shin-machi, Hirakata, Osaka, 573-1010, Japan
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Parker H, Hunt ET, Brazendale K, Klinggraeff LV, Jones A, Burkart S, Dugger R, Armstrong B, Beets MW, Weaver RG. Accuracy and Precision of Opportunistic Measures of Body Composition from the Tanita DC-430U. Child Obes 2023; 19:470-478. [PMID: 36201230 DOI: 10.1089/chi.2022.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background: It is essential to quantify the accuracy and precision of bioelectrical impedance (BIA)-estimated percent body fat (%BF) to better interpret community-based research findings that utilize opportunistic measures. Methods: Study 1 measured the accuracy of a new dual-frequency foot-to-foot BIA device (Tanita DC-430U) compared with dual-energy X-ray absorptiometry (DXA) among healthy elementary school-aged children (N = 50). Study 2 examined the precision of BIA %BF estimates within and between days among children and adults (N = 38). Results: Regarding accuracy, Tanita DC-430U underestimated %BF by 8.0 percentage points compared with DXA (20.6% vs. 28.5%), but correctly ranked children in terms of %BF. Differences in %BF between BIA and DXA were driven by lower BIA-estimated fat mass (7.8 kg vs. 9.9 kg, p < 0.05) and higher BIA-estimated fat-free mass (25.3 kg vs. 24.1 kg, p < 0.05). The absolute agreement between BIA and DXA for estimated %BF was moderate (concordance correlation coefficients = 0.53). Regarding precision, measures taken at the same time, but on different days (root mean square standard deviation [RMSD] = 0.42-0.74) were more precise than the measures taken at different times within a single day (RMSD = 1.04-1.10). Conclusion: The Tanita DC-430U substantially underestimated %BF compared with DXA, highlighting the need to assess accuracy of new BIA devices when they are introduced to the market. Opportunistic measures of %BF estimates were most precise when taken at consistent times and in the morning, but may be utilized throughout the day with an understanding of within- and between-day variability.
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Affiliation(s)
- Hannah Parker
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Ethan T Hunt
- Michael and Susan Dell Center for Healthy Living, UTHealth Science Center at Houston, Austin Campus, Austin, TX, USA
| | - Keith Brazendale
- Department of Health Sciences, University of Central Florida, Orlando, FL, USA
| | | | - Alexis Jones
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Sarah Burkart
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Roddrick Dugger
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Bridget Armstrong
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - Michael W Beets
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
| | - R Glenn Weaver
- Department of Exercise Science, University of South Carolina, Columbia, SC, USA
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Carter JL, Abdullah N, Bragg F, Murad NAA, Taylor H, Fong CS, Lacey B, Sherliker P, Karpe F, Mustafa N, Lewington S, Jamal R. Body composition and risk factors for cardiovascular disease in global multi-ethnic populations. Int J Obes (Lond) 2023; 47:855-864. [PMID: 37460680 PMCID: PMC10439008 DOI: 10.1038/s41366-023-01339-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 06/21/2023] [Accepted: 07/04/2023] [Indexed: 08/20/2023]
Abstract
BACKGROUND No large-scale studies have compared associations between body composition and cardiovascular risk factors across multi-ethnic populations. METHODS Population-based surveys included 30,721 Malay, 10,865 Indian and 25,296 Chinese adults from The Malaysian Cohort, and 413,737 White adults from UK Biobank. Sex-specific linear regression models estimated associations of anthropometry and body composition (body mass index [BMI], waist circumference [WC], fat mass, appendicular lean mass) with systolic blood pressure (SBP), low-density lipoprotein cholesterol (LDL-C), triglycerides and HbA1c. RESULTS Compared to Malay and Indian participants, Chinese adults had lower BMI and fat mass while White participants were taller with more appendicular lean mass. For BMI and fat mass, positive associations with SBP and HbA1c were strongest among the Chinese and Malay and weaker in White participants. Associations with triglycerides were considerably weaker in those of Indian ethnicity (eg 0.09 [0.02] mmol/L per 5 kg/m2 BMI in men, vs 0.38 [0.02] in Chinese). For appendicular lean mass, there were weak associations among men; but stronger positive associations with SBP, triglycerides, and HbA1c, and inverse associations with LDL-C, among Malay and Indian women. Associations between WC and risk factors were generally strongest in Chinese and weakest in Indian ethnicities, although this pattern was reversed for HbA1c. CONCLUSION There were distinct patterns of adiposity and body composition and cardiovascular risk factors across ethnic groups. We need to better understand the mechanisms relating body composition with cardiovascular risk to attenuate the increasing global burden of obesity-related disease.
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Affiliation(s)
- Jennifer L Carter
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Noraidatulakma Abdullah
- UKM Medical Molecular Biology Institute (UMBI), Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Fiona Bragg
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
- Medical Research Council, Population Health Research Unit, University of Oxford, Oxford, UK
| | - Nor Azian Abdul Murad
- UKM Medical Molecular Biology Institute (UMBI), Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Hannah Taylor
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Chin Siok Fong
- UKM Medical Molecular Biology Institute (UMBI), Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Benjamin Lacey
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Paul Sherliker
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Fredrik Karpe
- Oxford Centre for Diabetes, Endocrinology and Metabolism, University of Oxford, Churchill Hospital, Headington, OX3 7LE, UK
| | - Norlaila Mustafa
- Department of Medicine, Faculty of Medicine, University Kebangsaan Malaysia, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Sarah Lewington
- Clinical Trial Service Unit and Epidemiological Studies, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
- UKM Medical Molecular Biology Institute (UMBI), Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia
- Medical Research Council, Population Health Research Unit, University of Oxford, Oxford, UK
| | - Rahman Jamal
- UKM Medical Molecular Biology Institute (UMBI), Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia
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Coffey AB, Alai NL, Gray VB, Cotter JA, Barrack MT. Nutrition Education Curriculum Promotes Adolescent Runners' Self-Efficacy, Knowledge, and Intake of Nutrient-Rich Carbohydrate Foods. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2023; 42:178-186. [PMID: 35512779 DOI: 10.1080/07315724.2021.2019139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Endurance runners exhibit an elevated prevalence of low bone mass and characteristics consistent with undernourishment. OBJECTIVE This quasi-experimental, pretest-posttest design study evaluated the efficacy of a 4-week nutrition education curriculum to optimize nutrition knowledge, self-efficacy, and the intake of nutrient-rich carbohydrate foods. METHODS Forty-eight adolescent endurance runners, age 15.7 ± 1.2 y, from two high schools in Southern California were recruited to complete four, weekly lessons addressing the quantity, quality, and timing of carbohydrate intake. Differences in pre- compared to post-intervention nutrition knowledge and self-efficacy to consume nutrient-rich carbohydrate foods were evaluated using paired samples t-tests. Qualitative coding of open-response questions explored changes in food intake behaviors reported by runners during the intervention. RESULTS The percent of nutrition knowledge questions answered correctly increased after Lessons 1 and 2 (59.0% ± 20.0% pre- vs. 81.9% ± 22.8% post-Lesson 1; 44.7% ± 13.7% pre- vs. 74.5% ± 17.4% post-Lesson 2, P<.001) and the number of identified nutrient-rich carbohydrate foods (8.7 ± 2.7 vs. 12.4 ± 2.3, P < 0.001). Self-efficacy scores improved after all lessons (P<.001). After Lesson 2, 84% (n = 27/32) of runners increased the carbohydrate included in a snack or meal; after Lesson 4, 85% (n = 29/34) added a post-exercise snack. Frequent themes identified from questions addressing dietary changes included increasing quantity and quality of carbohydrates in snacks and meals and being more aware of food choices.Conclusions: Findings suggest that the curriculum enhanced nutrition knowledge, self-efficacy, and dietary behaviors related to intake of nutrient-dense carbohydrate foods in adolescent runners.
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Affiliation(s)
- Alaina B Coffey
- Department of Family and Consumer Sciences, California State University Long Beach, Long Beach, California, USA
| | - Nicole L Alai
- Department of Family and Consumer Sciences, California State University Long Beach, Long Beach, California, USA
| | - Virginia B Gray
- Department of Family and Consumer Sciences, California State University Long Beach, Long Beach, California, USA
| | - Joshua A Cotter
- Department of Kinesiology, California State University Long Beach, Long Beach, California, USA
| | - Michelle T Barrack
- Department of Family and Consumer Sciences, California State University Long Beach, Long Beach, California, USA
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Moeng-Mahlangu L, Monyeki MA, Reilly JJ, Kruger HS. Comparison of Several Prediction Equations Using Skinfold Thickness for Estimating Percentage Body Fat vs. Body Fat Percentage Determined by BIA in 6-8-Year-Old South African Children: The BC-IT Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:14531. [PMID: 36361413 PMCID: PMC9656018 DOI: 10.3390/ijerph192114531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/13/2022] [Accepted: 10/31/2022] [Indexed: 06/16/2023]
Abstract
Body composition measurement is useful for assessing percentage body fat (%BF) and medical diagnosis, monitoring disease progression and response to treatment, and is essential in assessing nutritional status, especially in children. However, finding accurate and precise techniques remains a challenge. The study compares %BF determined by bioelectrical impedance analysis (BIA) and calculated from available prediction equations based on skinfolds in young South African children. A cross-sectional study performed on 202 children (83 boys and 119 girls) aged 6-8 years. Height and weight, triceps and subscapular skinfolds were determined according to standard procedures. %BF was determined with BIA and three relevant available equations. SPSS analyzed the data using paired samples tests, linear regression, and Bland-Altman plots. Significant paired mean differences were found for BIA and Slaughter (t201 = 33.896, p < 0.001), Wickramasinghe (t201 = 4.217, p < 0.001), and Dezenberg (t201 = 19.910, p < 0.001). For all of the equations, the standards for evaluating prediction errors (SEE) were above 5. The Bland-Altman plots show relatively large positive and negative deviations from the mean difference lines and trends of systematic under- and over-estimation of %BF across the %BF spectrum. All three equations demonstrated a smaller %BF than the %BF measured by BIA, but the difference was smallest with the Wickramasinghe equation. In comparison, a poor SEE was found in the three %BF predicted equations and %BF derived from BIA. As such, an age-specific %BF equation incorporating criterion methods of deuterium dilution techniques or 'gold-standard' methods is needed to refute these findings. However, in the absence of developed %BF equations or 'gold-standard' methods, the available prediction equations are still desirable.
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Affiliation(s)
- Lynn Moeng-Mahlangu
- Physical Activity, Sport and Recreation Research Focus Area (PhASRec), Faculty of Health Sciences, North-West University, Potchefstroom 2531, South Africa
| | - Makama A. Monyeki
- Physical Activity, Sport and Recreation Research Focus Area (PhASRec), Faculty of Health Sciences, North-West University, Potchefstroom 2531, South Africa
| | - John J. Reilly
- Physical Activity for Health Group, School of Psychological Sciences and Health, University of Strathclyde, Glasgow G1 1XQ, UK
| | - Herculina S. Kruger
- Centre of Excellence for Nutrition, North-West University, Potchefstroom 2531, South Africa
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Olander RFW, Litwin L, Sundholm JKM, Sarkola T. Childhood cardiovascular morphology and function following abnormal fetal growth. Heart Vessels 2022; 37:1618-1627. [PMID: 35426503 PMCID: PMC9349157 DOI: 10.1007/s00380-022-02064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 03/25/2022] [Indexed: 12/01/2022]
Abstract
Studies examining the link between abnormal fetal growth and cardiac changes in childhood have presented conflicting results. We studied the effect of abnormal fetal growth on cardiac morphology and function during childhood, while controlling for body size, composition and postnatal factors. We report on the follow-up of 90 children (median age 5.81 years, IQR 5.67; 5.95) born appropriate for gestational age (AGA, N = 48), small for gestational age (SGA, N = 23), or large for gestational age (LGA, N = 19); SGA and LGA defined as birth weight Z-score < − 2 and > + 2, respectively. We examined the heart using echocardiography, including Doppler and strain imaging, in relation to anthropometrics, body composition, blood pressure, physical activity, and diet. Although groupwise differences in body size decreased during the first year after birth, LGA remained larger at follow-up, with higher lean body mass and BMI, while SGA were smaller. Slight changes in left ventricular diastolic function were present in SGA and LGA, with SGA showing increased mitral diastolic E- and A-wave peak flow velocities, and increased septal E/E′ ratio, and LGA showing larger left atrial volume adjusted for sex and lean body mass. In univariate analyses, lean body mass at follow-up was the strongest predictor of cardiac morphology. We found no groupwise differences at follow-up for ventricular sphericity, cardiac morphology adjusted for lean body mass and sex, or blood pressure, diet, or physical activity. Cardiac morphology is predicted by lean body mass during childhood, even in the setting of abnormal fetal growth. Our results are consistent with a limited effect of fetal programming on cardiac dimensions during childhood. Minor changes in diastolic function are present in both SGA and LGA children, however, the clinical significance of these changes at this stage is likely small.
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Affiliation(s)
- Rasmus F W Olander
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, 00029, Helsinki, Finland.
- Minerva Foundation Institute for Medical Research, Helsinki, Finland.
| | - Linda Litwin
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Congenital Heart Defects and Pediatric Cardiology, FMS, Medical University of Silesia, Katowice, Poland
| | - Johnny K M Sundholm
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, 00029, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Taisto Sarkola
- Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, 00029, Helsinki, Finland
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
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Holmes CJ, Racette SB, Symonds L, Arbeláez AM, Cao C, Granados A. Comparison of Bioelectrical Impedance Analysis with DXA in Adolescents with Cystic Fibrosis before and after a Resistance Training Intervention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19074037. [PMID: 35409718 PMCID: PMC8997924 DOI: 10.3390/ijerph19074037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/24/2022] [Accepted: 03/26/2022] [Indexed: 11/16/2022]
Abstract
Background: The purpose of this pilot study was to compare body composition metrics obtained by two portable bioelectrical impedance analysis (BIA) devices with dual-energy X-ray absorptiometry (DXA) among adolescents with cystic fibrosis (CF) before and after a resistance exercise training program. Methods: Participants with CF were assessed using DXA, single-frequency BIA (SFBIA), and multiple-frequency BIA (MFBIA) to quantify percent body fat (%Fat), fat mass (FM), and fat-free mass (FFM) at baseline and after a home-based resistance training intervention comprised of 36, 1 h sessions completed in 12–14 weeks. Repeated measures analysis of variance, paired samples t-tests, Cohen’s d effect sizes, and Pearson’s correlations were used to compare differences between and within methods at baseline and post-intervention. Results: Ten participants (15.8 ± 2.2 yr, 60.1 ± 15.1 kg) completed the assessments. At baseline, both SFBIA and MFBIA scales significantly underestimated %Fat and FM and overestimated FFM, with small to moderate effect sizes. Post-intervention, small, non-significant differences were found between DXA and both BIA scales for all body composition metrics. Significant changes in %Fat and FFM were observed with DXA. MFBIA displayed less constant error than SFBIA when compared to DXA for pre- and post-intervention assessments for %Fat (MFBIA: pre and post −2.8 and −0.8 vs. SFBIA: −4.6 and −2.0), FM (−0.4 and −0.4 vs. −3.0 and −1.1), and FFM (+0.8 and +0.6 vs. +3.1 and +1.3). Near-perfect correlations were observed at both time points between DXA and each BIA scale. Conclusions: Portable BIA results should be interpreted with caution, and further validation studies in CF patients are needed prior to clinical use.
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Affiliation(s)
- Clifton J. Holmes
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63108, USA; (S.B.R.); (C.C.)
- Center for Human Nutrition, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63108, USA
- Correspondence: ; Tel.: +1-314-392-2016
| | - Susan B. Racette
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63108, USA; (S.B.R.); (C.C.)
- Center for Human Nutrition, Department of Medicine, Washington University School of Medicine, St. Louis, MO 63108, USA
| | - Leslie Symonds
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63108, USA; (L.S.); (A.M.A.)
| | - Ana Maria Arbeláez
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63108, USA; (L.S.); (A.M.A.)
| | - Chao Cao
- Program in Physical Therapy, Washington University School of Medicine, St. Louis, MO 63108, USA; (S.B.R.); (C.C.)
| | - Andrea Granados
- Nicklaus Children’s Hospital, Division of Pediatric Endocrinology and Metabolism, Miami, FL 33155, USA;
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11
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Body Composition Assessment in Mexican Children and Adolescents. Part 2: Cross-Validation of Three Bio-Electrical Impedance Methods against Dual X-ray Absorptiometry for Total-Body and Regional Body Composition. Nutrients 2022; 14:nu14050965. [PMID: 35267947 PMCID: PMC8912617 DOI: 10.3390/nu14050965] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 02/18/2022] [Accepted: 02/18/2022] [Indexed: 02/01/2023] Open
Abstract
The aim of our study was to validate three different bioelectrical impedance analysis (BIA) methods for estimating body composition (BC). First, we generated BIA prediction equations based on the 4-C model as the reference method for fat mass (FM) and fat-free mass (FFM), and on dual X-ray absorptiometry (DXA) estimations of appendicular lean mass (ALM) and truncal fat mass (tFM). Then, we performed cross-validation in an independent BMI-, sex-, and Tanner-stratified sample of 450 children/adolescents. The three BIA methods showed good correlation and concordance with DXA BC estimations. However, agreement analyses showed significant biases, with increasing subestimations of FM and tFM, and overestimations of ALM, by all three BIA methods. In conclusion, the three BIA methods analysed in this study, provide valid estimations of BC for total body and body segments, in children and adolescents who are of a healthy weight, overweight, or obese. It should be noted that this validation cannot be extrapolated to other BIA methods.
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12
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Olander RFW, Sundholm JKM, Suonsyrjä S, Sarkola T. Arterial health during early childhood following abnormal fetal growth. BMC Pediatr 2022; 22:40. [PMID: 35031019 PMCID: PMC8759262 DOI: 10.1186/s12887-021-02951-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 10/13/2021] [Indexed: 12/11/2022] Open
Abstract
Background Abnormal fetal growth is associated with increased cardiovascular risk in adulthood. We investigated the effect of fetal programming on arterial health and morphology during early childhood. Methods We examined 90 children (median age 5.81 years, interquartile range: 5.67; 5.95), born small for gestational age with fetal growth restriction, large or appropriate for gestational age (SGA, N = 23, LGA, N = 19, AGA N = 48). We measured body composition, anthropometrics, blood pressure, pulse wave velocity (PWV), lipids, glucose and inflammatory markers, and assessed carotid, brachial, radial and femoral arterial morphology and stiffness using very-high resolution ultrasound (46–71 MHz). Results LGA showed increased anthropometry, lean body mass and body mass index. SGA displayed decreased anthropometry and lean body mass. Blood pressure, PWV, carotid artery stiffness and blood work did not differ groupwise. Differences in lumen diameters, intima-media thicknesses (IMT) and adventitia thicknesses disappeared when adjusted for lean body mass and sex. In multiple regression models arterial dimensions were mainly predicted by lean body mass, with birth weight remaining associated only with carotid and brachial lumen dimensions, and not with IMTs. Carotid-femoral PWV was predicted by height and blood pressure only. No independent effect of adiposity was observed. Conclusions Arterial dimensions in childhood associate with current anthropometrics, especially lean body mass, and sex, explaining differences in arterial layer thickness. We found no signs of fetal programming of cardiovascular risk or arterial health in early childhood. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02951-2.
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Affiliation(s)
- Rasmus F W Olander
- Children's Hospital, Pediatric Research Center, University of Helsinki, and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, FIN-00029, Helsinki, Finland. .,Minerva Foundation Institute for Medical Research, Helsinki, Finland.
| | - Johnny K M Sundholm
- Children's Hospital, Pediatric Research Center, University of Helsinki, and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, FIN-00029, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Sanna Suonsyrjä
- Children's Hospital, Pediatric Research Center, University of Helsinki, and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, FIN-00029, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
| | - Taisto Sarkola
- Children's Hospital, Pediatric Research Center, University of Helsinki, and Helsinki University Hospital, Stenbäckinkatu 9, POB 347, FIN-00029, Helsinki, Finland.,Minerva Foundation Institute for Medical Research, Helsinki, Finland
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13
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Gomes TLM, Peixoto MVM, de Azevedo ZMA, Fonseca VM, Ramos EG. Association of electrical bioimpedance vectors with the nutritional classification of vulnerable multiethnic children. Clin Nutr ESPEN 2021; 46:453-458. [PMID: 34857233 DOI: 10.1016/j.clnesp.2021.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/06/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND & AIMS Monitoring growth and body composition in childhood is vital for early detection of health and nutrition problems during child development. The bioelectrical impedance vector analysis (BIVA) revealed its effectiveness as an indicator of nutritional status. This study aimed to measure the bioimpedance vectors of a sample of multiethnic children and evaluate the utility of BIVA for the classification of the nutritional status in a group of children with greater vulnerability, including in the presence of obesity. METHODS This is a cross-sectional study that analyzed the bioelectrical impedance of a sample of 321 children from public daycare centers, aged 1-4 years, using the RXc graph method (tetrapolar analysis at 50 kHz frequency). The 95%, 75%, and 50% tolerance ellipses were plotted by age group. The Z-scores of bioimpedance parameters (Xc/H-Z and R/H-Z) were calculated regarding age, which were used to build reference tolerance ellipses for a single group, regardless of age. Such ellipses were evaluated for their ability to recognize the pattern and classify the deviations, using individual vectors of obese children. RESULTS The mean impedance vectors showed progressively higher reactances and lower resistances with age. In the group of obese children, the individual vectors located outside the 95% baseline tolerance ellipse were 12.5%, 18.75%, and 11.1% of the cases for the WHZ, WAZ, and BMIZ criteria, respectively, all above the expected 5%, but much below expectations. This may be a problem with the obesity criteria used, as WHZ, WAZ, and BMIZ do not differentiate fat from lean mass. CONCLUSION Bioimpedance vector analysis reflects differences in the bioelectric patterns of children classified as obese. Provided the obesity criteria are constructed based on fat measurements, rather than lean mass, the use of tolerance ellipses in the BIVA chart is promising as a tool for monitoring nutritional status where measuring body composition is difficult, because constant tissue hydration cannot be assumed.
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Affiliation(s)
- Taisa Lisboa Montagner Gomes
- Department of Education and Research, Instituto Federal de Educação, Ciência e Tecnologia do Maranhão, São Luís, Brazil.
| | - Maria Virginia Marques Peixoto
- Analytical Methods Laboratory, Research Department, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Zina Maria Almeida de Azevedo
- Intensive Care Unit, Pediatrics Department, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Vania Matos Fonseca
- Clinical Research Unit, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Eloane Gonçalves Ramos
- Clinical Research Unit, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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14
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Lee LW, Yen JB, Lu HK, Liao YS. Prediction of Nonalcoholic Fatty Liver Disease by Anthropometric Indices and Bioelectrical Impedance Analysis in Children. Child Obes 2021; 17:551-558. [PMID: 34265208 DOI: 10.1089/chi.2021.0054] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Nonalcoholic fatty liver disease (NAFLD) is highly prevalent in children and is associated with obesity. Objectives: To test whether addition of bioelectrical impedance analysis (BIA) parameters to BMI and anthropometric indices improves the prediction performance of NAFLD than BMI z score (BAZ) alone. Methods: This cross-sectional study recruited 933 children 6-12 years of age for anthropometric measure, BIA, and liver ultrasound. Prediction models of the BAZ, anthropometric, and BIA sets were built in children with obesity using machine learning algorithms. Results: Prevalences of NAFLD were 44.4% (59/133) and 20% (12/60) in boys and girls with obesity, respectively. In both sexes, BAZ set performed worst; adding anthropometric indices into the model improved the model performance, whereas BIA parameters were the best approach for predicting NAFLD. The best result in boys achieved had an accuracy of 75.9% and area under receiver operating characteristic curve of 0.854. In girls, the best result achieved had an F-measure score of 0.615, Matthews correlation coefficient of 0.512, and area under precision-recalled curve of 0.697. Conclusion: BIA is a simple and highly precise tool that yields better NAFLD prediction model than anthropometric indices, and much better performance than BAZ. This study suggests BIA as a potential predictor for pediatric NAFLD.
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Affiliation(s)
- Li-Wen Lee
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Nursing, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Ju-Bei Yen
- Department of Pediatrics, Chang Gung Memorial Hospital, Chiayi, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Taoyuan, Taiwan
| | - Hsueh-Kuan Lu
- General Education Center, National Taiwan University of Sport, Taichung, Taiwan
| | - Yu-San Liao
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan.,Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Yunlin, Taiwan
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15
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Lessons GR, Bhakta D, McCarthy D. Development of muscle mass and body fat reference curves for white male UK firefighters. Int Arch Occup Environ Health 2021; 95:779-790. [PMID: 34599408 DOI: 10.1007/s00420-021-01761-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 09/14/2021] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study describes the development of the world's first suite of firefighter body composition centile reference curves which can be used as both academic research tools and clinical references, to plot and track individual firefighter skeletal muscle mass (SMM) and fat mass (FM) measurements against the representative reference sample. METHODS The body composition of 497 white male London (England) firefighters was measured by anthropometry and bioelectrical impedance analysis. Smoothed centile curves were then generated for skeletal muscle mass index (SMMI), fat mass index (FMI), body fat percentage (BF%) and waist-to-height ratio (WHtR). RESULTS Between 48 and 62 years, firefighter SMMI is greater than the UK white male age-matched general population by a mean of 0.35 units, although SMMI declines 0.006 units/years faster in firefighters between these ages. This is estimated to translate to a mean decline of approximately 0.6% of absolute SMM per year. Between 40 and 49 years, firefighter FMI is 0.1 units greater than the UK white male age-matched general population, which becomes identical (7 units) between 50 and 54 years. At the 50th centile, WHtR exceeds 0.5 by 39 years reaching 0.55 at 62 years. This contrasts with FMI which remains stable from 47 years. CONCLUSION Firefighters in this study possess greater FM and SMM compared with the UK general population. SMM appears to decline rapidly within older age ranges. These references offer a novel improvement upon the limitations of BMI and BF% for the benefit of an occupational group at elevated risk of cardiovascular disease.
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Affiliation(s)
- Greg Richard Lessons
- Public Health Nutrition Research Group, London Metropolitan University, London, N7 8DB, UK.
| | - Dee Bhakta
- Public Health Nutrition Research Group, London Metropolitan University, London, N7 8DB, UK
| | - David McCarthy
- Public Health Nutrition Research Group, London Metropolitan University, London, N7 8DB, UK
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16
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Association between Body Fat and Elevated Blood Pressure among Children and Adolescents Aged 7-17 Years: Using Dual-Energy X-ray Absorptiometry (DEXA) and Bioelectrical Impedance Analysis (BIA) from a Cross-Sectional Study in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18179254. [PMID: 34501843 PMCID: PMC8431661 DOI: 10.3390/ijerph18179254] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 08/27/2021] [Accepted: 08/28/2021] [Indexed: 12/04/2022]
Abstract
To investigate the associations between body fat percentage (BF%) with childhood blood pressure (BP) levels and elevated BP (EBP) risks, and further examine the validity of bioelectrical impedance analysis (BIA), we conducted a cross-sectional study of 1426 children and adolescents aged 7–17 years in Beijing, 2020. EBP, including elevated systolic BP (ESBP) and elevated diastolic BP (EDBP), was defined based on the age- and sex-specific 90th BP reference values of children and adolescents in China. BF% was measured by dual-energy X-ray absorptiometry (DEXA) and BIA devices, and was divided into four quartiles. Log-binomial models were applied to calculate odds ratios (ORs) and 95% confidence intervals (95%CI). Girls tended to have higher BF% levels than boys (p < 0.05). There was 41.0% of girls who developed EBP. High BF% was associated with increased BP levels with ORs of 0.364 (95%CI = 0.283–0.444) for SBP, 0.112 (95%CI = 0.059–0.165) for DBP, and 1.043 (95%CI = 1.027–1.059) for EBP, while the effects were more pronounced in girls and older-aged children. BIA devices agreed well with BF% assessment obtained by DEXA. High BF% might have negative effects on childhood BP. Convenient measurements of body fat might help to assess childhood obesity and potential risks of hypertension.
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17
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Analysis of the Association between Fat Mass Distribution and Bone Mass in Chinese Male Adolescents at Different Stages of Puberty. Nutrients 2021; 13:nu13072163. [PMID: 34202423 PMCID: PMC8308367 DOI: 10.3390/nu13072163] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 06/15/2021] [Accepted: 06/19/2021] [Indexed: 12/12/2022] Open
Abstract
Background: Bone mineral acquisition during adolescence is crucial for maximizing peak bone mass. Fat mass (FM) and bone mass are closely related. This study investigated the association of FM distribution with bone mass in Chinese male adolescents. Method: A total of 693 male adolescents aged 10–18 years were recruited from a secondary school in Jiangmen, China. Their bone mass and body composition were measured by quantitative ultrasound and bioelectrical impedance analysis, respectively. The associations of the measures of fat distribution with bone parameters, i.e., broadband ultrasound attenuation, speed of sound (SOS), and stiffness index (SI), were analyzed using multiple linear regression. Age, height, body mass index, stage of puberty, physical activity, sedentary behavior, dietary energy intake, and dietary calcium and vitamin D intake were adjusted in the model. Further subgroup analyses of prepubertal and pubertal participants were conducted. Results: The measures of fat distribution showed negative associations with SOS and SI in total subjects (p < 0.010). In prepubertal boys, the measures of fat distribution were only associated with SOS (β = −0.377 to −0.393, p < 0.050). In pubertal boys, the measures of fat distribution had associations with all bone parameters (β = −0.205 to −0.584, p < 0.050). The strongest association was between trunk FM and SOS (β = −0.584, p < 0.001). Conclusion: This study supported that the measures of fat distribution were negatively associated with bone parameters in Chinese male adolescents. Trunk FM had the strongest association with bone parameter. These associations appear to be stronger in pubertal boys than in prepubertal boys.
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18
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Cross-Sectional and Longitudinal Associations between Non-School Time Physical Activity, Sedentary Time, and Adiposity among Boys and Girls: An Isotemporal Substitution Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094671. [PMID: 33925751 PMCID: PMC8125309 DOI: 10.3390/ijerph18094671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/22/2021] [Accepted: 04/25/2021] [Indexed: 11/17/2022]
Abstract
This study investigated the cross-sectional and longitudinal associations of the substitution of non-school time light physical activity (LPA), moderate-to-vigorous physical activity (MVPA), and sedentary time (ST) with adiposity in boys and girls. Boys (n = 65, baseline Mage= 9.93 ± 0.86 years) and girls (n = 77, baseline Mage = 10.17 ± 0.95 years) wore waist-worn accelerometers (ActiGraph GT3X) at baseline and at a 30-month follow-up, from which non-school time LPA, MVPA, ST, and total device wear were quantified. Body mass index (BMI) and waist-to-height-ratio (WHR) were measured at baseline and follow-up. Body fat percent (BF%) was obtained at follow-up only. Isotemporal substitution models assessed the cross-sectional and longitudinal associations of reallocating non-school time activity with BMI, WHR and BF%. In boys, replacing 30 min/day of LPA with MVPA was cross-sectionally (β = −8.26, p < 0.05) associated with a lower BF%. Replacing 30 min/day of ST with MVPA was cross-sectionally (β = −6.02, p < 0.05) associated with a lower BF% in boys. Longitudinally in boys, replacing 30 min of change in LPA with MVPA (β = −7.42, p < 0.10) and replacing 30 min of change in MVPA with ST (β = 5.78, p < 0.10) over 30 months was marginally associated with less BF%. Associations were null in girls (p > 0.05). These results may support targeting activity reallocation during non-school time for the purposes of adiposity improvement in boys. A multi-behavioral approach may be more appropriate for girls, as non-school time activity may not be driving adiposity status.
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19
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Thajer A, Skacel G, Truschner K, Jorda A, Vasek M, Horsak B, Strempfl J, Kautzky-Willer A, Kainberger F, Greber-Platzer S. Comparison of Bioelectrical Impedance-Based Methods on Body Composition in Young Patients with Obesity. CHILDREN-BASEL 2021; 8:children8040295. [PMID: 33920492 PMCID: PMC8070058 DOI: 10.3390/children8040295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/03/2021] [Accepted: 04/07/2021] [Indexed: 11/20/2022]
Abstract
(1) Background: The determination of body composition is an important method to investigate patients with obesity and to evaluate the efficacy of individualized medical interventions. Bioelectrical impedance-based methods are non-invasive and widely applied but need to be validated for their use in young patients with obesity. (2) Methods: We compiled data from three independent studies on children and adolescents with obesity, measuring body composition with two bioelectrical impedance-based devices (TANITA and BIACORPUS). For a small patient group, additional data were collected with air displacement plethysmography (BOD POD) and dual-energy X-ray absorptiometry (DXA). (3) Results: Our combined data on 123 patients (age: 6–18 years, body mass index (BMI): 21–59 kg/m²) and the individual studies showed that TANITA and BIACORPUS yield significantly different results on body composition, TANITA overestimating body fat percentage and fat mass relative to BIACORPUS and underestimating fat-free mass (p < 0.001 for all three parameters). A Bland–Altman plot indicated little agreement between methods, which produce clinically relevant differences for all three parameters. We detected gender-specific differences with both methods, with body fat percentage being lower (p < 0.01) and fat-free mass higher (p < 0.001) in males than females. (4) Conclusions: Both bioelectrical impedance-based methods provide significantly different results on body composition in young patients with obesity and thus cannot be used interchangeably, requiring adherence to a specific device for repetitive measurements to ascertain comparability of data.
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Affiliation(s)
- Alexandra Thajer
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (G.S.); (K.T.); (A.J.); (M.V.); (S.G.-P.)
- Correspondence:
| | - Gabriele Skacel
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (G.S.); (K.T.); (A.J.); (M.V.); (S.G.-P.)
| | - Katharina Truschner
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (G.S.); (K.T.); (A.J.); (M.V.); (S.G.-P.)
| | - Anselm Jorda
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (G.S.); (K.T.); (A.J.); (M.V.); (S.G.-P.)
| | - Martin Vasek
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (G.S.); (K.T.); (A.J.); (M.V.); (S.G.-P.)
| | - Brian Horsak
- Institute of Health Sciences, St. Pölten University of Applied Sciences, Matthias-Corvinus-Straße 15, 3100 St. Pölten, Austria;
| | - Johanna Strempfl
- Department of Physiotherapy, St. Pölten University of Applied Sciences, Matthias-Corvinus-Straße 15, 3100 St. Pölten, Austria;
| | - Alexandra Kautzky-Willer
- Gender Medicine Unit, Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria;
| | - Franz Kainberger
- Division of Neuro- and Musculoskeletal Radiology, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria;
| | - Susanne Greber-Platzer
- Division of Pediatric Pulmonology, Allergology and Endocrinology, Department of Pediatrics and Adolescent Medicine, Medical University of Vienna, Waehringer Guertel 18–20, 1090 Vienna, Austria; (G.S.); (K.T.); (A.J.); (M.V.); (S.G.-P.)
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20
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Rusek W, Baran J, Leszczak J, Adamczyk M, Baran R, Weres A, Inglot G, Czenczek-Lewandowska E, Pop T. Changes in Children's Body Composition and Posture during Puberty Growth. CHILDREN-BASEL 2021; 8:children8040288. [PMID: 33917775 PMCID: PMC8068155 DOI: 10.3390/children8040288] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 11/16/2022]
Abstract
The main goal of our study was to determine how the age of children, puberty and anthropometric parameters affect the formation of body composition and faulty body posture development in children. The secondary goal was to determine in which body segments abnormalities most often occur and how gender differentiates the occurrence of adverse changes in children's body posture and body composition during puberty. The study group consisted of 464 schoolchildren aged from 6-16. Body posture was assessed with the Zebris system. The composition of the body mass was tested with Tanita MC 780 MA body mass analyzer and the body height was measured using a portable stadiometer PORTSTAND 210. The participants were further divided due to the age of puberty. Tanner division was adopted. The cut-off age for girls is ≥10 years and for boys it is ≥12 years. The analyses applied descriptive statistics, the Pearson correlation, stepwise regression analysis and the t-test. The accepted level of significance was p < 0.05. The pelvic obliquity was lower in older children (beta = -0.15). We also see that age played a significant role in the difference in the height of the right pelvis (beta = -0.28), and the difference in the height of the right shoulder (beta = 0.23). Regression analysis showed that the content of adipose tissue (FAT%) increased with body mass index (BMI) and decreased with increasing weight, age, and height. Moreover, the FAT% was lower in boys than in girls (beta negative equal to -0.39). It turned out that older children (puberty), had greater asymmetry in the right shoulder blade (p < 0.001) and right shoulder (p = 0.003). On the other hand, younger children (who were still before puberty) had greater anomalies in the left trunk inclination (p = 0.048) as well as in the pelvic obliquity (p = 0.008). Girls in puberty were characterized by greater asymmetry on the right side, including the shoulders (p = 0.001), the scapula (p = 0.001) and the pelvis (p < 0.001). In boys, the problem related only to the asymmetry of the shoulder blades (p < 0.001). Girls were characterized by a greater increase in adipose tissue and boys by muscle tissue. Significant differences also appeared in the body posture of the examined children. Greater asymmetry within scapulas and shoulders were seen in children during puberty. Therefore, a growing child should be closely monitored to protect them from the adverse consequences of poor posture or excessive accumulation of adipose tissue in the body.
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Affiliation(s)
- Wojciech Rusek
- Rehabilitation Centre Rehamed-Center Sp z o.o. Tajecina 66A, 36-002 Tajęcina, Poland; (W.R.); (M.A.)
| | - Joanna Baran
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr. W. Kopisto 2a, 35-310 Rzeszów, Poland; (J.L.); (A.W.); (E.C.-L.); (T.P.)
- Natural and Medical Center for Innovative Research, ul. Litawora 2, 35-310 Rzeszów, Poland
- Correspondence:
| | - Justyna Leszczak
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr. W. Kopisto 2a, 35-310 Rzeszów, Poland; (J.L.); (A.W.); (E.C.-L.); (T.P.)
- Natural and Medical Center for Innovative Research, ul. Litawora 2, 35-310 Rzeszów, Poland
| | - Marzena Adamczyk
- Rehabilitation Centre Rehamed-Center Sp z o.o. Tajecina 66A, 36-002 Tajęcina, Poland; (W.R.); (M.A.)
| | - Rafał Baran
- RehaKlinika Sp. z o.o., ul. Pogodne Wzgórze 12, 35-317 Rzeszów, Poland
| | - Aneta Weres
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr. W. Kopisto 2a, 35-310 Rzeszów, Poland; (J.L.); (A.W.); (E.C.-L.); (T.P.)
- Natural and Medical Center for Innovative Research, ul. Litawora 2, 35-310 Rzeszów, Poland
| | - Grzegorz Inglot
- Solution-Statistical Analysis, ul. Stojałowskiego 4/73, 35-120 Rzeszów, Poland;
- Institute of Medical Sciences, Medical College, University of Rzeszów, Al. mjr. W. Kopisto 2a, 35-310 Rzeszów, Poland;
| | - Ewelina Czenczek-Lewandowska
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr. W. Kopisto 2a, 35-310 Rzeszów, Poland; (J.L.); (A.W.); (E.C.-L.); (T.P.)
- Natural and Medical Center for Innovative Research, ul. Litawora 2, 35-310 Rzeszów, Poland
| | - Teresa Pop
- Institute of Health Sciences, Medical College, University of Rzeszów, Al. mjr. W. Kopisto 2a, 35-310 Rzeszów, Poland; (J.L.); (A.W.); (E.C.-L.); (T.P.)
- Natural and Medical Center for Innovative Research, ul. Litawora 2, 35-310 Rzeszów, Poland
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21
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Effects of 4 Weeks of a Technique-Specific Protocol with High-Intensity Intervals on General and Specific Physical Fitness in Taekwondo Athletes: An Inter-Individual Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073643. [PMID: 33807435 PMCID: PMC8037394 DOI: 10.3390/ijerph18073643] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 01/10/2023]
Abstract
The aim of this research was to compare the effects of a technique-specific high-intensity interval training (HIIT) protocol vs. traditional taekwondo training on physical fitness and body composition in taekwondo athletes, as well as to analyse the inter-individual response. Utilising a parallel controlled design, sixteen male and female athletes (five females and 11 males) were randomly divided into an experimental group (EG) that participated in the technique-specific HIIT and a control group (CG) that participated in traditional taekwondo training. Both groups trained three days/week for four weeks. Squat jump (SJ), countermovement jump (CMJ), 5-metre sprint (5M), 20-metre shuttle run (20MSR), taekwondo specific agility test (TSAT), multiple frequency speed of kick test (FSKTMULT), total kicks, and kick decrement index (KDI), as well as body composition were evaluated. Results indicate that there are no significant differences (p > 0.05) in the factors group and time factor and group by time interaction (p > 0.05). Although percentage and effect size increases were documented for post-intervention fitness components in TSAT, total kicks, KDI, and 20MSR, responders and non-responders were also documented. In conclusion, a HIIT protocol based on taekwondo-specific technical movements does not report significant differences in fitness and body composition compared to traditional taekwondo training, nor inter-individual differences between athletes.
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22
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Larsen MN, Krustrup P, Araújo Póvoas SC, Castagna C. Accuracy and reliability of the InBody 270 multi-frequency body composition analyser in 10-12-year-old children. PLoS One 2021; 16:e0247362. [PMID: 33770106 PMCID: PMC7996997 DOI: 10.1371/journal.pone.0247362] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 02/05/2021] [Indexed: 12/12/2022] Open
Abstract
The aim of this study was at examining the validity and reliability of a marketed bioimpedance (BIA) scale for body composition assessment, in children engaged in an educational football project (FIFA 11 for Health). One-hundred and twenty-seven children (70 boys and 57 girls; age 10.7±0.5 years, body mass 41.2±9.0 kg, Body mass index 18.5±3.3 kg·m-2 and stature 149±7 cm) were evaluated for total body mass, lean body mass, muscle mass, using BIA (InBody 270, Biospace, California, USA) and dual-energy X-ray absorptiometry (DEXA, Lunar Prodigy, GE Medical Systems, Madison, Wisconsin, USA), at baseline conditions. Data analyses were carried out separately for girls and boys. Nearly perfect associations (r = 0.97−0.99) and excellent absolute (TEM = 0.04−1.9%) and relative (ICC = 0.98−1.00) inter-device reliability were found between DEXA and BIA variables. Fat and lean body mass bias (p < .0001) were practically relevant both for the boys (2.56 and 11.22 kg, respectively) and the girls (2.33 and 10.49 kg, respectively). Muscle mass and body fat were underestimated and overestimated, respectively, for the boys and girls. InBody 270 is a valid BIA system for estimating body composition with an excellent inter-device relative and absolute reliability. However, the remarkable measurements bias of BIA fat and muscle mass values discourage its use for clinical prescription. The BIA body composition biases were sex dependent.
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Affiliation(s)
- Malte Nejst Larsen
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, United Kingdom
- Department of Physical Education and Sports Training, Shanghai University of Sport, Shanghai (SUS), China
| | - Susana Cristina Araújo Póvoas
- Department of Sports Science and Clinical Biomechanics, SDU Sport and Health Sciences Cluster (SHSC), Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
- Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI, Maia, Portugal
| | - Carlo Castagna
- Technical Department, Fitness Training and Biomechanics Laboratory, Italian Football Federation, Coverciano, Florence, Italy
- School of Sport and Exercise Sciences, University of Rome Tor Vergata, Rome, Italy
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23
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Köchli S, Endes K, Grenacher J, Streese L, Lona G, Hauser C, Deiseroth A, Zahner L, Hanssen H. Socioeconomic Status and Parental Lifestyle Are Associated With Vascular Phenotype in Children. Front Public Health 2021; 9:610268. [PMID: 33842418 PMCID: PMC8032988 DOI: 10.3389/fpubh.2021.610268] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 03/03/2021] [Indexed: 01/08/2023] Open
Abstract
Background/Aims: Socioeconomic barriers and lifestyle conditions affect development of cardiovascular disease in adults, but little is known about the association of parental lifestyle and education with childhood health. We aimed to investigate the association of socioeconomic status (SES), migration background, parental physical activity (PA) and smoking status with micro-and macrovascular health in children. Methods: In 2016/2017, 833 school children (aged 7.2 ± 0.4 years) in Basel (Switzerland) were screened for retinal arteriolar-to-venular ratio (AVR), pulse wave velocity (PWV), SES, migration background and parental PA as well as smoking status. Results: High parental PA levels were associated with a favorable higher AVR (p = 0.020) and lower PWV (p = 0.035), but not independent of parental smoking status. Children with parents who smoked had a higher PWV [4.39 (4.35-4.42) m/s] compared to children with non-smoking parents [4.32 (4.29-4.34) m/s, p = 0.001]. Children of parents with a low household income had a higher PWV [4.36 (4.32-4.41) m/s] compared to children of parents with a high household income [4.30 (4.26-4.34) m/s, p = 0.033]. Low parental educational level was associated with a lower AVR [0.86 (0.85-0.88)] compared to children with highly educated parents [AVR:0.88 (0.87-0.88), p = 0.007; PWV: 4.33 (4.30-4.35) m/s, p = 0.041]. Children with a European background showed a higher AVR [0.88 (0.87-0.88)] compared to non-European children [AVR: (0.86 (0.85-0.87), p = 0.034]. Conclusion: Parental PA is associated with better macro- and microvascular childhood health. However, the positive association is lost when parental smoking is considered in the analysis. Socioeconomic factors seem to associate with subclinical vascular alterations in children. Primary prevention programs should focus on including parental lifestyle interventions and educational programs to reduce the burden of lifestyle-associated barriers in order to improve cardiovascular health during lifespan. Clinical Trial Registration: ClinicalTrials.gov Exercise and Arterial Modulation in Youth, https://clinicaltrials.gov/ct2/show/NCT02853747, NCT02853747.
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Affiliation(s)
- Sabrina Köchli
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Katharina Endes
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Julia Grenacher
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Lukas Streese
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Giulia Lona
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Christoph Hauser
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Arne Deiseroth
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Lukas Zahner
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
| | - Henner Hanssen
- Department of Sport, Exercise and Health, Medical Faculty, University of Basel, Basel, Switzerland
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24
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Alkutbe RB, Alruban A, Alturki H, Sattar A, Al-Hazzaa H, Rees G. Fat mass prediction equations and reference ranges for Saudi Arabian Children aged 8-12 years using machine technique method. PeerJ 2021; 9:e10734. [PMID: 33665006 PMCID: PMC7908871 DOI: 10.7717/peerj.10734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 12/17/2020] [Indexed: 11/20/2022] Open
Abstract
Background The number of children with obesity has increased in Saudi Arabia, which is a significant public health concern. Early diagnosis of childhood obesity and screening of the prevalence is needed using a simple in situ method. This study aims to generate statistical equations to predict body fat percentage (BF%) for Saudi children by employing machine learning technology and to establish gender and age-specific body fat reference range. Methods Data was combined from two cross-sectional studies conducted in Saudi Arabia for 1,292 boys and girls aged 8-12 years. Body fat was measured in both studies using bio-electrical impedance analysis devices. Height and weight were measured and body mass index was calculated and classified according to CDC 2,000 charts. A total of 603 girls and 374 boys were randomly selected for the learning phase, and 153 girls and 93 boys were employed in the validation set. Analyses of different machine learning methods showed that an accurate, sensitive model could be created. Two regression models were trained and fitted with the construction samples and validated. Gradient boosting algorithm was employed to achieve a better estimation and produce the equations, then the root means squared error (RMSE) equation was performed to decrease the error. Body fat reference ranges were derived for children aged 8-12 years. Results For the gradient boosting models, the predicted fat percentage values were more aligned with the true value than those in regression models. Gradient boosting achieved better performance than the regression equation as it combined multiple simple models into a single composite model to take advantage of that weak classifier. The developed predictive model archived RMSE of 3.12 for girls and 2.48 boys. BF% and Fat mass index charts were presented in which cut-offs for 5th, 75th and 95th centiles are used to define 'under-fat', 'normal', 'overfat' and 'subject with obesity'. Conclusion Machine learning models could represent a significant advancement for investigators studying adiposity-related issues in children. These models and newly developed centile charts could be useful tools for the estimation and classification of BF%.
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Affiliation(s)
- Rabab B Alkutbe
- School of Biomedical sciences, University of Plymouth, Plymouth, UK
| | - Abdulrahman Alruban
- College of Computer and Information Sciences, Majmaah University, Majmaah, Saudi Arabia
| | - Hmidan Alturki
- King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Anas Sattar
- School of Biomedical sciences, University of Plymouth, Plymouth, UK
| | - Hazzaa Al-Hazzaa
- Lifestyle and Health Research Center, Health Sciences Research Center, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia
| | - Gail Rees
- School of Biomedical sciences, University of Plymouth, Plymouth, UK
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25
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Hua MC, Su HM, Lai MW, Yao TC, Tsai MH, Liao SL, Lai SH, Huang JL. Palmitoleic and Dihomo-γ-Linolenic Acids Are Positively Associated With Abdominal Obesity and Increased Metabolic Risk in Children. Front Pediatr 2021; 9:628496. [PMID: 33898358 PMCID: PMC8062925 DOI: 10.3389/fped.2021.628496] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 03/15/2021] [Indexed: 12/14/2022] Open
Abstract
Background: The impact of abdominal obesity (AO) on plasma fatty acid changes and cardiometabolic risk in children who are obese and overweight has rarely been investigated. This study determined whether plasma fatty acid composition differed between children with AO and those without AO and its relationship with metabolic risk, particularly in the obese and overweight groups. Methods: A total of 181 schoolchildren (aged 7-18 years) were included. Anthropometric and biochemical data and plasma fatty acid profiles were analyzed, and the indices of desaturase activity were estimated. Children were categorized based on their body weight and AO status. A continuous metabolic risk score was calculated using the sum of the z-scores of metabolic variables. A one-way analysis of variance test was used to compare the composition ratio of fatty acids between children with and without AO in the obese and overweight groups and normal-weight controls. Pearson analysis was also used to explore significant fatty acid and desaturase indicators associated with metabolic abnormalities. Results: Children who were obese and overweight (N = 126) displayed higher dihomo-γ-linolenic acid (20:3n-6) and γ-linolenic acid (18:3n-6) proportions than normal-weight controls (N = 55), but lower heptadecanoic acid (17:0) proportion, regardless of the AO status of each individual. Obese and overweight children with AO (N = 89), but not their non-AO counterparts (N = 37), exhibited a significantly higher proportion of palmitoleic acid (16:1n-7) than the remaining study groups. Pearson analysis showed that high proportions of palmitoleic acid and dihomo-γ-linolenic acid, as well as increased stearoyl-coenzyme A desaturase-1(16) and delta-6 desaturase and decreased delta-5 desaturase activities, are strongly correlated with weight-height ratio, homeostasis model of assessment values for insulin resistance, hypertriglyceridemia, and continuous metabolic risk scores. Conclusion: Higher palmitoleic acid and dihomo-γ-linolenic acid proportions, as well as increased stearoyl-coenzyme A desaturase-1(16) and delta-6 desaturase and decreased delta-5 desaturase activities are associated with AO and increased metabolic risk in children who are obese and overweight.
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Affiliation(s)
- Man-Chin Hua
- Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan.,Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hui-Min Su
- Department of Physiology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Ming-Wei Lai
- Chang Gung University College of Medicine, Taoyuan, Taiwan.,Division of Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tsung-Chieh Yao
- Chang Gung University College of Medicine, Taoyuan, Taiwan.,Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ming-Han Tsai
- Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan.,Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Sui-Ling Liao
- Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan.,Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Shen-Hao Lai
- Chang Gung University College of Medicine, Taoyuan, Taiwan.,Division of Chest, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Jing-Long Huang
- Chang Gung University College of Medicine, Taoyuan, Taiwan.,Department of Pediatrics, Municipal TuCheng Hospital, Chang Gung Memorial Hospital, New Taipei City, Taiwan
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26
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Development of population-specific prediction equations for bioelectrical impedance analyses in Vietnamese children. Br J Nutr 2020; 124:1345-1352. [PMID: 32616079 DOI: 10.1017/s000711452000241x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
There is a need for accurate, inexpensive and field-friendly methods to assess body composition in children. Bioelectrical impedance analysis (BIA) is a promising approach; however, there have been limited validation and use among young children in resource-poor settings. We aim to develop and validate population-specific prediction equations for estimating total fat mass (FM), fat free-mass (FFM) and percentage body fat (PBF) in Vietnamese children (4-7 years) using reactance and resistance from BIA, anthropometric variables and demographic information. We conducted a cross-sectional survey of 120 children. Body composition was measured using dual-energy X-ray absorptiometry (DXA), BIA and anthropometry. To develop prediction equations, we split all data into development (70 %) and validation datasets (30 %). The model performance was evaluated using predicted residual error sum of squares, root mean squared error (RMSE), mean absolute error (MAE) and R2. We identified a top performing model with the least number of parameters (age, sex, weight and resistance index or resistance and height), low RMSE (FM 0·70, FFM 0·74, PBF 3·10), low MAE (FM 0·55, FFM 0·62, PBF 2·49), high R2 (FM 0·95, FFM 0·92, PBF 0·82) and the least difference between predicted values and actual values from DXA (FM 0·03 kg or 0·01 sd, FFM 0·06 kg or 0·02 sd, PBF 0·27 % or 0·04 sd). In conclusion, we developed the first valid and highly predictive equations to estimate FM, FFM and PBF in Vietnamese children using BIA. These findings have important implications for future research on the double burden of disease and risks associated with overweight and obesity in young children.
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27
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Lin JZ, Chen CT, Ma JD, Mo YQ, Li QH, Chen LF, Yang ZH, Cheng WM, He XL, Zheng DH, Dai L. Neglected extra-articular manifestations in rheumatoid arthritis patients with normal body mass index: reduced skeletal muscle overlapping overfat. Ther Adv Chronic Dis 2020; 11:2040622320975241. [PMID: 33294150 PMCID: PMC7705189 DOI: 10.1177/2040622320975241] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 10/09/2020] [Indexed: 02/06/2023] Open
Abstract
Background: Chronic inflammation in rheumatoid arthritis (RA) can induce reduced muscle mass (myopenia) and ectopic fat deposition probably showing normal body mass index (BMI). We aimed to investigate their body composition (BC) characteristics and clinical significance. Methods: BMI and BC were collected in consecutive RA patients and control subjects. Myopenia was defined by appendicular skeletal muscle mass index (ASMI) ⩽7.0 kg/m2 in men and ⩽5.7 kg/m2 in women. Overfat was defined by body fat percentage (BF%) as ⩾25% for men and ⩾35% for women. Results: There were 620 RA patients (57.6% with normal BMI) and 2537 control subjects (62.5% with normal BMI) recruited. After 1:1 age and sex matching with control subjects, RA patients with normal BMI (n = 240) showed significantly higher prevalence of myopenia (43.3% versus 22.1%) and overfat (19.2% versus 7.1%) as well as myopenia overlapping overfat (17.1% versus 3.3%). In all RA patients with normal BMI (n = 357), there were 18.2% patients with myopenia overlapping overfat who had the worst radiographic scores and highest rates of previous glucocorticoid treatment and hypertension. Compared with those without, normal BMI RA patients with previous glucocorticoid treatment (24.4% versus 10.3%) or hypertension (27.8% versus 13.6%) had a higher rate of myopenia overlapping overfat. Previous glucocorticoid treatment [odds ratio (OR) = 2.844, 95% confidence interval (CI) 1.441–5.614] and hypertension (OR = 2.452, 95% CI 1.283–4.685) were potential associated factors of myopenia overlapping overfat in RA patients with normal BMI. Conclusion: Myopenia overlapping overfat is an important extra-articular manifestation which should not be ignored in RA patients with normal BMI, especially with glucocorticoid treatment and hypertension.
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Affiliation(s)
- Jian-Zi Lin
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, PR China
| | - Chu-Tao Chen
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, PR China
| | - Jian-Da Ma
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, PR China
| | - Ying-Qian Mo
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, PR China
| | - Qian-Hua Li
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, PR China
| | - Le-Feng Chen
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, PR China
| | - Ze-Hong Yang
- Department of Radiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong, PR China
| | - Wan-Mei Cheng
- Shanghai Healthare Co. Ltd, Zhangjiang Innopark, Shanghai, PR China
| | - Xiao-Ling He
- Shanghai Healthare Co. Ltd, Zhangjiang Innopark, Shanghai, PR China
| | - Dong-Hui Zheng
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong 510120, PR China
| | - Lie Dai
- Department of Rheumatology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou, Guangdong 510120, PR China
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28
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Lin JZ, Liu Y, Ma JD, Mo YQ, Chen CT, Chen LF, Li QH, Yang ZH, Zheng DH, Ling L, Miossec P, Dai L. Reduced skeletal muscle independently predicts 1-year aggravated joint destruction in patients with rheumatoid arthritis. Ther Adv Musculoskelet Dis 2020; 12:1759720X20946220. [PMID: 32922525 PMCID: PMC7448126 DOI: 10.1177/1759720x20946220] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Accepted: 07/02/2020] [Indexed: 12/15/2022] Open
Abstract
Background Numerous cross-sectional studies have reported the associations between rheumatoid arthritis (RA) and reduced skeletal muscle. We firstly explored the dynamic change of skeletal muscle and its effect on RA clinical outcomes in a real-world prospective cohort. Methods Consecutive RA patients were treated according to the treat-to-target strategy and completed at least 1-year follow up. Clinical data and muscle index (assessed by bioelectric impedance analysis) were collected at baseline and visits at 3, 6, 9 and 12 months. Myopenia was defined by appendicular skeletal muscle mass index ⩽7.0 kg/m2 in men and ⩽5.7 kg/m2 in women. A 1-year radiographic progression as primary outcome was defined by a change in the total Sharp/van der Heijde modified score ⩾0.5 units. Results Among 348 recruited patients, 315 RA patients (mean age 47.9 years, 84.4% female) completed 1-year follow up. There were 143 (45.4%) RA patients showing myopenia at baseline. Compared with those without baseline myopenia, RA patients with baseline myopenia had higher rate of 1-year radiographic progression (43.4% versus 21.5%, all p < 0.05). Baseline myopenia was an independent risk factor for 1-year radiographic progression with adjusted odds ratio (AOR) of 2.5-fold, especially among RA patients in remission at baseline both defined by Disease Activity Score in 28 joints (DAS28) including C-reactive protein (DAS28-CRP) or erythrocyte sedimentation rate (DAS28-ESR) with AOR of 18.5~42.9-fold. Further analysis of six subtypes of dynamic skeletal muscle change showed that newly acquired myopenia at endpoint was associated with radiographic progression (AOR of 5.4-fold). Conclusions Reduced skeletal muscle is an independent predicting factor for 1-year aggravated joint destruction, especially in remission RA. The importance of dynamic monitoring of skeletal muscle and muscle improvement therapy are worth exploration.
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Affiliation(s)
- Jian-Zi Lin
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, PR China
| | - Yin Liu
- Department of Medical Statistics, Sun Yat-sen University, Guangzhou, Guangdong, PR China
| | - Jian-Da Ma
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, PR China
| | - Ying-Qian Mo
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, PR China
| | - Chu-Tao Chen
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, PR China
| | - Le-Feng Chen
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, PR China
| | - Qian-Hua Li
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, PR China
| | - Ze-Hong Yang
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Guangzhou, Guangdong, PR China
| | - Dong-Hui Zheng
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou 510120, PR China
| | - Li Ling
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, 74 Zhongshan Road II, Guangzhou, Guangdong 510080, PR China
| | - Pierre Miossec
- Department of Clinical Immunology and Rheumatology, and Immunogenomics and Inflammation Research Unit EA 4130, University of Lyon and Hospices Civils de Lyon, Lyon, France
| | - Lie Dai
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-sen University, 107 Yan Jiang West Road, Guangzhou 510120, PR China
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Delshad M, Beck KL, Conlon CA, Mugridge O, Kruger MC, von Hurst PR. Validity of quantitative ultrasound and bioelectrical impedance analysis for measuring bone density and body composition in children. Eur J Clin Nutr 2020; 75:66-72. [PMID: 32814858 DOI: 10.1038/s41430-020-00711-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/21/2020] [Accepted: 08/04/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND/OBJECTIVES Using dual X-ray absorptiometry (DXA) to assess body composition in children has limitations including expense, lack of portability, and exposure to radiation. The aims of this study were to examine: (1) validity of quantitative ultrasound (QUS) against DXA for measuring bone density and (2) the validity of in-built algorithm of bioelectrical impedance analysis (BIA) for measuring body composition in children (8-13 years) living in New Zealand. SUBJECTS/METHODS Total body less head (TBLH), bone mineral content (BMC), bone mineral density (BMD), and body composition were measured with DXA (QDR Discovery A, Hologic, USA); calcaneal BMD and stiffness index (SI) with QUS (Sahara QUS, Hologic, USA), and BIA on the InBody 230 (Biospace Ltd., Seoul, Korea). Relative validity was assessed using Pearson's and Lin's concordance correlation coefficients (CCC), and Bland-Altman plots. RESULTS In 124 healthy children, positive correlations between QUS SI and DXA (BMC and BMD) were observed (range = 0.30-0.45, P < 0.01). Results from Lin's CCC test showed almost perfect correlations between BIA and DXA fat free mass (0.96), fat mass (0.92), and substantial correlation for percentage of fat mass (0.75) (P < 0.05). CONCLUSION Although BIA results were not as accurate as DXA and DXA remains the gold standard method for clinical assessment, BIA can be an alternative method for investigating body composition among children in large cohort field studies. Calcaneal QUS and DXA are not interchangeable methods for measuring bone density in children similar to our study population.
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Affiliation(s)
- Maryam Delshad
- College of Health, Massey University, Auckland, New Zealand
| | - Kathryn L Beck
- College of Health, Massey University, Auckland, New Zealand
| | | | - Owen Mugridge
- College of Health, Massey University, Auckland, New Zealand
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McLester CN, Nickerson BS, Kliszczewicz BM, McLester JR. Reliability and Agreement of Various InBody Body Composition Analyzers as Compared to Dual-Energy X-Ray Absorptiometry in Healthy Men and Women. J Clin Densitom 2020; 23:443-450. [PMID: 30472111 DOI: 10.1016/j.jocd.2018.10.008] [Citation(s) in RCA: 157] [Impact Index Per Article: 39.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 10/27/2018] [Accepted: 10/30/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND Bioelectrical impedance analysis has evolved over the years to include the use of multiple frequencies and impedance measurements to improve the accuracy and reliability of body composition estimates. The purpose of this investigation was to evaluate the reliability of the InBody230, InBody720, and InBody770 to measure body fat percent (BF%), fat mass (FM), and fat-free mass (FFM) in the general population and to compare results to dual-energy X-ray absorptiometry (DXA). METHODS A total of 31 males and 36 females participated in 2 d of testing separated by 24-72 h. Each visit consisted of a DXA scan, and analysis with the InBody230, InBody720, and InBody770. RESULTS All 3 bioelectrical impedance devices (InBody230, InBody720, and InBody770) were reliable in men and women as indicated by high intraclass correlation coefficients for BF% (≥0.98), FM (≥0.98), and FFM (≥0.99) and low standard error of measurement for BF% (0.77%-0.99%), FM (0.54-0.87 kg), and FFM (0.58-0.84 kg) and minimum difference for BF% (2.12%-2.73%), FM (1.49-2.39 kg), and FFM (1.60-2.32 kg), respectively. When examining the agreement between the 3 InBody analyzers with DXA, systematic bias (underestimation of BF% and FM and overestimation of FFM) was present for all comparisons (p < 0.05) while proportional bias was present for FM in women and FFM in men. However, there was small individual error for all comparisons as indicated by the standard error of estimate and 95% limits of agreement. CONCLUSION The InBody analyzers produce small individual error, which suggest these methods can be used as a surrogate when DXA is not available; however, practitioners should be aware of the systematic bias for all comparisons and proportional bias for FM in women and FFM in men. Furthermore, findings revealed that the research grade models, InBody720 and InBody770, added minimal benefit over the portable InBody230 when assessing BF%, FM, and FFM.
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Affiliation(s)
- Cherilyn N McLester
- Kennesaw State University, Department of Exercise Science and Sport Management, Kennesaw, GA, USA.
| | - Brett S Nickerson
- Texas A&M International University, Department of Curriculum and Pedagogy, Laredo, TX, USA
| | - Brian M Kliszczewicz
- Kennesaw State University, Department of Exercise Science and Sport Management, Kennesaw, GA, USA
| | - John R McLester
- Kennesaw State University, Department of Exercise Science and Sport Management, Kennesaw, GA, USA
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Lee LW, Liao YS, Lu HK, Hsieh KC, Chi CC. Performance of Bioelectrical Impedance Analysis in the Estimation of Bone Mineral Content in Healthy Children Aged 6-12 Years. J Clin Densitom 2020; 23:411-417. [PMID: 30979543 DOI: 10.1016/j.jocd.2019.03.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/12/2019] [Accepted: 03/12/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Bioelectrical impedance analysis (BIA) is a widely available tool which provides mineral estimate. However, BIA is not currently recognized as a bone mineral measuring method. This study aimed to explore the ability of BIA to predict bone mineral content (BMC) in children, using dual-energy X-ray absorptiometry as a gold standard. METHODS Healthy children aged 6-12 years (n = 176) were recruited for BIA and dual-energy X-ray absorptiometry measurements. Predictive models were generated using basic indices (age, height, weight, waist circumference, hip circumference, etc.) and BIA parameters (minerals, fat mass, and fat free mass). RESULTS The root-mean-square deviation and R2 for the total BMC predictive model were 0.089 kg and 0.926, respectively using height and weight as predictors whereas 0.113 kg and 0.886, respectively using minerals by BIA. The root-mean-square deviation and R2 for the subtotal BMC predictive model were 0.080 kg and 0.935, respectively using height and weight as predictors whereas 0.098 kg and 0.906, respectively using minerals by BIA. The best predictive models included basic indices and BIA parameters as predictors, but they had only slightly better performance over simple models. CONCLUSIONS Mineral content by BIA was good predictor of total and subtotal BMC in healthy children but with similar overall model performance compared to basic indices. More complex models combined all the predictive variables gave better prediction power, but of little improvement to these simple models. The BIA instrument does not appear to be useful in estimating BMC in healthy children as basic indices are more widely available measures but provide comparable performance. Future studies are needed to determine the clinical usefulness of the more complex prediction model in children with disease or children in other subgroups.
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Affiliation(s)
- Li-Wen Lee
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi, Taiwan; Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Taiwan
| | - Yu-San Liao
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi Campus, Taiwan; Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Yunlin, Taiwan
| | - Hsueh-Kuan Lu
- Sport Science Research Center, National Taiwan University of Sport, Taichung, Taiwan
| | - Kuen-Chang Hsieh
- Office of Physical Education and Sport, National Chung Hsing University, Taichung, Taiwan; Research Center, Charder Electronic Co, Ltd, Taichung, Taiwan
| | - Ching-Chi Chi
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; College of Medicine, Chang Gung University, Taoyuan, Taiwan.
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Vander Wyst KB, Olson ML, Keller CS, Soltero EG, Williams AN, Peña A, Ayers SL, Jager J, Shaibi GQ. Sex as a moderator of body composition following a randomized controlled lifestyle intervention among Latino youth with obesity. Pediatr Obes 2020; 15:e12620. [PMID: 32072749 PMCID: PMC9275591 DOI: 10.1111/ijpo.12620] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 01/05/2020] [Accepted: 01/10/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Body composition differences between males and females emerge during adolescence and continue throughout adulthood; however, whether sex moderates body composition changes in adolescents with obesity after an intervention is unknown. OBJECTIVE To examine sex as a moderator of changes in adiposity following lifestyle intervention. METHODS A total of 136 Latino youth with obesity (BMI% 98.2 ± 1.3) aged 14 to 16 years old were randomized to either a 12-week lifestyle intervention (27 males/40 females) or control (35 males/34 females) group. The intervention included nutrition education (1 h/wk) and moderate-to-vigorous physical activity (3 h/wk). Anthropometric data (body mass index [BMI], BMI%, waist circumference, total body fat, and fat-free mass) were obtained pre- and post-intervention. Sex differences were examined by general linear models with significance determined at P < .05 for the F-statistic. RESULTS Sex did not moderate changes in BMI (F1,115 = 0.01, P = .9), BMI% (F1,115 = 0.14, P = .7), or waist circumference (F1,117 = 1.1, P = .3). Sex significantly moderated changes in body fat percent (F1,117 = 5.3, P = .02), fat mass (F1,116 = 4.5, P = .04), and fat-free mass (F1,116 = 4.3, P = .04). Intervention males compared with females had greater relative reductions in fat percent (-4.1 ± 0.8% vs -1.2 ± 0.7%, P = .02) and fat mass (-5.0 ± 1.1 kg vs -1.5 ± 0.9 kg, P = .02) and gained more fat free mass (3.6 ± 0.9 kg vs 0.5 ± 0.8 kg, P = .02) when compared with same sex controls. CONCLUSION Males and females exhibited a differential response to lifestyle intervention for percent fat, fat mass, and fat-free mass indicating that sex-specific improvements in body composition favours males over females.
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Affiliation(s)
- Kiley B. Vander Wyst
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
| | - Micah L. Olson
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children’s Hospital, Phoenix, Arizona
| | - Colleen S. Keller
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
| | - Erica G. Soltero
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
| | - Allison N. Williams
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
| | - Armando Peña
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
| | - Stephanie L. Ayers
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona
| | - Justin Jager
- T. Denny Sanford School of Social and Family Dynamics, Arizona State University, Phoenix, Arizona
| | - Gabriel Q. Shaibi
- Center for Health Promotion and Disease Prevention, Arizona State University, Phoenix, Arizona
- Division of Pediatric Endocrinology and Diabetes, Phoenix Children’s Hospital, Phoenix, Arizona
- Southwest Interdisciplinary Research Center, Arizona State University, Phoenix, Arizona
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Relative Accuracy of Bioelectrical Impedance Analysis for Assessing Body Composition in Children With Severe Obesity. J Pediatr Gastroenterol Nutr 2020; 70:e129-e135. [PMID: 32443048 PMCID: PMC7283978 DOI: 10.1097/mpg.0000000000002666] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVES The accuracy of different bioelectrical impedance analysis (BIA) devices for assessing body composition in children with obesity is unclear. We determined the relative accuracy of 2 BIA devices compared to dual x-ray absorptiometry (DXA) in obese and severely obese children. METHODS We measured body composition in a cross-sectional study of 78 obese children by a handheld single frequency tetrapolar BIA device (Omron), a stationary multifrequency octopolar BIA device (InBody 370) and DXA. Intermethod agreement was assessed by intraclass correlations, paired t tests, and Bland-Altman analyses. RESULTS Participants (37% female, age 14.8 ± 2.7 years) had mean (±standard deviation) body mass index of 36.7 ± 7.5 kg/m, body fat percentage of 46.4% ± 5.2%, and appendicular lean mass of 22.5 ± 6.0 kg by DXA. Intraclass correlations with DXA for body fat percentage were 0.39 and 0.87 for single frequency tetrapolar and multifrequency octopolar BIA devices, respectively. The single frequency tetrapolar BIA underestimated body fat percentage by 5.5% ± 2.9% (P < 0.0001). Differences between the multifrequency octopolar BIA and DXA for body fat percentage (-1.1% ± 2.8%) and appendicular lean mass (-0.3 ± 1.4 kg) were small, and 95% limits of agreement were approximately ±5%. CONCLUSIONS BIA machines vary in relative accuracy in measuring body composition in children who are obese and severely obese. The multifrequency octopolar BIA device accurately estimated body fat percentage and appendicular lean mass relative to DXA and has the advantage of point of care performance.
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Liao YS, Li HC, Lu HK, Lai CL, Wang YS, Hsieh KC. Comparison of Bioelectrical Impedance Analysis and Dual Energy X-ray Absorptiometry for Total and Segmental Bone Mineral Content with a Three-Compartment Model. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17072595. [PMID: 32290133 PMCID: PMC7177846 DOI: 10.3390/ijerph17072595] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 12/12/2022]
Abstract
Modern bioelectrical impedance analysis (BIA) provides a wide range of body composition estimates such as fat mass (FM), lean body mass (LBM), and body water, using specific algorithms. Assuming that the fat free mass (FFM) and LBM can be accurately estimated by the 8-electrode BIA analyzer (BIA8MF; InBody230, Biospace), the bone mineral content (BMC) may be calculated by subtracting the LBM from the FFM estimates based on the three-compartment (3C) model. In this cross-sectional study, 239 healthy Taiwanese adults (106 male and 133 female) aged 20-45 years were recruited for BIA and dual-energy X-ray absorptiometry (DXA) measurements of the whole body and body segments, with DXA as the reference. The results showed a high correlation between BIA8MF and DXA in estimating total and segmental LBM, FM and percentage body fat (r = 0.909-0.986, 0.757-0.964, and 0.837-0.936, respectively). For BMC estimates, moderate to high correlations (r = 0.425-0.829) between the two methods were noted. The percentage errors and pure errors for BMC estimates between the methods ranged from 33.9% to 93.0% and from 0.159 kg to 0.969 kg, respectively. This study validated that BIA8MF can accurately assesses LBM, FM and body fat percentage (BF%). However, the estimation of segmental BMC based on the difference between FFM and LBM in body segments may not be reliable by BIA8MF.
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Affiliation(s)
- Yu-San Liao
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Yunlin 638, Taiwan;
- Department of Nursing, Chang Gung University of Science and Technology, Chiayi 613, Taiwan
- Department of Chemistry and Biochemistry, National Chung Cheng University, Chiayi 621, Taiwan
| | - Hung-Chou Li
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi 613, Taiwan;
| | - Hsueh-Kuan Lu
- General Education Center, National Taiwan University of Sport, Taichung 404, Taiwan;
| | - Chung-Liang Lai
- Department of Physical Medicine and Rehabilitation, Puzi Hospital, Ministry of Health and Welfare, Chiayi 613, Taiwan;
- Department of Occupational Therapy, Asia University, Taichung 413, Taiwan
| | - Yue-Sheng Wang
- Department of Diagnostic Radiology, Chang Gung Memorial Hospital, Chiayi613, Taiwan;
| | - Kuen-Chang Hsieh
- Fundamental Education Center, National Chin-Yi University of Technology, Taichung 411, Taiwan
- Correspondence: ; Tel.: +886-4-2406-3766
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Lee MM, Jebb SA, Oke J, Piernas C. Reference values for skeletal muscle mass and fat mass measured by bioelectrical impedance in 390 565 UK adults. J Cachexia Sarcopenia Muscle 2020; 11:487-496. [PMID: 31943835 PMCID: PMC7113534 DOI: 10.1002/jcsm.12523] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 09/25/2019] [Accepted: 11/14/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND Loss of skeletal muscle mass (SMM) increases the risk of frailty and, together with excess fat mass (FM), is a risk factor for cardio-metabolic disease. However, use of body composition measurements in nutritional surveillance and routine clinical practice is limited by the lack of reference data. Our aim was to produce age-specific and sex-specific reference values for SMM and FM in the White ethnic adult population in the UK. Secondary objectives were to examine the tracking over time using a subsample of the population with repeated measures of body composition and to assess the validity of these reference values in different ethnic subgroups. METHODS We used data from segmental bioelectrical impedance analysis (BIA) in 390 565 participants, aged 40-69 years, in the UK Biobank, and data from dual-energy X-ray absorptiometry from n = 905 participants to validate the BIA measurements. SMM was calculated as the sum of the predicted muscle mass from the limbs. The LMS method was used to produce percentile curves for the SMM index (SMMI = SMM/height2 ) and the FM index (FMI = FM/height2 ). We investigated the validity of the White ethnic reference values by plotting z-scores (99.7% confidence interval) from Black and Asian groups to check if their confidence interval included zero. Longitudinal trajectories were predicted based on the baseline z-scores and the correlation between repeated measurements at follow-up. RESULTS The percentile curves show that SMMI declines in men from the age of 40, whereas in women, SMMI is more stable and decreases only slightly among women in the higher percentiles. FMI increases with age in both men and women. Women have higher FMI and lower SMMI than men in all age groups. The validity of the White-based reference values for non-White ethnic groups is poor. Longitudinal trajectories in body composition in the subsample of participants with a follow-up assessment show regression towards the mean in both men and women, with some evidence of declining SMMI only among men. The predicted 90% limits for the expected 5 year trajectories of SMMI and FMI can be used to identify people with unusual trajectories and in clinical practice to identify and track individuals at risk of excessive loss of SMM. CONCLUSIONS These body composition reference values developed from BIA in a middle/older-aged healthy White ethnic population in the UK could be used as a simple assessment tool for nutritional surveillance and to identify individuals with low SMMI or high FMI who may be at increased risk of disease and/or frailty.
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Affiliation(s)
- Mei-Man Lee
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.,The George Institute for Global Health, University of Oxford, Oxford, UK
| | - Susan A Jebb
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Jason Oke
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Carmen Piernas
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
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Litwin L, Sundholm JKM, Rönö K, Koivusalo SB, Eriksson JG, Sarkola T. Transgenerational effects of maternal obesity and gestational diabetes on offspring body composition and left ventricle mass: the Finnish Gestational Diabetes Prevention Study (RADIEL) 6-year follow-up. Diabet Med 2020; 37:147-156. [PMID: 31344268 DOI: 10.1111/dme.14089] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/23/2019] [Indexed: 12/27/2022]
Abstract
AIM To investigate the influence of maternal adiposity and gestational diabetes on offspring body composition and left ventricle mass in early childhood. METHODS The observational follow-up study included 201 mother-child pairs, a sub-cohort from the Finnish Gestational Diabetes Prevention Study, who were recruited 6.1 ± 0.5 (mean ± SD) years postpartum, aiming for an equal number of mothers with and without gestational diabetes. RESULTS Maternal pre-pregnancy BMI (mean ± SD; 30.5 ± 5.6 kg/m2 ) was associated with child body fat percentage [0.26 (95% CI; 0.08, 0.44)% increase in child body fat per 1 kg/m2 increase in pre-pregnancy BMI of mothers with obesity] and was reflected in child BMI Z-score (mean ± SD; 0.45 ± 0.93). Left ventricle mass, left ventricle mass index and left ventricle mass Z-score were not associated with gestational diabetes, pre-pregnancy BMI or child body fat percentage. After adjusting for child sex, body fat percentage, systolic blood pressure, pre-pregnancy BMI and maternal lean body mass, left ventricle mass increased by 3.08 (95% CI; 2.25, 3.91) g for each 1 kg in child lean body mass. CONCLUSIONS Left ventricle mass at 6 years of age is determined predominantly by lean body mass. Maternal pre-gestational adiposity is reflected in child, but no direct association between left ventricle mass and child adiposity or evidence of left ventricle mass foetal programming related to gestational diabetes and maternal adiposity was observed in early childhood.
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Affiliation(s)
- L Litwin
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Congenital Heart Defects and Pediatric Cardiology, SMDZ in Zabrze, SUM, Katowice, Poland
| | - J K M Sundholm
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - K Rönö
- Women's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - S B Koivusalo
- Women's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - J G Eriksson
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
| | - T Sarkola
- Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Associations between Dairy Intake, Body Composition, and Cardiometabolic Risk Factors in Spanish Schoolchildren: The Cuenca Study. Nutrients 2019; 11:nu11122940. [PMID: 31817012 PMCID: PMC6950103 DOI: 10.3390/nu11122940] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2019] [Revised: 11/21/2019] [Accepted: 11/26/2019] [Indexed: 12/11/2022] Open
Abstract
Full-fat dairy has been traditionally associated with obesity and cardiovascular disease (CVD); however, recent evidence shows that the amount of dairy intake might have a beneficial effect over these pathologies, regardless of their fat content. The aim of this study was to examine the association between the intake of dairy products (including milk with different fat contents) with both adiposity and serum lipid concentration, adjusted by cardiorespiratory fitness (CRF), in Spanish schoolchildren. A cross-sectional study of 1088 children, aged 8 to 11 years, was conducted in which anthropometric variables (body mass index (BMI), waist circumference (WC), fat mass percentage (FM%) and fat mass index (FMI)), blood lipid profile, and dairy intake (using a food frequency questionnaire), and CRF (through a 20-m shuttle run test) were measured. Results showed that children with lower BMI, WC, FM%, and FMI had higher whole-fat milk intake and lower skimmed and semi-skimmed milk intake than children with higher BMI, WC, FM%, and FMI. Children with normal levels of triglycerides and high density lipoproteins (HLD) cholesterol consumed more whole-fat milk and less reduced-fat milk than children with dyslipidemic patterns. These relationships persisted after adjustment for CRF. Our findings suggest that full-fat milk intake should be promoted in children without obesity or high cardiometabolic risk.
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Equation models developed with bioelectric impedance analysis tools to assess muscle mass: A systematic review. Clin Nutr ESPEN 2019; 35:47-62. [PMID: 31987121 DOI: 10.1016/j.clnesp.2019.09.012] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 09/06/2019] [Accepted: 09/21/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND & AIMS This systematic review aims to systematically assess and summarize the equation models developed to estimate muscle mass with bioelectric impedance analysis (BIA) instruments against a reference instrument (DXA, MRI, CT-scan, Ultrasonography), in order to help researchers and clinicians choose the most adapted equation, depending on the device and the population in question. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) statement was followed. Medline (via Ovid) and Scopus were searched in January 2019 for observational (transversal, longitudinal, retrospective) studies developing an equation prediction model to validate BIA against another reference method for the assessment of muscle mass. Study selection and data extraction was performed independently by two researchers. Methodological quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. RESULTS 25 studies matched the inclusion criteria and were included in the present systematic review. Among them, 10 studies proposed an equation for subjects aged 65 years and older, 9 for adults, 4 for infants and 2 did not report the age of the population. A large heterogeneity was observed regarding the brand and type of BIA as well as the administration protocol (mode, frequency, number of electrodes, administration position and empty bladder/stomach or not). Most of the studies used DXA as the reference instrument, except 4 that used MRI. In each of the included papers authors provided, through simple or multiple regression, a predictive equation for muscle mass. BIA resistance index, sex, weight, age, BIA reactance and height were most frequently included as predictive variables. The majority of the equations developed explained more than 80% of the variance between both instruments. Out of the 25 equations available, only 9 were also validated in another population within the same paper. CONCLUSION This systematic review of the literature offers clinicians and researchers the opportunity to verify the existence of a prediction equation when using a BIA device for estimating muscle mass. This will help them to obtain a valid estimation of muscle mass in a specific population and with a specific instrument. If the equation exists and has been validated by a study free of high risk of bias, it's use is recommended because the development of a new equation in the same context seems redundant and undesirable. If a validation has not been carried out for a specific brand of BIA, reference method or population, we recommend the development and cross-validation of a new equation.
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Dalrymple KV, Thompson JMD, Begum S, Godfrey KM, Poston L, Seed PT, McCowan LME, Wall C, Shelling A, North R, Cutfield WS, Mitchell EA. Relationships of maternal body mass index and plasma biomarkers with childhood body mass index and adiposity at 6 years: The Children of SCOPE study. Pediatr Obes 2019; 14:e12537. [PMID: 31232532 PMCID: PMC6731120 DOI: 10.1111/ijpo.12537] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Revised: 03/28/2019] [Accepted: 04/02/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Maternal obesity has been implicated in the origins of childhood obesity through a suboptimal environment in-utero. OBJECTIVE We examined relationships of maternal early pregnancy body mass index (BMI), overweight/obesity, and plasma biomarkers of obesity, inflammation, insulin resistance, and placental function with measures of childhood BMI and adiposity. METHODS BMI z-score, sum of skinfold thicknesses (SST), body fat percentage (BFP, by bioelectrical impedance), and waist, arm, and hip circumferences were measured in 1173 6-year-old children of nulliparous pregnant women in the Screening for Pregnancy Endpoints (SCOPE) study, New Zealand. Relationships of maternal early pregnancy (15 weeks' gestation) BMI and biomarkers with these childhood anthropometric measures were assessed by linear regression, with appropriate adjustment. RESULTS 28.1% of mothers were classified as overweight and 10.1% with obesity; compared with normal weight mothers, the BFP of their children were 5.3% higher (0.16 SD [95% CI, 0.04-0.29] p = .01) and 7.8% higher (0.27 [0.08-0.47] p = .006) with comparable values for BMI z-score and arm, waist, and hip circumferences. Early pregnancy maternal BMI and plasma placental growth factor (PlGF) were associated with higher child's SST, BMI z-score, hip circumference, and BFP. None of the metabolic or inflammatory maternal biomarkers were associated with childhood obesity. CONCLUSION In this contemporary large prospective cohort study with extensive maternal/childhood phenotyping and a high prevalence of maternal overweight/obesity, we found independent relationships of maternal early pregnancy BMI with childhood BMI and adiposity; similar associations were observed with PlGF, which may imply a role for placenta function in the developmental programming of childhood obesity risk.
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Affiliation(s)
- Kathryn V Dalrymple
- Department of Women and Children’s Health, School of Life
Course Sciences, King’s College London, UK
| | - John M D Thompson
- Department of Paediatrics, Child & Youth Health, Faculty of
Medical and Health Science, University of Auckland, New Zealand,Department of Obstetrics and Gynaecology, Faculty of Medical and
Health Science, University of Auckland, New Zealand
| | - Shahina Begum
- Department of Women and Children’s Health, School of Life
Course Sciences, King’s College London, UK
| | - Keith M Godfrey
- MRC Lifecourse Epidemiology Unit and NIHR Southampton Biomedical
Research Centre, University of Southampton and University Hospital Southampton NHS
Foundation Trust, UK
| | - Lucilla Poston
- Department of Women and Children’s Health, School of Life
Course Sciences, King’s College London, UK
| | - Paul T Seed
- Department of Women and Children’s Health, School of Life
Course Sciences, King’s College London, UK
| | - Lesley M E McCowan
- Department of Obstetrics and Gynaecology, Faculty of Medical and
Health Science, University of Auckland, New Zealand
| | - Clare Wall
- Department of Nutrition, School of Medical Sciences, University of
Auckland, New Zealand
| | - Andrew Shelling
- Department of Obstetrics and Gynaecology, Faculty of Medical and
Health Science, University of Auckland, New Zealand
| | - Robyn North
- Department of General Medicine, Auckland City Hospital, Auckland New
Zealand
| | | | - Edwin A Mitchell
- Department of Paediatrics, Child & Youth Health, Faculty of
Medical and Health Science, University of Auckland, New Zealand
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Lin JZ, Liang JJ, Ma JD, Li QH, Mo YQ, Cheng WM, He XL, Li N, Cao MH, Xu D, Dai L. Myopenia is associated with joint damage in rheumatoid arthritis: a cross-sectional study. J Cachexia Sarcopenia Muscle 2019; 10:355-367. [PMID: 30701694 PMCID: PMC6463467 DOI: 10.1002/jcsm.12381] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2018] [Revised: 10/15/2018] [Accepted: 11/20/2018] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND The link between body mass index (BMI) and disease characteristics in rheumatoid arthritis (RA) remains controversial. Body composition (BC) has been more frequently recommended to be used instead of BMI for more accurate assessment. Our study aimed to investigate the characteristics of BC in RA patients and their associations with disease characteristics. METHODS Body composition was assessed in consecutive Chinese RA patients and control subjects by bioelectric impedance analysis. Overfat was defined by body fat percentage (BF%) as ≥25% for men and ≥35% for women. Myopenia was defined by appendicular skeletal muscle mass index (ASMI) ≤7.0 kg/m2 in men and ≤5.7 kg/m2 in women. BMI and clinical data including disease activity, function, and radiographic assessment were collected. Active disease was defined by disease activity score in 28 joints with four variables including C-reactive protein (DAS28-CRP) ≥2.6. Functional limitation was defined as Stanford health assessment questionnaire disability index (HAQ-DI) >1. Radiographic joint damage (RJD) was defined as the Sharp/van der Heijde modified sharp score (mTSS) >10. RESULTS There were 457 RA patients (mean age 49.5 ± 13.1 years old with 82.7% women) and 1860 control subjects (mean age 34.3 ± 9.9 years old with 51.2% women) recruited. Comparisons of BMI and BC between RA patients and control subjects in age and gender stratification showed that lower BMI with 17.7% underweight and lower ASMI with 45.1% myopenia are the main characteristics in RA patients. Compared with those without myopenia, RA patients with myopenia had significantly higher DAS28-CRP (median 3.5 vs. 3.0), higher HAQ-DI (median 0.38 vs. 0.13) with higher rate of functional limitation (24.8% vs. 7.6%), and higher mTSS (median 22.3 vs. 9.0) with more RJD (71.8% vs. 45.8%) (all P < 0.001). Multivariate logistic regression analysis showed myopenia were positively associated with functional limitation (OR = 2.546, 95% CI: 1.043-6.217) and RJD (OR = 2.660, 95% CI: 1.443-4.904). All RA patients were divided into four BC subgroups according to overfat and myopenia. Those with both overfat and myopenia had the worst disease characteristics. After adjustment for confounding factors, significant additive interactions were observed between overfat and myopenia in active disease (AP = 0.528, 95% CI: 0.086-0.971), functional limitation (AP = 0.647, 95% CI: 0.356-0.937), and RJD (AP = 0.514, 95% CI: 0.139-0.890). CONCLUSIONS Myopenia is very common in RA patients that is associated with functional limitation and joint damage in RA. Further research on the underlying mechanism and the effect of skeletal muscle mass improvement in RA management are worth exploring in the future.
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Affiliation(s)
- Jian-Zi Lin
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jin-Jian Liang
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Jian-Da Ma
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Qian-Hua Li
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Ying-Qian Mo
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Wan-Mei Cheng
- Shanghai Healthcare Co. Ltd., Zhangjiang Innopark, Building 7, Shanghai, China
| | - Xiao-Ling He
- Shanghai Healthcare Co. Ltd., Zhangjiang Innopark, Building 7, Shanghai, China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Ming-Hui Cao
- Department of Radiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Dan Xu
- Centre of Clinical Research and Education, School of Public Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Lie Dai
- Department of Rheumatology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong, China
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Sundholm JKM, Litwin L, Rönö K, Koivusalo SB, Eriksson JG, Sarkola T. Maternal obesity and gestational diabetes: Impact on arterial wall layer thickness and stiffness in early childhood - RADIEL study six-year follow-up. Atherosclerosis 2019; 284:237-244. [PMID: 30819513 DOI: 10.1016/j.atherosclerosis.2019.01.037] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Revised: 12/28/2018] [Accepted: 01/30/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND AND AIMS Gestational diabetes (GDM) and maternal obesity are linked to weight gain in childhood and an increased risk of cardiovascular disease later in life. We assessed the effects of GDM and maternal obesity on arterial function and morphology in relation to body anthropometrics and composition in early childhood. METHODS We assessed body size and composition, blood pressure (BP), arterial morphology and stiffness in 201 pairs of obese mothers (pre-pregnancy BMI 30.7 ± 5.6 kg/m2, 96 with GDM) and their children at 6.1 years (SD 0.5). RESULTS Child BMI (z-score 0.45 ± 0.92; p < 0.001) and common carotid intima-media thickness (IMT, z-score 0.15 ± 0.75, p = 0.003) were increased compared with a healthy Finnish reference population. No associations with maternal GDM was found. Carotid IMT and pulse wave velocity were unrelated to child sex, anthropometrics, body composition, BP, as well as maternal anthropometrics and body composition. Carotid stiffness was independently predicted by second trimester fasting glucose. Child lean body mass was the strongest independent predictor for radial (RA), and brachial artery (BA) lumen diameter (LD) and BA IMT (LD: RA: r2 = 0.068, p < 0.001; BA: r2 = 0.108, p < 0.001; IMT: BA: r2 = 0.161, p < 0.001) and carotid LD (r2 = 0.066, p < 0.001). CONCLUSIONS Children of obese mothers have increased BMI, blood pressure and carotid IMT suggesting a transgenerational effect of maternal obesity and clustering of cardiovascular risk factors in the population. Arterial dimensions were mainly predicted by child LBM, and not associated with maternal or child adiposity, or GDM. There was a weak association with maternal gestational fasting glucose and increased carotid artery stiffness.
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Affiliation(s)
- Johnny K M Sundholm
- Children's Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, Finland.
| | - Linda Litwin
- Children's Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, Finland; Department of Congenital Heart Defects and Pediatric Cardiology, SMDZ in Zabrze, SUM, Katowice, Poland
| | - Kristiina Rönö
- Women's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Saila B Koivusalo
- Women's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Johan G Eriksson
- University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland
| | - Taisto Sarkola
- Children's Hospital, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
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Hua MC, Huang JL, Hu CC, Yao TC, Lai MW. Including Fibroblast Growth Factor-21 in Combined Biomarker Panels Improves Predictions of Liver Steatosis Severity in Children. Front Pediatr 2019; 7:420. [PMID: 31750276 PMCID: PMC6842980 DOI: 10.3389/fped.2019.00420] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2019] [Accepted: 10/02/2019] [Indexed: 12/12/2022] Open
Abstract
Background: Previous studies reported conflicting results regarding the association between fibroblast growth factor-21 (FGF-21) and non-alcoholic fatty liver disease (NAFLD). This study aimed to evaluate the feasibility of combining FGF-21, obesity indices, and biochemical tests for predicting high-grade liver steatosis in children. Methods: A total of 203 children and adolescents aged 5-18 years were enrolled, and their anthropometric data, body composition, liver ultrasound score for NAFLD (range, 0-6), biochemical test results, and FGF-21, leptin, and adiponectin levels were analyzed. Children were categorized according to body mass index (BMI) and NAFLD scores. Univariate analysis and multivariate linear regression were used to identify independent predictors for the degree of liver steatosis. The accuracy of the models was also evaluated using a receiver-operating characteristic (ROC) curve. Results: FGF-21 levels were significantly higher in subjects with high-grade liver steatosis (P < 0.001). In obese and overweight children, regression analysis indicated that higher BMI and higher gamma-glutamyl transferase (γ-GT), triglycerides (TG), and FGF-21 levels were independent risk factors strongly correlated with NAFLD scores. FGF-21 combined with any of the above parameters showed a larger area under the ROC (AUROC, 0.861-0.873) than either parameter used alone. Overall, the best performance was obtained by combing FGF-21, γ-GT, and TG, with an AUROC of 0.871, specificity of 82.54%, and sensitivity of 83.78% for predicting high-grade liver steatosis. Conclusion: BMI, FGF-21, γ-GT, and TG levels were strongly correlated with liver steatosis severity. Including FGF-21 in the biomarker panels may improve the accuracy for identifying obese and overweight children with high-grade liver steatosis.
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Affiliation(s)
- Man-Chin Hua
- Department of Pediatrics, Chang Gung Memorial Hospital, Keelung, Taiwan.,Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Jing-Long Huang
- Chang Gung University College of Medicine, Taoyuan, Taiwan.,Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ching-Chih Hu
- Chang Gung University College of Medicine, Taoyuan, Taiwan.,Division of Hepatology, Department of Hepatogastroenterology, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Tsung-Chieh Yao
- Chang Gung University College of Medicine, Taoyuan, Taiwan.,Division of Allergy, Asthma and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ming-Wei Lai
- Chang Gung University College of Medicine, Taoyuan, Taiwan.,Division of Gastroenterology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Liver Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Physical Fitness and Body Composition in 10-12-Year-Old Danish Children in Relation to Leisure-Time Club-Based Sporting Activities. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9807569. [PMID: 30687761 PMCID: PMC6327252 DOI: 10.1155/2018/9807569] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 10/31/2018] [Accepted: 11/29/2018] [Indexed: 11/18/2022]
Abstract
This study investigated whether the physical fitness and body composition of 10–12-year-old Danish children are related to participation in leisure-time club-based sporting activities. The study involved 544 Danish 10–12-year-old 5th-grade municipal schoolchildren (269 boys and 275 girls, 11.1 ± 0.4 years). After answering a questionnaire about leisure-time sporting activities, the children were divided into four groups: football club participation (FC; n=141), other ball games (OBG; n=42), other sports (OS; n=194), and no sports-club participation (NSC; n=167). The children completed a battery of health and fitness tests, including a 20 m sprint test, a standing long-jump test, the Yo-Yo IR1 children's test (YYIR1C), and body composition, blood pressure, resting heart rate (HRrest), and the flamingo balance test. The children engaged in club-based ball games (FC and OBG) had higher (p<0.05) lean body mass than NSC (FC: 17.5 ± 2.9; OBG: 18.4 ± 2.6; OS: 16.7 ± 2.9; NSC: 16.4 ± 2.8 kg), performed better (p<0.05) in the YYIR1C test (FC: 1083 ± 527; OBG: 968 ± 448; OS: 776 ± 398; NSC: 687 ± 378 m), and had lower (p<0.05) %HRmax after 1, 2, and 3 min of YYIR1C. Moreover, HRrest was lower (p<0.05) for FC than for OS and NSC (FC: 68 ± 9 vs OS: 72 ± 10 and NSC: 75 ± 10 bpm), and lower (p<0.05) for OBG than for NSC (OBG: 70 ± 10 vs NSC: 75 ± 10 bpm). This study found that 10–12-year-old Danish children engaged in club-based football and other ball games had better exercise capacity, lower resting heart rate, and higher muscle mass than children not engaged in leisure-time sports. Thus, participation in club-based leisure-time ball-game activities seems to be of importance for the fitness and health profile of prepubertal children.
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Quadri M, Ariza AJ, Selvaraj K, Schaller K, Binns HJ. Percent Body Fat Measurement in the Medical Management of Children with Obesity. Pediatr Ann 2018; 47:e487-e493. [PMID: 30543377 DOI: 10.3928/19382359-20181116-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Sustaining weight loss can be challenging, as physiological responses to weight loss, including metabolic and hormonal adaptations and decreased energy expenditure, promote weight regain. Paired with sustained dietary changes, physical activity can promote weight maintenance after successful weight loss, as physical activity can help maintain fat-free mass. We present several illustrative cases to highlight the potential use of body composition measurement using a bioelectrical impedance analysis (BIA) scale to augment obesity management counseling in a tertiary care pediatric weight-management clinic. BIA does require some interpretation, as it can be affected by hydration status and time of day, as well as patient age, sex, and body mass index. Nonetheless, BIA can be a helpful aid to obesity counseling. More research is needed to better understand how to use change in percent body fat over time as a motivational tool for management of children with obesity. [Pediatr Ann. 2018;47(12):e487-e493.].
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Ndagire CT, Muyonga JH, Isabirye D, Odur B, Somda SMA, Bukenya R, Andrade JE, Nakimbugwe D. Assessing the reliability of FTIR spectroscopy measurements and validity of bioelectrical impedance analysis as a surrogate measure of body composition among children and adolescents aged 8-19 years attending schools in Kampala, Uganda. BMC Public Health 2018; 18:687. [PMID: 29866098 PMCID: PMC5987600 DOI: 10.1186/s12889-018-5627-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Accepted: 05/29/2018] [Indexed: 11/16/2022] Open
Abstract
Background Accurate measurement of body composition in children and adolescents is important as the quantities of fat and fat-free mass have implications for health risk. The objectives of the present study were: to determine the reliability of Fourier Transform Infrared spectroscopy (FTIR) measurements and; compare the Fat Mass (FM), Fat Free Mass (FFM) and body fat percentage (%BF) values determined by bioelectrical impedance analysis (BIA) to those determined by deuterium dilution method (DDM) to identify correlations and agreement between the two methods. Methods A cross-sectional study was conducted among 203 children and adolescents aged 8–19 years attending schools in Kampala city, Uganda. Pearson product-moment correlation at 5% significance level was considered for assessing correlations. Bland Altman analysis was used to examine the agreement between of FTIR measurements and between estimates by DDM and BIA.. Reliability of measurements was determined by Cronbach’s alpha. Results There was good agreement between the in vivo D2O saliva enrichment measurements at 3 and 4 h among the studied age groups based on Bland-Altman plots. Cronbach’s alpha revealed that measurements of D2O saliva enrichment had very good reliability. For children and young adolescents, DDM and BIA gave similar estimates of FFM, FM, and %BF. Among older adolescents, BIA significantly over-estimated FFM and significantly under-estimated FM and %BF compared to estimates by DDM. The correlation between FFM, FM and %BF estimates by DDM and BIA was high and significant among young and older adolescents and for FFM among children. Conclusions Reliability of the FTIR spectroscopy measurements was very good among the studied population. BIA is suitable for assessing body composition among children (8–9 years) and young adolescents (10–14 years) but not among older adolescents (15–19 years) in Uganda. The body composition measurements of older adolescents determined by DDM can be predicted using those provided by BIA using population-specific regression equations.
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Affiliation(s)
- Catherine T Ndagire
- School of Food Technology, Nutrition and Bio-engineering, Makerere University, Kampala, Uganda.
| | - John H Muyonga
- School of Food Technology, Nutrition and Bio-engineering, Makerere University, Kampala, Uganda
| | - Dan Isabirye
- Department of Biochemistry and Sports Science, Makerere University, Kampala, Uganda
| | - Benard Odur
- Department of Statistical Methods and Actuarial Science, School of Statistics, Makerere University, Kampala, Uganda
| | | | - Richard Bukenya
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, USA
| | - Juan E Andrade
- Division of Nutritional Sciences, University of Illinois, Urbana-Champaign, USA.,Department of Food Science and Human Nutrition, University of Illinois, Urbana-Champaign, USA
| | - Dorothy Nakimbugwe
- School of Food Technology, Nutrition and Bio-engineering, Makerere University, Kampala, Uganda
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Fredriksen PM, Skår A, Mamen A. Waist circumference in 6–12-year-old children: The Health Oriented Pedagogical Project (HOPP). Scand J Public Health 2018; 46:12-20. [DOI: 10.1177/1403494818767790] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Aims: With overweight and obesity increasing worldwide, it has become ever more important to monitor the development and distribution of adiposity in children. This study investigated how the measurements of waist circumference (WC) and waist-to-height ratio (WHtR) in children 6–12 years old relate to earlier studies. Methods: In 2015, 2271 children (boys, n = 1150) were measured for height, weight, and WC. Parental education level was used as a measure of socioeconomic status. Results: A significant increase in WC with age was revealed for both sexes ( p < .0001). Boys at 10 and 12 years had a larger WC than girls; otherwise no difference between sexes was found. The WHtR decreased with age for girls ( p < .0001); 14% of the sample displayed a WHtR ≥ 0.50. Comparison with earlier studies showed a higher WC and WHtR despite no change in weight and body mass index. Conclusion: WC and WHtR are recommended as tools for identifying central obesity in children. The results indicate increased WC in 6–12-year-old children compared with earlier findings.
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Affiliation(s)
| | - Angelica Skår
- Department of Health Sciences, Kristiania University College, Norway
| | - Asgeir Mamen
- Department of Health Sciences, Kristiania University College, Norway
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Isasi CR, Strizich GM, Kaplan R, Daviglus ML, Sotres-Alvarez D, Vidot DC, Llabre MM, Talavera G, Carnethon MR. The association of cardiorespiratory fitness with cardiometabolic factors, markers of inflammation, and endothelial dysfunction in Latino youth: findings from the Hispanic Community Children's Health Study/Study of Latino Youth. Ann Epidemiol 2018; 28:583-589.e3. [PMID: 29548689 DOI: 10.1016/j.annepidem.2018.02.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 02/01/2018] [Accepted: 02/12/2018] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the relationship of cardiorespiratory fitness (CRF) with cardiovascular disease risk factors and a biomarker of endothelial dysfunction (e-selectin) among Hispanic/Latino youth. METHODS The study included 1380 Hispanic/Latino youths (8-16 years old) from the Hispanic Community Children's Health Study/Study of Latino Youth that enrolled from four cities (Bronx, Chicago, Miami, and San Diego). CRF was assessed by a 3-minute step test that uses postexercise heart rate to estimate maximal oxygen uptake. Regression models assessed differences in cardiometabolic markers across quartiles of CRF, adjusting for potential confounders. RESULTS CRF was higher among boys (mean: 57.6 mL per kg/min, 95% confidence interval, 56.8-58.4) compared to girls (mean: 54.7 mL per kg/min, 95% confidence interval, 53.9-55.5). Higher levels of CRF were associated with more favorable levels of cardiometabolic, inflammation, and endothelial dysfunction factors (P-values <.001) and independently of physical activity and sedentary time. Compared to the lowest quartile of CRF, the odds of having greater than or equal to two cardiovascular disease risk factors was lower at higher quartiles of CRF, after adjustment for potential confounders. CONCLUSIONS Among Hispanic/Latino youth, CRF appears to be a strong protective factor for endothelial dysfunction and cardiometabolic risk factors. Strategies to improve CRF may be a useful approach for improving cardiovascular health in youth.
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Affiliation(s)
- Carmen R Isasi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY.
| | - Garrett M Strizich
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Robert Kaplan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago
| | - Daniela Sotres-Alvarez
- Collaborative Studies Coordinating Center, Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill
| | - Denise C Vidot
- Department of Psychology, University of Miami Miller School of Medicine, Miami, FL
| | - Maria M Llabre
- Department of Psychology, University of Miami, Miami, FL
| | - Gregory Talavera
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA
| | - Mercedes R Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
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Pham DD, Lee JH, Kim KY, Song JY, Kim JE, Leem CH. Anthropometry-based estimation of body heat capacity in individuals aged 7-69 years: the Size Korea Survey 2010. Sci Rep 2018; 8:2490. [PMID: 29410474 PMCID: PMC5802818 DOI: 10.1038/s41598-018-20872-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Accepted: 01/25/2018] [Indexed: 11/09/2022] Open
Abstract
Although our previously developed anthropometry-based calculation of heat capacity (HC) for adults appeared to be precise and valid, its use in children and adolescents may be associated with bias. This study investigated a large dataset from the Size Korea survey, a national anthropometric survey conducted in 2010, to revalidate our previous HC equation and to develop another one that is appropriate for children and adolescents. We enrolled 12,766 participants aged 7-69 years with body composition data measured by multi-frequency bioelectrical impedance analysis. Age was associated with HC in children aged 7-19 years (R2 = 0.58) but not in adults (R2 = 0.007). Linear regression was appropriate to describe the relationship between HC and body surface area (BSA) in adults, whereas the regression in children and adolescent was quadratic. The previously developed HC equation had high reliability (intra-class correlation coefficient = 0.995) and predictive power (accurate prediction rate = 86.1%) in the >20 age group. The model composed of sex, body weight, BSA, and BSA2 was appropriate for the prediction of HC in young individuals aged 7-19 years. In conclusion, anthropometric-based modelling is a simple, reliable, and useful method for the calculation of HC.
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Affiliation(s)
- Duong Duc Pham
- Department of Physiology, University of Ulsan College of Medicine, 88 Olympic-Ro 43-gil Songpa-gu, Seoul, Republic of Korea
| | - Jeong Hoon Lee
- Department of Physiology, University of Ulsan College of Medicine, 88 Olympic-Ro 43-gil Songpa-gu, Seoul, Republic of Korea
| | - Ka Yul Kim
- Department of Physiology, University of Ulsan College of Medicine, 88 Olympic-Ro 43-gil Songpa-gu, Seoul, Republic of Korea
| | - Ji Yeon Song
- Department of Physiology, University of Ulsan College of Medicine, 88 Olympic-Ro 43-gil Songpa-gu, Seoul, Republic of Korea
| | - Ji Eun Kim
- Department of Physiology, University of Ulsan College of Medicine, 88 Olympic-Ro 43-gil Songpa-gu, Seoul, Republic of Korea
| | - Chae Hun Leem
- Department of Physiology, University of Ulsan College of Medicine, 88 Olympic-Ro 43-gil Songpa-gu, Seoul, Republic of Korea.
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