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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.

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.

SUBMITTER: Chen M

PROVIDER: S-EPMC8431661 | biostudies-literature |

REPOSITORIES: biostudies-literature

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Project description:Background:The 4-component (4C) model is a criterion method for human body composition that separates the body into fat, water, mineral, and protein, but requires 4 measurements with significant cost and time requirements that preclude wide clinical use. A simplified model integrating only 2 measurements-dual-energy X-ray absorptiometry (DXA) and bioelectrical impedance analysis (BIA)-and 10 min of patient time has been proposed. Objective:We aimed to validate a rapid, simplified 4C DXA + BIA body composition model in a clinical population. Design:This was a cross-sectional observational study of 31 healthy adults. Participants underwent whole-body DXA, segmental BIA, air displacement plethysmography (ADP), and total body water (TBW) measurement by deuterium (D2O) dilution. 4C composition was calculated through the use of the Lohman model [DXA mineral mass, D2O TBW, ADP body volume (BV), scale weight] and the simplified model (DXA mineral mass and BV, BIA TBW, scale weight). Accuracy of percentage of fat (%Fat) and protein measurements was assessed via linear regression. Test-retest precision was calculated with the use of duplicate DXA and BIA measurements. Results:Of 31 participants, 23 were included in the analysis. TBWBIA showed good test-retest precision (%CV = 5.2 raw; 1.1 after outlier removal) and high accuracy to TBWD2O [TBWD2O = 0.956*TBWBIA, R2= 0.92, root mean squared error (RMSE) = 2.2 kg]. %Fat estimates from DXA, ADP, D2O, and BIA all showed high correlation with the Lohman model. However, only the 4C simplified model provides high accuracy for both %Fat (R2 = 0.96, RMSE = 2.33) and protein mass (R2= 0.76, RMSE = 1.8 kg). %Fat precision from 4C DXA + BIA was comparable with DXA (root mean square-SD = 0.8 and 0.6 percentage units, respectively). Conclusions:This work validates a simplified 4C method that measures fat, water, mineral, and protein in a 10-min clinic visit. This model has broad clinical application to monitor many conditions including over/dehydration, malnutrition, obesity, sarcopenia, and cachexia.

Project description:Dual-energy X-ray absorptiometry (DXA) has been considered a reference method for measuring body fat percentage (BF%) in children and adolescents with an excess of adiposity. However, given that the DXA technique is impractical for routine field use, there is a need to investigate other methods that can accurately determine BF%. We studied the accuracy of bioelectrical impedance analysis (BIA) technology, including foot-to-foot and hand-to-foot impedance, and Slaughter skinfold-thickness equations in the measurement of BF%, compared with DXA, in a population of Latin American children and adolescents with an excess of adiposity. A total of 127 children and adolescents (11?17 years of age; 70% girls) from the HEPAFIT (Exercise Training and Hepatic Metabolism in Overweight/Obese Adolescent) study were included in the present work. BF% was measured on the same day using two BIA analysers (Seca® 206, Allers Hamburg, Germany and Model Tanita® BC-418®, TANITA Corporation, Sportlife Tokyo, Japan), skinfold measurements (Slaughter equation), and DXA (Hologic Horizon DXA System®, Quirugil, Bogotá, Columbia). Agreement between measurements was analysed using t-tests, Bland?Altman plots, and Lin's concordance correlation coefficient (?c). There was a significant correlation between DXA and the other BF% measurement methods (r > 0.430). According to paired t-tests, in both sexes, BF% assessed by BIA analysers or Slaughter equations differ from BF% assessed by DXA (p < 0.001). The lower and upper limits of the differences compared with DXA were 6.3?22.9, 2.2?2.8, and -3.2?21.3 (95% CI) in boys and 2.3?14.8, 2.4?20.1, and 3.9?18.3 (95% CI) in girls for Seca® mBCA, Tanita® BC 420MA, and Slaughter equations, respectively. Concordance was poor between DXA and the other methods of measuring BF% (?c < 0.5). BIA analysers and Slaughter equations underestimated BF% measurements compared to DXA, so they are not interchangeable methods for assessing BF% in Latin American children and adolescents with excess of adiposity.

Project description:IntroductionMethods of body composition estimation such as dual-energy X-ray absorptiometry (DXA), anthropometry, and bioimpedance (BIA) are used for the estimation of skeletal muscle mass (SMM) and lean body mass (LBM). No previous studies have examined whether these methods generate comparable results, or whether they are valid by using DXA as the reference. The aims of the present investigation were: (a) to assess the differences between DXA, anthropometry, and BIA in the estimation of SMM and LBM, taking into consideration the impact of sex and hydration status; and (b) to examine the agreement of anthropometry and BIA as compared to DXA for the estimation of SMM and LBM.MethodsA descriptive cross-sectional design was followed with 262 healthy young adults (159 males and 103 females). LBM and SMM were assessed by anthropometry with the formulas from Lee et al. and Kulkarni et al. for LBM; and Kerr (opt a), Kerr (opt b), Lee et al., Poortmans, Matiegka, Martin et al., Drinkwater and Ross, and Heymsfield et al. for SMM; by BIA with the formula reported by the TANITA MC-780-MA software for LBM and SMM; and DXA with the formula reported by the Hologic Horizon software for LBM, and the conversion by Kim et al. for SMM.ResultsSignificant differences were found for both SMM and LBM in kg, and percentages between most methods and formulas for the overall sample (p < 0.001-0.003) and divided by sex (p < 0.001-0.035). Hydration status did not have a significant effect on the differences between methods and formulas (p = 0.058-0.870). Lin's coefficient revealed limited agreement among the majority of formulas and methods (CCC = 0.007-0.880). The Bland-Altman analysis showed significant differences in most methods and formulas, both in the overall sample and divided by sex, when using SMM and LBM with DXA as the reference (p < 0.001-0.030).ConclusionThere is a lack of agreement between methods and formulas for assessing SMM and LBM. Sex was found to be a significant factor in this analysis. Furthermore, significant differences were observed between most formulas and methods as compared to DXA, except for the equations to estimate SMM with anthropometry by Poortmans.

Project description:BackgroundSarcopenia is associated with disability, mortality, and poorer survival in cirrhotic patients. For the evaluation of muscle volume, computed tomography (CT) is the most accurate tool. Unfortunately, it would be hard to apply a muscle mass measuring CT to daily practice. This research aims to study the utility of handgrip strength (HGS) and bioelectrical impedance analysis (BIA) to detect sarcopenia in cirrhotic patients compared with CT as the reference.MethodsIn cirrhotic patients who met inclusions criteria (age 20-70 years, ascites < grade 2 of International Ascites Club grading system, no active malignancy, and no cardiac implanted device), HGS were measured using a Jamar dynamometer. Subsequently, patients with low muscle strength (defined as JSH criteria, < 26 kg in male, < 18 kg in female) were then underwent CT and BIA (Tanita MC780 MA) on the same day to measure muscle volume, the definition of sarcopenia by CT was according to the Japan Society of Hepatology (JSH). We also collected data from patients with normal HGS whose CT results were available in the study period.ResultsFrom 146 cirrhotic patients who underwent HGS, 30 patients (20.5%) had diagnosed low HSG. Data from 50 patients whose available CT results included 30 low HGS and 20 patients with normal HSG. The HGS was strongly correlated with skeleton muscle index (SMI) by CT (r = 0.81, p < 0.001) and had an excellent diagnostic performance for detecting sarcopenia by using JSH criteria the sensitivity, specificity, NPV and PPV were 88.2%, 100%, 100%, and 98.7% respectively. In contrast, only 6 of 30 patients (20%) met sarcopenic criteria by BIA. Among sarcopenic patients, the result showed a fair correlation between SMI and BIA (r = 0.54; p < 0.002).ConclusionOur study demonstrated an excellent correlation between HGS and SMI by CT in the mixed cirrhotic population from the sarcopenia and non-sarcopenia groups. The HGS using the JSH criteria showed an excellent performance in detecting sarcopenia compared to CT. Nonetheless, for the BIA by using the current cut-offs demonstrated unacceptable rate to detect sarcopenia.

Dataset Information

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.

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