Evaluation of Methods to Assess Reduced Body Fat in Patients with Anorexia Nervosa

Haas, Verena; Stark, Dorothea; Kohn, Michael; Müller, Manfred J.; Clarke, Simon; Blumenthal, C.; Briody, Julie; Madden, Sloane; Gaskin, Kevin

doi:10.1080/07315724.2013.767619

Cited by 7 publications

(8 citation statements)

References 36 publications

(39 reference statements)

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“…Previously, Birmingham et al reported the inability of BIA to detect changes in body composition due to altered hydration, compared to skinfold measurements, in AN patients [9]. Skinfold measurements and DXA were similar in performance for the estimation of percentage of body fat in 80 AN patients [8]. Bonaccorsi et al compared BIA (BIA software and Deurenberg equations) to DXA in 30 young girls (11 to 19 years old) with AN [6].…”

Section: Discussionmentioning

confidence: 99%

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Validity of Bioimpedance Equations to Evaluate Fat-Free Mass and Muscle Mass in Severely Malnourished Anorectic Patients

Coëffier

Gaté

Rimbert

et al. 2020

JCM

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Background: Bioelectrical impedance analysis (BIA) is a simple and rapid technique to measure body composition (BC). Validity of BIA in patients with low body mass index (BMI) remains controversial. We assessed the validity of several BIA equations to evaluate fat-free mass (FFM), fat mass (FM) and muscle mass in patients with anorexia nervosa (AN) by using dual X ray absorptiometry (DXA) as reference. Methods: Sixteen BIA equations developed for FFM and appendicular lean mass (ALM) were applied on electrical data measured by BIA in AN patients with BMI <16 kg/m². BIA and DXA were done the same day after overnight fasting. Results were compared with the Bland–Altman method, Pearson correlation and a Lin concordance test. Results: Data from 115 female AN patients (14.6 ± 1.2 kg/m²; 32.3 ± 14.5 years) were included. FM and FFM assessed by DXA were, respectively, 4.2 ± 2.4 kg and 35.5 ± 3.8 kg. The best results were obtained with Sun’s equation: respectively for FM and FFM, Bland Altman bias at 0.548 and 0.706 kg, Pearson correlation r at 0.86 and 0.86 and Lin concordance coefficient at 0.81 and 0.84. However, confidence intervals (CI) at 95% were high (−2.73–3.83 kg for FM; −4.55–3.13 kg for FFM). Other equations also showed high 95% CI. Accuracy was acceptable for Sun and Bedogni equations for FFM (approximately 66%) but very low for FM prediction considering all equations (<15%). Concerning ALM evaluated at 14.88 ± 2.04 kg by DXA, only Scafoglieri and Yoshida equations showed acceptable values: bias (−0.2 and 2.8%), Pearson r (0.89 and 0.86), Lin concordance coefficient (0.82 and 0.82) and accuracy (83.5 and 82.6%). Confidence intervals at 95% were high for both equations (−2.1–2.0 for Scafoglieri equation and −1.6–2.4 for Yoshida equation). Conclusion: In AN patients with BMI < 16 kg/m², no BIA equation tested was adapted to evaluate BC at the individual level.

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Section: Discussionmentioning

confidence: 99%

“…Comparison of body composition assessment by DXA and BIA in AN patients has been reported in some studies [6][7][8][9] showing inconsistent results. We previously reported in malnourished patients that BIA underestimated FFM and overestimated FM when using the manufacturer's BIA equation [10].…”

Section: Introductionmentioning

confidence: 99%

Validity of Bioimpedance Equations to Evaluate Fat-Free Mass and Muscle Mass in Severely Malnourished Anorectic Patients

Coëffier

Gaté

Rimbert

et al. 2020

JCM

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“…Attempts have been made to exactly monitor the increase of body fat. For this purpose, skinfold anthropometry and DXA as well as whole-body impedance vector components, resistance (R) and reactance (X(c) have been used [3][4][5][6].…”

Section: Discussionmentioning

confidence: 99%

“…Elaborate methods such as dual-energy x-ray absorptiometry (DXA) as well as whole-body impedance vector components, resistance (R) and reactance (X(c) have been used in order to determine the body composition of AN patients [3][4][5][6]. Yet some investigators found that comparatively simple anthropometric measurements such as triceps skinfold thickness or girth at different regions of the body show a very good correlation to the elaborate measurements in AN, whereas BMI proved as less reliable [5,7].…”

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confidence: 99%

Anthropometric data before, during and after in-patient treatment of Anorexia Nervosa: Thigh circumference as reliable direct correlate to BMI and to prognosis.

Weber

Raimann

Wadlegger

et al. 2020

Preprint

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Purpose The aim of the study was to determine the extent of changes in circumferential measurements taken at various localizations before, during and after in-patient treatment in patients with anorexia nervosa (AN) and their relation to BMI. Furthermore, we analyzed a possible impact of these values on long-term prognosis. Methods We retrospectively analyzed data of 269 patients (258 females, 11 males) with anorexia nervosa treated between 1999 and 2013 at a single institution by a 6-weeks quick refeeding therapy cycle. A complete set of data was available from 230 patients. BMI and 13 circumferential measuring points at the trunk and the extremities were monitored every day and at follow-up. Results 229 out of the total collective (85.13 %) had a favourable outcome with restored, stable weight after a mean observation time of 138 +- 52 months. All measuring parameters showed a highly significant increase from admission to end of treatment cycle (p < 0.0001 for each parameter. The highest gain expressed as percent of the value at admission was achieved in BMI, followed by girth of thigh. Measurements at the end of term of thorax, waist, upper arm and thigh correlated with a favourable prognosis. A thigh circumference >50 cm was significantly connected to BMI>18 and a beneficial outcome. Conclusions The highest gain in circumference during refeeding was found at the thigh. A thigh circumference greater than 50 if achieved after the first refeeding cycle was significantly linked to BMI >=18 and was a predictor of a favourable long-term course. Level of evidence Level II, comparative study

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“…Deviations between predicted body fat based on quantitative surrogates (such as BMI) and actual body fat as measured by DXA are reported in studies of "atypical" groups such as muscular athletes, endurance athletes, jockeys, and individuals with eating disorders. [55][56][57][58][59][60][61][62][63][64][65][66][67]…”

Section: S45mentioning

confidence: 99%

Estimation of Absolute and Relative Body Fat Content Using Noninvasive Surrogates: Can DXA Be Bypassed?

Greenblatt,

Bruno,

Harmatz

et al. 2023

The Journal of Clinical Pharma

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Dual‐energy x‐ray absorptiometry (DXA) scanning is used for objective determination of body composition, but instrumentation is expensive and not generally available in customary clinical practice. Anthropometric surrogates are often substituted as anticipated correlates of absolute and relative body fat content in the clinical management of obesity and its associated medical risks. DXA and anthropometric data from a cohort of 9230 randomly selected American subjects, available through the ongoing National Health and Nutrition Examination Survey, was used to evaluate combinations of surrogates (age, height, total weight, waist circumference) as predictors of DXA‐determined absolute and relative body fat content. Multiple regression analysis yielded linear combinations of the 4 surrogates that were closely predictive of DXA‐determined absolute fat content (R2 = 0.93 and 0.96 for male and female subjects). Accuracy of the new algorithm was improved over customary surrogate‐based predictors such as body mass index. However prediction of relative body fat was less robust (R2 less than 0.75), probably due to the nonlinear relation between degree of obesity (based on body mass index) and relative body fat. The paradigm was validated using an independent cohort from the National Health and Nutrition Examination Survey, as well as two independent external subject groups. The described regression‐based algorithm is likely to be a sufficiently accurate predictor of absolute body fat (but not relative body fat) to substitute for DXA scanning in many clinical situations. Further work is needed to assess algorithm validity for subgroups of individuals with “atypical” body construction.

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Evaluation of Methods to Assess Reduced Body Fat in Patients with Anorexia Nervosa

Abstract: In our group of patients with AN, the Deurenberg skinfold model and DXA were similar in performance; however, DXA overestimated %BF in healthy subjects.

Cited by 7 publications

References 36 publications

Validity of Bioimpedance Equations to Evaluate Fat-Free Mass and Muscle Mass in Severely Malnourished Anorectic Patients

Validity of Bioimpedance Equations to Evaluate Fat-Free Mass and Muscle Mass in Severely Malnourished Anorectic Patients

Anthropometric data before, during and after in-patient treatment of Anorexia Nervosa: Thigh circumference as reliable direct correlate to BMI and to prognosis.

Estimation of Absolute and Relative Body Fat Content Using Noninvasive Surrogates: Can DXA Be Bypassed?

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