Validity of bioelectrical impedance to estimate fat-free mass in boys with Duchenne muscular dystrophy

Grilo, Evellyn Câmara; Cunha, Thais Alves; Costa, Ádila Danielly S.; Araújo, Bárbara Gurgel Magalhães de; Lopes, Márcia Marília Gomes Dantas; Maciel, Bruna L. L.; Alves, Camila Xavier; Vermeulen-Serpa, Karina Marques; Dourado-Júnior, Mario Emílio Teixeira; Leite-Lais, Lúcia; Brandão-Neto, José; Vale, Sancha Helena de Lima

doi:10.1371/journal.pone.0241722

Cited by 6 publications

(4 citation statements)

References 38 publications

(45 reference statements)

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“…DXA has been used to measure lean mass in DMD (Grilo et al . 2020); however, we observed no relationship between DXA lean mass and muscle mass. Although we observed a significant overall relationship between FFM estimated by TBW and MM in all subjects ( r 2 = 0.832, P < 0.0001) with a stronger relationship in controls ( r 2 = 0.746, P = 0.006) than in DMD ( r 2 = 0.598, P = 0.025), we report, for the first time, that MM was on average 34% ± 9% of FFM and 17% ± 10% of body weight in DMD compared to 41% ± 9% and 56% ± 9% in control, indicating that FFM substantially overestimates MM, particularly in DMD, and should not be used as a surrogate for MM.…”

Section: Discussioncontrasting

confidence: 78%

Profoundly lower muscle mass and rate of contractile protein synthesis in boys with Duchenne muscular dystrophy

Evans

Shankaran

Smith³

et al. 2021

The Journal of Physiology

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Boys with Duchenne muscular dystrophy (DMD) experience a progressive loss of functional muscle mass, with fibrosis and lipid accumulation. Accurate evaluation of whole‐body functional muscle mass (MM) in DMD patients has not previously been possible and the rate of synthesis of muscle proteins remains unexplored. We used non‐invasive, stable isotope‐based methods from plasma and urine to measure the fractional rate of muscle protein synthesis (FSR) functional muscle mass (MM), and fat free mass (FFM) in 10 DMD (6–17 years) and 9 age‐matched healthy subjects. An oral dose of D3creatine in 70% 2H2O was administered to determine MM and FFM followed by daily 70% 2H2O to measure protein FSR. Functional MM was profoundly reduced in DMD subjects compared to controls (17% vs. 41% of body weight, P < 0.0001), particularly in older, non‐ambulant patients in whom functional MM was extraordinarily low (<13% body weight). We explored the urine proteome to measure FSR of skeletal muscle‐derived proteins. Titin, myosin light chain and gelsolin FSRs were substantially lower in DMD subjects compared to controls (27%, 11% and 40% of control, respectively, P < 0.0001) and were strongly correlated. There were no differences in muscle‐derived sarcoplasmic proteins FSRs (creatine kinase M‐type and carbonic anhydrase‐3) measured in plasma. These data demonstrate that both functional MM, body composition and muscle protein synthesis rates can be quantified non‐invasively and are markedly different between DMD and control subjects and suggest that the rate of contractile but not sarcoplasmic protein synthesis is affected by a lack of dystrophin. Key points Duchenne muscular dystrophy (DMD) results in a progressive loss of functional skeletal muscle but total body functional muscle mass or rates of muscle protein synthesis have not previously been assessed in these patients. D3‐creatine dilution was used to measure total functional muscle mass and oral 2H2O was used to examine the rates of muscle protein synthesis non‐invasively in boys with DMD and healthy controls using urine samples. Muscle mass was profoundly lower in DMD compared to control subjects, particularly in older, non‐ambulant patients. The rates of contractile protein synthesis but not sarcoplasmic proteins were substantially lower in DMD. These results may provide non‐invasive biomarkers for disease progression and therapeutic efficacy in DMD and other neuromuscular diseases.

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Section: Discussioncontrasting

confidence: 78%

Profoundly lower muscle mass and rate of contractile protein synthesis in boys with Duchenne muscular dystrophy

Evans

Shankaran

Smith³

et al. 2021

The Journal of Physiology

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“…The BIA is one of the most convenient techniques for assessing body composition in a clinical setting and in epidemiological approaches, mainly, because it is easy to apply, fast, and non-invasive, in addition to having a relatively low cost ( 5 , 45 , 46 ). The use of predictive equations that have been developed and cross-validated in groups with similar characteristics to those of the subjects that we intend to evaluate can reduce discrepancies among studies ( 7 , 20 , 47 ).…”

Section: Discussionmentioning

confidence: 99%

Development and Cross-Validation of a Predictive Equation for Fat-Free Mass in Brazilian Adolescents by Bioelectrical Impedance

et al. 2022

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The bioelectrical impedance analysis (BIA) is one of the most commonly used techniques for assessing body composition in a clinical setting and in field approaches, as it has the advantages of easy application, fast, and non-invasive, in addition to its relatively low cost. However, the available predictive equations need to be valid for the evaluated subjects. The aim of this study was to verify the validity of several published BIA equations in estimating fat-free mass (FFM) among Brazilian adolescents, in addition to developing and cross-validating a BIA equation to estimate FFM appropriate for Brazilian adolescents. This is a cross-sectional study with 257 adolescents (128 girls) aged 10–19 years, randomly divided into two groups, namely, development (n = 172) and cross-validation (n = 85). The standard technique for assessing FFM was dual X-ray absorptiometry (DXA). The paired t-test, multiple regression, and the Bland-Altman plots were used to test the validity of the proposed models and to perform cross-validation of the model. The equation derived in this study was as follows: FFM = −17.189 + 0.498 (Height2/Resistance) + 0.226 Weight + 0.071 Reactance − 2.378 Sex + 0.097 Height + 0.222 Age; r2 = 0.92; standard error of the estimate = 2.49 kg; the new equation for FFM showed better agreement when compared with that of the equations developed in other countries. In conclusion, the newly developed equations provide a valid FFM estimation and are recommended for Brazilian adolescents with similar characteristics.

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“…The predictive equations for BIA validated for the healthy population should be applied with caution in patients with DMD since their body composition is affected by the disease, sedentary lifestyle, and the prolonged use of steroids (Elliott et al, 2015). However, Grilo et al (Grilo et al, 2020) aimed to validate the BIA method using predictive formulas compared to dual-energy X-ray absorptiometry imaging, concluding that BIA is a viable method for estimating the percentage of fat-free mass in children and adolescents with DMD.…”

Section: Discussionmentioning

confidence: 99%

When age matters: boys with Duchenne muscular dystrophy have growth delay and a fat mass accumulation, as they get older

Cunha

Grilo

Costa

et al. 2021

RSD

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Anthropometry and body composition evaluation in boys with Duchenne muscular dystrophy (DMD) are challenging, but crucial methods to evaluate the nutritional status, and better anthropometric reference values and body composition predictive equations are needed for this population. Based on these aspects, this study aimed to investigate the hypothesis that changes in anthropometric parameters and body composition of boys with DMD occur according to age. A cross-sectional study with 49 individuals diagnosed with DMD at the neurological outpatient facility at the Onofre Lopes University Hospital in Natal, Brazil, was performed between September 2016 and March 2019. These individuals underwent anthropometric and body composition evaluation. According to age, the participants were divided into four groups: G1 (2.6 - 8.2y), G2 (8.5 - 10.8y), G3 (11.0 - 14.0y), and G4 (15.9 - 23.0y). The parameters weight-for-age (W/A) (p=0.025), tricipital skinfold (TSF) (p=0.027), adductor pollicis muscle (p=0.041), and corrected arm muscle area (cAMA) (p=0.005) were different among the groups. Regarding anthropometric parameters, was prevalence in the categories of appropriate W/A and a height-for-age (H/A), and eutrophy for body mass index-for-age (BMI/A). For the TSF, there was a higher frequency of severe malnutrition or obesity. The cAMA indicated severe malnutrition in most individuals. As for %FM, high adiposity was more frequent, increasing over age groups (G1 to G4). The boys with DMD presented different patterns of anthropometric and body composition parameters. An increase of fat mass and a decrease of lean mass with age/disease progression were observed.

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Validity of bioelectrical impedance to estimate fat-free mass in boys with Duchenne muscular dystrophy

Cited by 6 publications

References 38 publications

Profoundly lower muscle mass and rate of contractile protein synthesis in boys with Duchenne muscular dystrophy

Profoundly lower muscle mass and rate of contractile protein synthesis in boys with Duchenne muscular dystrophy

Development and Cross-Validation of a Predictive Equation for Fat-Free Mass in Brazilian Adolescents by Bioelectrical Impedance

When age matters: boys with Duchenne muscular dystrophy have growth delay and a fat mass accumulation, as they get older

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