Objective. To examine measurement of body composition by ultrasound compared with a reference technique:dual energy X-ray absorptiometry (DXA). We evaluated the accuracy of a portable ultrasound-based device in estimating total body fat mass with those assessed by DXA in adult. Methods. Body fat mass has been estimated using a portable ultrasound-based device in comparison with a contemporary reference DXA apparatus: the Hologic Discovery A. Anthropometric data has been assessed in order to maximize the output of the software associated with the ultrasound-based device. A cross-validation between ultrasound technique (US) and DXA was developed in this study. Total body fat mass estimated by ultrasound was compared with this DXA model in a sample of 83 women and 41 men. Results. Ultrasound technique (US) of body fat (BF) was better correlated with DXA in both women ( , ) and men ( , ) with standard errors of estimates (SEE) being 2.1？kg and 2.2？kg, respectively. Conclusion. The use of a portable device based on a US produced a very accurate BF estimate in relation to DXA reference technique. As DXA absorptiometry techniques are not interchangeable, the use of our ultrasound-based device needs to be recalibrated on a more contemporary DXA. 1. Introduction Body composition is one of the most important long-term indicator of nutritional status and it is directly related with the health status. In the two compartments model of body composition, body weight (Body Weight, BW) is considered as the sum of body fat mass (BF) and fat-free or lean mass (Fat Free Mass, FFM). Consequently, change in body weight does not give us information on body composition and often generates diagnoses of obesity without considering the relationship between fat mass and lean body mass [1]. Furthermore, body weight alone does not consider adipose tissue distribution while it is well known that the finding of an excessive increase of fat mass, especially in the abdominal-visceral district, may be associated with an increase in cardiovascular risk. DXA represents a reference method for measuring body fat mass. This instrument allows a fast and accurate measurement of the body composition with an exposure to a minimum dose of X-ray radiation. The high cost, the lack of portability, and the relative invasiveness of the technique are limits to the diffusion of this method. It is known that by ultrasound technique it is also possible to measure subcutaneous fat thickness and to estimate total fat percentage [2, 3]. Until now, the ultrasound technique has often been used for local
References
[1]
J. C. Pineau, A. M. Guihard-Costa, and M. Bocquet, “Validation of ultrasound techniques applied to body fat measurement,” Annals of Nutrition and Metabolism, vol. 51, no. 5, pp. 421–427, 2007.
[2]
M. T. Fanelli and R. J. Kuczmarski, “Ultrasound as an approach to assessing body composition,” The American Journal of Clinical Nutrition, vol. 39, no. 5, pp. 703–709, 1984.
[3]
M. Yasukawa, S. M. Horvath, K. Oishi, M. Kimura, R. Williams, and T. Maeshima, “Total body fat estimations by near-infrared interactance, A-mode ultrasound, and underwater weighing,” Applied Human Science, vol. 14, no. 4, pp. 183–189, 1995.
[4]
R. P. Stolk, O. Wink, P. M. J. Zelissen, R. Meijer, A. P. G. van Gils, and D. E. Grobbee, “Validity and reproducibility of ultrasonography for the measurement of intra-abdominal adipose tissue,” International Journal of Obesity, vol. 25, no. 9, pp. 1346–1351, 2001.
[5]
A. Wirth and B. Steinmetz, “Gender differences in changes in subcutaneous and intra-abdominal fat during weight reduction: an ultrasound study,” Obesity Research, vol. 6, no. 6, pp. 393–399, 1998.
[6]
F. Armellini, M. Zamboni, R. Robbi, et al., “Total and intra-abdominal fat measurements by ultrasound and computerized tomography,” International Journal of Obesity and Related Metabolic Disorders, vol. 17, no. 4, pp. 209–214, 1993.
[7]
G. Tornaghi, R. Raiteri, C. Pozzato, et al., “Anthropometric or ultrasonic measurements in assessment of visceral fat? A comparative study,” International Journal of Obesity and Related Metabolic Disorders, vol. 18, no. 11, pp. 771–775, 1994.
[8]
Y. Ishida, J. F. Carroll, M. I. Pollock, J. E. Graves, and S. H. Leggett, “Reliability of B-mode ultrasound for the measurement of body fat and muscle thickness,” American Journal of Human Biology, vol. 4, pp. 511–520, 1992.
[9]
N. Sabir, E. Pakdemirli, Y. Sermez, M. Zencir, and S. Kazil, “Sonographic assessment of changes in thickness of different abdominal fat layers in response to diet in obese women,” Journal of Clinical Ultrasound, vol. 31, no. 1, pp. 26–30, 2003.
[10]
B. Oldroyd, J. G. Truscott, G. Woodrow et al., “Comparison of in-vivo body composition using two Lunar dual-energy X-ray absorptiometers,” European Journal of Clinical Nutrition, vol. 52, no. 3, pp. 180–185, 1998.
[11]
P. A. Tataranni, D. J. Pettitt, and E. Ravussin, “Dual energy X-ray absorptiometry: inter-machine variability,” International Journal of Obesity and Related Metabolic Disorders, vol. 20, no. 11, pp. 1048–1050, 1996.
[12]
L. D. Plank, “Dual-energy X-ray absorptiometry and body composition,” Current Opinion in Clinical Nutrition & Metabolic Care, vol. 8, no. 3, pp. 305–309, 2005.
[13]
F. A. Tylavsky, T. G. Lohman, M. Dockrell et al., “Comparison of the effectiveness of 2 dual-energy X-ray absorptiometers with that of total body water and computed tomography in assessing changes in body composition during weight change,” American Journal of Clinical Nutrition, vol. 77, no. 2, pp. 356–363, 2003.
[14]
P. Pludowski, M. Jaworski, H. Matusik, M. Kobylinska, P. Klimek, and R. S. Lorenc, “The evaluation of consistency between body composition assessments in pediatric population using pencil beam and fan beam dual-energy x-ray absorptiometers,” Journal of Clinical Densitometry, vol. 13, no. 1, pp. 84–95, 2010.
[15]
H. Hull, Q. He, J. Thornton et al., “iDXA, prodigy, and DPXL dual-energy X-ray absorptiometry whole-body scans: a cross-calibration study,” Journal of Clinical Densitometry, vol. 12, no. 1, pp. 95–102, 2009.
[16]
N. J. Crabtree, N. J. Shaw, C. M. Boivin, B. Oldroyd, and J. G. Truscott, “Pediatric in vivo cross-calibration between the GE Lunar Prodigy and DPX-L bone densitometers,” Osteoporosis International, vol. 16, no. 12, pp. 2157–2167, 2005.
[17]
F. E. von Eyben, E. Mouristen, J. Holm, et al., “Intra-abdominal obesity and metabolic risk factors: a study of young adults,” International Journal of Obesity, vol. 27, no. 8, pp. 941–949, 2003.
[18]
M. I. Goran, “Visceral fat in prepubertal children: influence of obesity, anthropometry, ethnicity, gender, diet, and growth,” American Journal of Human Biology, vol. 11, no. 2, pp. 201–207, 1999.
[19]
J. N. Roemmich and A. D. Rogol, “Hormonal changes during puberty and their relationship to fat distribution,” American Journal of Human Biology, vol. 11, no. 2, pp. 209–224, 1999.
[20]
T. G. Lohman, A. F. Roche, and R. Martorell, Eds., Anthropometric Standardization Reference Manual, Human Kinetics, Champaign, Ill, USA, 1988.
[21]
T. G. Lohman, “Skinfolds and body density and their relation to body fatness: a review,” Human Biology, vol. 53, no. 2, pp. 181–225, 1981.
[22]
J. M. Bland and D. G. Altman, “Statistical methods for assessing agreement between two methods of clinical measurement,” Lancet, vol. 1, no. 8476, pp. 307–310, 1986.
[23]
E. Black, L. Petersen, M. Kreutzer et al., “Fat mass measured by DXA varies with scan velocity,” Obesity Research, vol. 10, no. 2, pp. 69–77, 2002.
[24]
J. A. Shepherd, S. L. Morgan, and Y. Lu, “Comparing BMD results between two similar DXA systems using the generalized least significant change,” Journal of Clinical Densitometry, vol. 11, no. 2, pp. 237–242, 2008.
[25]
H. Lantz, G. Samuelson, L. E. Bratteby, H. Mallmin, and L. Sj？str？m, “Differences in whole body measurements by DXA-scanning using two Lunar DPX-L machines,” International Journal of Obesity and Related Metabolic Disorders, vol. 23, no. 7, pp. 764–770, 1999.
[26]
M. K. Covey, J. K. Berry, and E. D. Hacker, “Regional body composition: cross-calibration of DXA scanners—QDR4500W and Discovery Wi,” Obesity, vol. 18, no. 3, pp. 632–637, 2010.
