Measuring body composition in pediatric patients with complex diagnoses: Acceptability, practicality, and validation of different techniques.

Autor: Lara-Pompa NE; Childhood Nutrition Research Centre, UCL Great Ormond St Institute of Child Health, London, UK.; Clinical Nutrition, Hospital Infantil Teletón de Oncología, Santiago de Querétaro, México., Macdonald S; Gastroenterology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK., Fawbert K; Gastroenterology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK., Shaw V; Gastroenterology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK., Wells JC; Childhood Nutrition Research Centre, UCL Great Ormond St Institute of Child Health, London, UK., Fewtrell M; Childhood Nutrition Research Centre, UCL Great Ormond St Institute of Child Health, London, UK., Hill S; Gastroenterology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Jazyk: angličtina
Zdroj: Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition [Nutr Clin Pract] 2024 Jun; Vol. 39 (3), pp. 673-684. Date of Electronic Publication: 2023 Dec 24.
DOI: 10.1002/ncp.11098
Abstrakt: Background: Body composition could help identify malnutrition in pediatric patients, but there is uncertainty over which techniques are most suitable and prevailing opinion that measurements are difficult to obtain in practice. This study examined the acceptability, practicality, reliability, and validity of different anthropometric and body composition measurements in patients with complex diagnoses in a tertiary pediatric hospital.
Methods: A total of 152 children aged 5-18 years had weight, height, body mass index (BMI), mid-upper arm circumference (MUAC), 4-site skinfold thicknesses (SFT), bioelectrical impedance analysis (BIA), and dual-energy x-ray absorptiometry (DXA) assessed on admission and discharge. Acceptability was assessed in a continuous scale, practicality with number/percentage of successful measurements, reliability with intraclass correlation coefficients and coefficients of repeatability, and validity between "simpler" techniques and DXA with Bland-Altman analysis of agreement and Cohen kappa.
Results: Techniques were overall acceptable. Measurements were successful in >50%, with patient refusal uncommon. Coefficients of repeatability were good (0.3 cm MUAC and height, 0.2 kg weight, and 1.0 mm SFTs). All techniques significantly overestimated DXA fat mass, but BMI and triceps SFT better identified abnormal fat mass (κ = 0.46 and 0.49). BIA fat-free mass was not significantly different from DXA, with substantial agreement between techniques (κ = 0.65).
Conclusion: Body composition by a range of techniques is acceptable, practical, and reliable in a diverse group of children with complex diagnoses. BIA seems a good alternative to DXA for assessing fat-free mass, triceps SFT, and BMI for fat mass but should be used with care as it could overestimate total fat mass in individuals.
(© 2023 American Society for Parenteral and Enteral Nutrition.)
Databáze: MEDLINE
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