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Assessment of body composition in Indian adults: comparison between dual-energy X-ray absorptiometry and isotope dilution technique

  • Bharati Kulkarni (a1) (a2), Hannah Kuper (a3), Amy Taylor (a4), Jonathan C. Wells (a5), K. V. Radhakrishna (a2), Sanjay Kinra (a3), Yoav Ben-Shlomo (a4), George Davey Smith (a4), Shah Ebrahim (a3) (a6), A. V. Kurpad (a7), Nuala M. Byrne (a1) and Andrew P. Hills (a8)...

Abstract

Dual-energy X-ray absorptiometry (DXA) and isotope dilution technique have been used as reference methods to validate the estimates of body composition by simple field techniques; however, very few studies have compared these two methods. We compared the estimates of body composition by DXA and isotope dilution (18O) technique in apparently healthy Indian men and women (aged 19–70 years, n 152, 48 % men) with a wide range of BMI (14–40 kg/m2). Isotopic enrichment was assessed by isotope ratio mass spectroscopy. The agreement between the estimates of body composition measured by the two techniques was assessed by the Bland–Altman method. The mean age and BMI were 37 (sd 15) years and 23·3 (sd 5·1) kg/m2, respectively, for men and 37 (sd 14) years and 24·1 (sd 5·8) kg/m2, respectively, for women. The estimates of fat-free mass were higher by about 7 (95 % CI 6, 9) %, those of fat mass were lower by about 21 (95 % CI − 18, − 23) %, and those of body fat percentage (BF%) were lower by about 7·4 (95 % CI − 8·2, − 6·6) % as obtained by DXA compared with the isotope dilution technique. The Bland–Altman analysis showed wide limits of agreement that indicated poor agreement between the methods. The bias in the estimates of BF% was higher at the lower values of BF%. Thus, the two commonly used reference methods showed substantial differences in the estimates of body composition with wide limits of agreement. As the estimates of body composition are method-dependent, the two methods cannot be used interchangeably.

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Copyright

The online version of this article is published within an Open Access environment subject to the conditions of the Creative Commons Attribution licence http://creativecommons.org/licenses/by/3.0/

Corresponding author

* Corresponding author: B. Kulkarni, fax +91 40 27019074, email dr.bharatikulkarni@gmail.com

References

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1 Ouchi, N, Parker, JL, Lugus, JJ, et al. (2011) Adipokines in inflammation and metabolic disease. Nat Rev Immunol 11, 8597.
2 Wolfe, RR (2006) The underappreciated role of muscle in health and disease. Am J Clin Nutr 84, 475482.
3 Dulloo, AG, Jacquet, J, Solinas, G, et al. (2010) Body composition phenotypes in pathways to obesity and the metabolic syndrome. Int J Obes (Lond) 34, Suppl. 2, S417.
4 Nightingale, CM, Rudnicka, AR, Owen, CG, et al. (2013) Influence of adiposity on insulin resistance and glycemia markers among U.K. children of South Asian, black African-Caribbean, and white European origin: child heart and health study in England. Diabetes Care 36, 17121719.
5 Loveday, SJ, Thompson, JM & Mitchell, EA (2012) Bioelectrical impedance for measuring percentage body fat in young persons with Down syndrome: validation with dual-energy absorptiometry. Acta Paediatr 101, e491e495.
6 Karelis, AD, Chamberland, G, Aubertin-Leheudre, M, et al. (2013) Validation of a portable bioelectrical impedance analyzer for the assessment of body composition. Appl Physiol Nutr Metab 38, 2732.
7 Bousbiat, S, Jaffrin, MY & Dongmo, E (2011) Comparison of body fat-free masses calculated from hand-to-foot and foot-to-foot resistances with DXA measurements. Med Biol Eng Comput 49, 13291336.
8 Visser, M, Fuerst, T, Lang, T, et al. (1999) Validity of fan-beam dual-energy X-ray absorptiometry for measuring fat-free mass and leg muscle mass. Health, Aging, and Body Composition Study – Dual-Energy X-ray Absorptiometry and Body Composition Working Group. J Appl Physiol 87, 15131520.
9 Schoeller, DA, Tylavsky, FA, Baer, DJ, et al. (2005) QDR 4500A dual-energy X-ray absorptiometer underestimates fat mass in comparison with criterion methods in adults. Am J Clin Nutr 81, 10181025.
10 Yajnik, C, Fall, C, Coyaji, K, et al. (2003) Neonatal anthropometry: the thin–fat Indian baby. The Pune Maternal Nutrition Study. Int J Obes Relat Metab Disord 27, 173180.
11 Misra, A, Vikram, NK, Arya, S, et al. (2004) High prevalence of insulin resistance in postpubertal Asian Indian children is associated with adverse truncal body fat patterning, abdominal adiposity and excess body fat. Int J Obes Relat Metab Disord 28, 12171226.
12 Bhat, DS, Yajnik, CS, Sayyad, MG, et al. (2005) Body fat measurement in Indian men: comparison of three methods based on a two-compartment model. Int J Obes (Lond) 29, 842848.
13 Pandit, D, Chiplonkar, S, Khadilkar, A, et al. (2009) Body fat percentages by dual-energy X-ray absorptiometry corresponding to body mass index cutoffs for overweight and obesity in Indian children. Clin Med Pediatr 3, 5561.
14 Bhatt, SP, Nigam, P, Misra, A, et al. (2013) Independent associations of low 25 hydroxy vitamin D and high parathyroid hormonal levels with nonalcoholic fatty liver disease in Asian Indians residing in north India. Atherosclerosis 230, 157163.
15 Kulkarni, B, Shatrugna, V, Nagalla, B, et al. (2010) Regional body composition of Indian women from a low-income group and its association with anthropometric indices and reproductive events. Ann Nutr Metab 56, 182189.
16 Haroun, D, Taylor, SJ, Viner, RM, et al. (2010) Validation of bioelectrical impedance analysis in adolescents across different ethnic groups. Obesity (Silver Spring) 18, 12521259.
17 Kinra, S, Radha Krishna, K, Kuper, H, et al. (2013) Cohort Profile: Andhra Pradesh Children and Parents Study (APCAPS). Int J Epidemiol (Epublication ahead of print version 9 September 2013).
18 Ebrahim, S, Kinra, S, Bowen, L, et al. (2010) The effect of rural-to-urban migration on obesity and diabetes in India: a cross-sectional study. PLoS Med 7, e1000268.
19 Colley, RC, Byrne, NM & Hills, AP (2007) Implications of the variability in time to isotopic equilibrium in the deuterium dilution technique. Eur J Clin Nutr 61, 12501255.
20 Racette, SB, Schoeller, DA, Luke, AH, et al. (1994) Relative dilution spaces of 2H- and 18O-labeled water in humans. Am J Physiol 267, E585E590.
21 Martin Bland, J & Altman, D (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 327, 307310.
22 Fuller, NJ, Jebb, SA, Laskey, MA, et al. (1992) Four-component model for the assessment of body composition in humans: comparison with alternative methods, and evaluation of the density and hydration of fat-free mass. Clin Sci (Lond) 82, 687693.
23 He, M, Li, ET & Kung, AW (1999) Dual-energy X-ray absorptiometry for body composition estimation in Chinese women. Eur J Clin Nutr 53, 933937.
24 Deurenberg-Yap, M & Deurenberg, P (2002) Validity of deuterium oxide dilution for the measurement of body fat among Singaporeans. Food Nutr Bull 23, 3437.
25 Arngrimsson, S, Evans, EM, Saunders, MJ, et al. (2000) Validation of body composition estimates in male and female distance runners using estimates from a four-component model. Am J Hum Biol 12, 301314.
26 Bergsma-Kadijk, JA, Baumeister, B & Deurenberg, P (1996) Measurement of body fat in young and elderly women: comparison between a four-compartment model and widely used reference methods. Br J Nutr 75, 649657.
27 Deurenberg-Yap, M, Schmidt, G, van Staveren, WA, et al. (2001) Body fat measurement among Singaporean Chinese, Malays and Indians: a comparative study using a four-compartment model and different two-compartment models. Br J Nutr 85, 491498.
28 Van Der Ploeg, GE, Withers, RT & Laforgia, J (2003) Percent body fat via DEXA: comparison with a four-compartment model. J Appl Physiol 94, 499506.
29 Withers, RT, LaForgia, J, Pillans, RK, et al. (1998) Comparisons of two-, three-, and four-compartment models of body composition analysis in men and women. J Appl Physiol 85, 238245.
30 Williams, JE, Wells, JC, Wilson, CM, et al. (2006) Evaluation of Lunar Prodigy dual-energy X-ray absorptiometry for assessing body composition in healthy persons and patients by comparison with the criterion 4-component model. Am J Clin Nutr 83, 10471054.
31 van Marken Lichtenbelt, WD, Hartgens, F, Vollaard, NB, et al. (2004) Body composition changes in bodybuilders: a method comparison. Med Sci Sports Exerc 36, 490497.
32 Prior, BM, Cureton, KJ & Modlesky, CM (1997) In vivo validation of whole body composition estimates from dual-energy X-ray absorptiometry. J Appl Physiol (1985) 83, 623630.
33 LaForgia, J, Dollman, J, Dale, MJ, et al. (2009) Validation of DXA body composition estimates in obese men and women. Obesity (Silver Spring) 17, 821826.
34 Genton, L, Hans, D, Kyle, UG, et al. (2002) Dual-energy X-ray absorptiometry and body composition: differences between devices and comparison with reference methods. Nutrition 18, 6670.
35 Shepherd, JA, Fan, B, Lu, Y, et al. (2012) A multinational study to develop universal standardization of whole-body bone density and composition using GE Healthcare Lunar and Hologic DXA systems. J Bone Miner Res 27, 22082216.
36 Sakai, Y, Ito, H, Meno, T, et al. (2006) Comparison of body composition measurements obtained by two fan-beam DXA instruments. J Clin Densitom 9, 191197.
37 Robotham, DR, Schoeller, DA, Mercado, AB, et al. (2006) Estimates of body fat in children by Hologic QDR-2000 and QDR-4500A dual-energy X-ray absorptiometers compared with deuterium dilution. J Pediatr Gastroenterol Nutr 42, 331335.
38 Pearson, D, Horton, B & Green, DJ (2011) Cross calibration of Hologic QDR2000 and GE lunar prodigy for whole body bone mineral density and body composition measurements. J Clin Densitom 14, 294301.
39 Krumbiegel, P (2010) Assessment of body composition and total energy expenditure in humans using stable isotope techniques, IAEA Human Health Series No. 3.
40 Toombs, RJ, Ducher, G, Shepherd, JA, et al. (2012) The impact of recent technological advances on the trueness and precision of DXA to assess body composition. Obesity (Silver Spring) 20, 3039.
41 Taylor, AE, Kuper, H, Varma, RD, et al. (2012) Validation of dual energy X-ray absorptiometry measures of abdominal fat by comparison with magnetic resonance imaging in an Indian population. PLOS ONE 7, e51042.

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