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Estimating body composition in children with Duchenne muscular dystrophy: comparison of bioelectrical impedance analysis and skinfold-thickness measurement^1,2,3

¹ From INSERM Centre D'Investigation Clinique 9202, Assistance Publique-Hôpitaux de Paris, Hôpital Robert Debré, Paris, France (EM, CD, and RH); Laboratoire Adaptation Physiologique aux Activités Physiques EA3813, Université de Poitiers, Poitiers, France (EM and RH); EA3925 INSERM Centre D'Investigation Clinique 9301, Centre Hospitalier Régional Universitaire de Lille, Lille, France (LB); EA3925 Clinique de Pédiatrie, Centre Hospitalier Régional Universitaire de Lille, Hôpital Jeanne de Flandre, Lille, France (FG and LB); Unité du métabolisme protéino-énergétique, UMR INRA 1019 Laboratoire de Nutrition Humaine, Clermont-Ferrand, France (PG); the Pharmacy, Assistance Publique-Hôpitaux de Paris, Hôpital Jean-Verdier, Paris, France (J-EF); and the Service de Neuropédiatrie, Centre Hospitalier Régional Universitaire Lille, Hôpital Roger-Salengro, Lille, France (J-MC).

Background: Duchenne muscular dystrophy (DMD) is often associated with obesity, which worsens the handicap early in the course of the disease. Nutritional assessment, however, can be difficult and often misleading in DMD.

Objective: Two methods of estimating body composition in DMD, skinfold-thickness (ST) measurement and bioelectrical impedance analysis (BIA), were compared with a reference method, labeled water dilution (WD).

Design: Body composition was estimated by using ST measurements and BIA (50 kHz, 800 mAmp), as well as the WD method (1 mL H₂¹⁸O/kg) in 11 DMD patients with a mean (±SD) age of 10.0 ± 2.5 y.

Results: When compared with the WD method, ST measurement significantly (P < 0.01) overestimated fat-free mass (FFM) ( ± SD ST: 24.5 ± 5.9 kg; ± SD WD: 18.2 ± 2.5 kg), which led to an underestimation of the percentage of fat mass (%FM) (ST: 23.3 ± 10.4%; WD: 40.1 ± 17.1%; P < 0.05). In contrast, estimates obtained with BIA (FFM: 21.5 ± 4.5 kg; %FM: 31.3 ± 13.9%) did not differ from those obtained with WD. The difference from the reference method was less for BIA (: 3.3 kg; 95% CI: 0.8, 4.9 kg) than for ST (6.3 kg; 2.2, 8.6 kg). WD and BIA defined 73% and 55%, respectively, of the children as obese (%FM associated with body mass index cutoffs for obesity), whereas ST measurements defined 9% as obese (P < 0.01).

Conclusions: Body-composition estimates by BIA are closer to those by WD than are those by ST measurement. Early detection of fat accumulation and longitudinal monitoring of nutritional care are 2 relevant applications of BIA to prevent obesity and hence lessen the burden of DMD.

Key Words: Obesity • Duchenne muscular dystrophy • bioelectrical impedance • body composition • isotope labeling • children • fat-free mass • percentage fat mass • nutritional assessment • handicap

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				E. Mok, C. E.-D. Violante, C. Daubrosse, F. Gottrand, O. Rigal, J.-E. Fontan, J.-M. Cuisset, J. Guilhot, and R. Hankard Oral glutamine and amino acid supplementation inhibit whole-body protein degradation in children with Duchenne muscular dystrophy. Am. J. Clinical Nutrition, April 1, 2006; 83(4): 823 - 828. [Abstract] [Full Text] [PDF]