Body composition assessment in spinal cord injury subjects

Abstract

Total and segmental body composition (fat mass, FM; fat-free mass, FFM; bone mineral density, BMD) were evaluated in 13 sedentary spinal cord injury (SCI) subjects and in 13 able-bodied healthy males (control, C) using dual X-ray absorptiometry (DXA) and skinfold methods. In the SCI group, total FM was significantly higher (31.1+/-8.2 vs. 20.8+/-6.9%) and total FFM was significantly lower (62.2+/-8.9 vs. 73.5+/-6.4%) than in C subjects. Total BMD did not differ between the SCI and C groups (1.20+/-0.11 vs. 1.30+/-0.11 g/cm(2)). In the SCI group, segmental FM was higher in the legs and trunk, whereas BMD was lower in legs only. The skinfold method significantly underestimated FM in the SCI group. Body composition is severely modified in paralyzed segments. The predictive equations developed for healthy populations appear to be inapplicable to SCI subjects.

A review of body mass index and waist circumference as markers of obesity and coronary heart disease risk in persons with chronic spinal cord injury

“…6,22,23 Thus, despite greater fat mass in subjects with versus without SCI, body weight and BMI often do not differ. 5,6,8,9,11,22 Buchholz et al 22 found the 30 kg/m 2 BMI cutoff correctly identified only 20% of truly obese paraplegic subjects, as compared with published sensitivity values of 48-66% in able-bodied populations. [24][25][26] In the study of Buchholz et al, weight was measured using a wheelchair scale, length was measured using a length board, fat mass was determined by isotope dilution and obesity was defined by the method of Lohman.…”

“…2 Mean percent fat mass (measured by dual energy X-ray absorptiometry (DXA), isotope dilution or the threecompartment model) reported in cross-sectional studies of persons (mostly men) with chronic spinal cord injury (SCI) ranges from 23 to 35%. [4][5][6][7][8][9][10][11] The percentage of body weight as fat mass is 8-18% higher in SCI versus age-, height-and/or weight-matched able-bodied control subjects. These values are often consistent with the above definitions of obesity, and are summarized in Table 1.…”

“…12 Mean BMI values in studies of persons with long-standing SCI range from 20 to 27, 5,6,10,[13][14][15][16][17][18] consistent with the classifications of normal and overweight, but inconsistent with classification based on measured percent fat mass. [4][5][6][7][8][9][10][11] One reason for the underestimation of obesity using BMI may be the potential measurement error associated with determination of weight and/or height in persons with SCI. While weight can be measured using a wheelchair scale, an accurate height is difficult to obtain in those who are wheelchair dependent.…”

Serum leptin, abdominal obesity and the metabolic syndrome in individuals with chronic spinal cord injury

“…On the basis of these specific markers, several studies have shown that SCI individuals have a lower total body and regional lean mass (LM), especially in lower limb, and a higher FM than controls. [7][8][9] Adipose tissue is an important secretory organ that produces various bioactive substances known as adipokines, which include leptin, tumor necrosis factor-a, adiponectin and plasminogen activator inhibitor-1 (PAI-1); they contribute to obesity-linked metabolic and vascular diseases, as well as MetS. 10 In the SCI population, correlation between adipokine levels and body composition is assumed to be different from that in general population because of differences in location of adipose tissue.…”

Análise dos valores de composição corporal em homens com diferentes níveis de lesão medular

“…However, formulas for calculating the body fat percentage did not have a good correlation to this assessment, although they are usually widely adopted in studies involving men with spinal cord injury (13,14,(19)(20)(21)(22). This limitation leads such measures to serve only for comparative analysis of the individual her/himself over time, instead of a relation to reference values.…”