Comparison of Fat Mass Percentage and Body Mass Index in Koreans With Spinal Cord Injury According to the Severity and Duration of Motor Paralysis

Abstract

ObjectiveTo analyze the relationship of the change in fat mass percentage (FMP) and body mass index (BMI) with the change in obesity rate according to gender, extent of spinal cord injury (SCI) and the duration.MethodsThe retrospective study was conducted with medical records of 915 patients. FMP was calculated with BMI and bioelectrical impedance analysis (BIA). Statistical analysis of the relationship between FMP and gender, extent of SCI and the duration after SCI was done.ResultsFMP increased in relation to the duration. The mean FMP was higher in the motor complete tetraplegia group, as compared to the motor incomplete group. The rate of obesity was 69.8% with cutoff FMP values of over 22% and 35% for male and female patients, respectively. Rate of obesity was correlated with the duration after SCI and degree of paralysis. The rate of obesity was 17.1% with a cutoff value of BMI 25 kg/m2 and 51.3% with a cutoff value of 22 kg/m2. For evaluation of the diagnostic value of BMI to predict obesity according to FMP standards, a cutoff value of 25 kg/m2 showed a sensitivity level of 22.3% and specificity level of 94.9%. When the cutoff level for BMI was set at 22 kg/m2, the sensitivity and specificity were 59.3% and 67.0%, respectively.ConclusionIn Korean SCI patients, FMP showed good correlation with the duration of SCI and the extent of SCI, while BMI did not. Especially in the motor complete tetraplegia group, the diagnostic value of BMI decreased as the duration after SCI increased. This study suggested that FMP could be used complementarily when evaluating the obesity of SCI patients.

Body Composition in Swiss Elite Wheelchair Athletes

“…A lower total lean body mass in individuals with a spinal cord injury compared to able-bodied controls was found (3,4,29). Fat mass revealed a good correlation with the duration of the injury (30,31). Furthermore, the total body fat percentage was compared to the Body-Mass-Index (BMI), whereas McDonald et al (28) suggested that BMI underestimated obesity in this population.…”

Body Composition According to Spinal Cord Injury Level: A Systematic Review and Meta-Analysis

“…Individuals with tetraplegia had lower mean BMI compared to individuals with paraplegia (weighted mean difference (WMD) −0.9 kg/m 2 , 95% confidence interval (CI) −1.4, −0.5; I 2 86.5%) (Table 2). This was based on 32 [13][14][15][16][31][32][33][34][35]37,40,41,43,[45][46][47][48][49][51][52][53][54][55][57][58][59][60][61][62][63]65,76,77] out of 36 studies comparing tetraplegia and paraplegia, which comprised 3837 participants. We found no differences when comparing high and low paraplegia (WMD −0.2, 95% CI −1.0, 0.5; I 2 22.7%) (Table 2).…”

“…Eleven studies [13][14][15][16]35,36,39,40,43,48,76], which included 1386 participants, were included in the meta-analysis of total body composition to compare tetraplegia and paraplegia (Table 2). Whole-body composition was estimated through various methods.…”

“…Whole-body composition was estimated through various methods. Three studies used bioelectrical impedance [35,43,76], seven studies used X-ray absorptiometry [10,13,15,16,36,48,64], and one study used magnetic resonance imaging [14]. Individuals with tetraplegia had a higher mean fat percentage and lower mean lean mass compared to individuals with paraplegia with WMD 1.9%, (95% CI 0.6, 3.1; I 2 46.7%), and WMD −3.0 kg (95% CI −5.9, −0.2; I 2 84.1%), respectively (Table 2).…”

“…Complete injury has low to absent residual motor or sensory function below the injury level. As such, complete injury has lower resting energy requirements [80], and higher fat composition, as compared to incomplete injury [16,43]. In our analysis, studies include different proportions of complete injury that caused high heterogeneity in our analysis.…”