Correlations of skin fold thickness and validation of prediction equations using DEXA as the gold standard for estimation of body fat composition in Pakistani children

Abstract

ObjectiveTo determine the correlation between dual energy X-ray absorptiometry (DEXA) and skin fold thickness (SKF) equations for estimation of body fat (BF) composition in secondary school children and validation of prediction equations by Slaughter, Goran and Dezenberg.DesignCross sectional analytical study.SettingJoint Commission for International Accredited (JCIA) tertiary care hospital of Karachi, Pakistan from January 2010 to May 2010.ParticipantsThe study was approved by the Hospital's ethical review committee. Written and verbal consents were obtained from principals of two schools and parents of 99 children (mean age of 14±1.89 years; min–max 9–19 years; 54 men and 45 women) accrued in study. DEXA scan was acquired and SKF was measured at angle of the scapula, iliac crest and mid-arm for bicep and tricep skin folds using Holtain Callipers. Correlations were established between estimated fat mass (FM) and per cent BF (%BF) calculated by DEXA and those predicted by prediction equations. On obtaining significant correlation of >0.5, overall accuracy, precision and bias was calculated.ResultsThere was an overall increased adiposity in females with FM of 3.57 kg and %BF 6.2% higher than male counterparts (p<0.05). Slaughter equation predicted %BF accurately with overall high accuracy, minimal bias and with good precision with DEXA. Dezenberg and Goran equations had significant bias in prediction of FM which was statistically significant with low level of accuracy of the Goran equation.ConclusionsWe conclude that Slaughter equation for estimating %BF showed reasonable validation with DEXA. Nevertheless further studies with consideration for maturity and ethnicity are warranted for better results. However, for estimation of FM, previously formulated equations by Goran and Dezenberg showed significant difference in our population. We do recommend further studies for developing and validation of skin fold equations specific to Pakistani paediatric population.

BMI-for-Age and Weight-for-Length in Children 0 to 2 Years

“…Although weight-for-length was used as the criterion measure, it may be argued that a more accurate and proximate measure of body fat (eg, skinfold test, dual energy x-ray absorptiometry) be considered a "gold standard" to assess weight status. [31][32][33] We did not collect data on these measures in our study. Importantly, though, weight-for-length is the currently recommended measure to use for growth monitoring by the American Academy of Pediatrics 4 and the Canadian Pediatric Society 3 in children <2 years.…”

BMI, body fat and waist-to-height ratio of stunted v. non-stunted Indian children: a case–control study

“…BF% was calculated using the equation given by Slaughter et al (26) . Slaughter's equation has been reported to predict BF% with high accuracy (95 %) and minimal bias, and has shown good precision compared with dual-energy X-ray absorptiometry in school-going children in Pakistan (27) .…”

Mathematical model for body fat percentage of children with cerebral palsy

“…The overestimation of fat mass was also detected by Svendsen et al (1993), but the authors pointed out that the estimated standard error (EPE) was below 3% (1.9kg) associated with a correlation r>0.97, acceptable value for a reference method. Low EPE were also found by Prior et al (1997) Specifically in children and adolescents the applicability of DXA has also been widely discussed in the literature, being considered as a great method for estimating body composition (Elberg et al, 2004;Hussain et al, 2014). However, Sopher et al (2004) conducted a study with 411 children and adolescents aged six to 18, in order to compare the fat percentage measured by DXA and the model of 4-C, they found overestimated values for DXA in those with a high fat percentage and underestimated in individuals with low fat percentage.…”

“…Although exposing the subject to a source of X-rays, it can be used in people of all ages (Hussain et al, 2014). The DXA Technology has been tested and validated in several populations, in different age groups, becoming recognized as a reference method in the body composition analysis (Albanese et al, 2003;Prior et al, 1997;Toombs et al, 2012).…”