Imaging of body composition in children

Simoni, Paolo; Guglielmi, Riccardo; Gómez, Maria Pilar Aparisi

doi:10.21037/qims.2020.04.06

Cited by 31 publications

(29 citation statements)

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“…The objective of this study was to assess areal bone mineral density (aBMD) and body composition using dual‐energy X‐ray absorptiometry (DXA) in HR‐NBL survivors treated with cis ‐RA as part of neuroblastoma therapy. DXA is a method of comprehensive bone and body composition assessment in children 19 . We have previously used DXA to demonstrate body composition abnormalities in long‐term survivors of paediatric haematopoietic stem cell transplantation and acute lymphoblastic leukaemia (ALL) 20 .…”

Section: Introductionmentioning

confidence: 99%

“…DXA is a method of comprehensive bone and body composition assessment in children. 19 We have previously used DXA to demonstrate body composition abnormalities in long‐term survivors of paediatric haematopoietic stem cell transplantation and acute lymphoblastic leukaemia (ALL). 20 We apply these techniques to a population of long‐term survivors of HR‐NBL to examine aBMD, lean mass, fat mass, visceral adiposity and subcutaneous adiposity.…”

Section: Introductionmentioning

confidence: 99%

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Sarcopenia and preserved bone mineral density in paediatric survivors of high‐risk neuroblastoma with growth failure

Guo

Zemel

Hawkes

et al. 2021

J cachexia sarcopenia muscle

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Background Survival from paediatric high‐risk neuroblastoma (HR‐NBL) has increased, but cis‐retinoic acid (cis‐RA), the cornerstone of HR‐NBL therapy, can cause osteoporosis and premature physeal closure and is a potential threat to skeletal structure in HR‐NBL survivors. Sarcopenia is associated with increased morbidity in survivors of paediatric malignancies. Low muscle mass may be associated with poor prognosis in HR‐NBL patients but has not been studied in these survivors. The study objective was to assess bone density, body composition and muscle strength in HR‐NBL survivors compared with controls. Methods This prospective cross‐sectional study assessed areal bone mineral density (aBMD) of the whole body, lumbar spine, total hip, femoral neck, distal 1/3 and ultradistal radius and body composition (muscle and fat mass) using dual‐energy X‐ray absorptiometry (DXA) and lower leg muscle strength using a dynamometer. Measures expressed as sex‐specific standard deviation scores (Z‐scores) included aBMD (adjusted for height Z‐score), bone mineral apparent density (BMAD), leg lean mass (adjusted for leg length), whole‐body fat mass index (FMI) and ankle dorsiflexion peak torque adjusted for leg length (strength‐Z). Muscle‐specific force was assessed as strength relative to leg lean mass. Outcomes were compared between HR‐NBL survivors and controls using Student's t‐test or Mann–Whitney U test. Linear regression models examined correlations between DXA and dynamometer outcomes. Results We enrolled 20 survivors of HR‐NBL treated with cis‐RA [13 male; mean age: 12.4 ± 1.6 years; median (range) age at therapy initiation: 2.6 (0.3–9.1) years] and 20 age‐, sex‐ and race‐matched controls. Height‐Z was significantly lower in HR‐NBL survivors compared with controls (−1.73 ± 1.38 vs. 0.34 ± 1.12, P < 0.001). Areal BMD‐Z, BMAD‐Z, FMI‐Z, visceral adipose tissue and subcutaneous adipose tissue were not significantly different in HR‐NBL survivors compared with controls. Compared with controls, HR‐NBL survivors had lower leg lean mass‐Z (−1.46 ± 1.35 vs. − 0.17 ± 0.84, P < 0.001) and strength‐Z (−1.13 ± 0.86 vs. − 0.15 ± 0.71, P < 0.001). Muscle‐specific force was lower in HR‐NBL survivors compared with controls (P < 0.05). Conclusions Bone mineral density and adiposity are not severely impacted in HR‐NBL survivors with growth failure, but significant sarcopenia persists years after treatment. Future studies are needed to determine if sarcopenia improves with muscle‐specific interventions in this population of cancer survivors.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Sarcopenia and preserved bone mineral density in paediatric survivors of high‐risk neuroblastoma with growth failure

Guo

Zemel

Hawkes

et al. 2021

J cachexia sarcopenia muscle

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“…Despite previous evidence that body weight is a simple tool for assessing nutritional status, this measure cannot discriminate among differences in the proportion of fat mass and fat-free mass [11,12]. Currently, several reliable and valid imaging techniques have been proposed to measure body composition, including dual-energy X-ray absorptiometry, whole-body K + counting, 24 h creatinine excretion [13][14][15], plethysmography [16], multislice computerized tomography (CT) [17] and magnetic resonance imaging (MRI) [18]. Unfortunately, the majority of these tools are complex, time-consuming and expensive [19].…”

Section: Introductionmentioning

confidence: 99%

Reference Data for Fat Mass and Fat-Free Mass Measured by Bioelectrical Impedance in Croatian Youth

Kasović

Štefan

Neljak

et al. 2021

IJERPH

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Fat mass and fat-free mass have become useful clinical indices in determining healthy growth and physical development during critical periods of childhood and adolescence; however, despite a wide range of nutritional surveillance its study is limited by a lack of reference data. The purpose of this study was to establish sex-specific and age-specific standards for fat mass and fat-free mass in a large sample of Croatian children and adolescents. In this cross-sectional study, we collected data from 12,678 participants aged 11 to 18 years old (mean age ± standard deviation (SD): 14.17 ± 2.25 years; height 164.56 ± 11.31 cm; weight: 57.45 ± 13.73 kg; body mass index: 21.24 ± 3.67 kg/m2; 53% girls). Fat mass and fat-free mass were measured three times by bioelectrical impedance. The Lambda, Mu and Sigma methods were used to create percentile charts for fat mass index (FMI) and fat-free mass index (FFMI; fat mass and fat-free mass divided by height2). Sex and age differences were calculated using an analysis of variance (ANOVA) with post hoc comparisons. Boys had lower FMI (from 2.66 to 3.89) and higher FFMI values (from 16.90 to 17.80) in all age groups, compared to girls (for FMI from 2.79 to 5.17 and for FFMI from 14.50 to 14.90, p < 0.001). In boys, FMI slightly declined until the age of 14, after which an increase from the age of 15 to 18 was observed. In girls, FMI gradually increased from the age of 11 to 18 (p < 0.001). In general, FFMI increased by age in boys [F(7,5440) = 52.674, p < 0.001], while girls had more stable FFMI across all age groups [F(7,7222) = 2.728, p = 0.057]. The newly established sex-specific and age-specific reference data could be used for national surveillance and to screen for children and adolescents with high FMI and low FFMI.

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“…Another diagnostic tool frequently used in children is magnetic resonance imaging (MRI). Due to the different magnetic properties of water and fat-bound protons, this radiation-free technique allows to assess lean and adipose tissue compartments (13)(14)(15)(16)(17). However, a dedicated MRI whole-body protocol for the assessment of nutritional status is highly costly and timedemanding thus is limited in clinical use.…”

Section: Introductionmentioning

confidence: 99%

MRI-Derived Subcutaneous and Visceral Adipose Tissue Reference Values for Children Aged 6 to Under 18 Years

et al. 2021

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The assessment of body composition in pediatric population is essential for proper nutritional support during hospitalization. However, currently available methods have limitations. This study aims to propose a novel approach for nutrition status assessment and introduce magnetic resonance imaging (MRI)-derived subcutaneous and visceral fat normative reference values. A total of 262 healthy subjects aged from 6 to 18 years underwent MRI examinations and anthropometric measurements. MRI images at the second lumbar vertebrae were used by two radiologists to perform the semi-automatic tissue segmentation. Based on obtained adipose tissue surface areas and body mass index (BMI) scores sex-specific standard percentile curves (3rd, 10th, 25th, 50th, 75th, 90th, 97th) and z-scores were constructed using LMS method. Additionally, 85th and 95th centiles of subcutaneous and visceral adipose tissue were proposed as equivalents of overweight and obesity. Bland-Altman plots revealed an excellent intra-observer reproducibility and inter-observer agreement. In conclusion, our findings demonstrate highly reproducible method and suggest that MRI-derived reference values can be implemented in clinical practice.

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Imaging of body composition in children

Cited by 31 publications

References 50 publications

Sarcopenia and preserved bone mineral density in paediatric survivors of high‐risk neuroblastoma with growth failure

Sarcopenia and preserved bone mineral density in paediatric survivors of high‐risk neuroblastoma with growth failure

Reference Data for Fat Mass and Fat-Free Mass Measured by Bioelectrical Impedance in Croatian Youth

MRI-Derived Subcutaneous and Visceral Adipose Tissue Reference Values for Children Aged 6 to Under 18 Years

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