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Assessment of skinfold thickness equations in estimating body composition in children with inflammatory bowel disease
Céline Callias1, Jessica Ezri1, Pedro Manuel Marques-Vidal2
1Pediatric Gastroenterology Unit, Department of Pediatrics, University of Lausanne, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland.
Insights
Skifold thickness equations show good correlation but poor agreement for estimating fat mass in pediatric IBD patients compared to DEXA. These equations are not recommended for assessing body composition in this group.
Area of Science:
- Pediatric Gastroenterology
- Body Composition Analysis
- Inflammatory Bowel Disease (IBD) Research
Background:
- Accurate assessment of body composition, specifically fat mass (FM%), is crucial in managing pediatric patients with inflammatory bowel disease (IBD).
- Traditional methods like skinfold thickness equations are commonly used but their accuracy in IBD populations is not well-established.
- Dual-energy X-ray absorptiometry (DEXA) is considered a reference standard for body composition analysis.
Purpose of the Study:
- To evaluate the agreement between commonly used skinfold thickness equations and DEXA for estimating FM% in pediatric IBD patients.
- To determine if skinfold equations provide reliable body composition data in this specific clinical population.
- To compare the performance of six different pediatric skinfold equations against DEXA.
Main Methods:
- A study involving 21 pediatric IBD patients (11 female, 10 male; mean age 14.3 years) diagnosed with Crohn's disease or ulcerative colitis.
- Calculation of FM% using six established pediatric skinfold thickness equations.
- Comparison of skinfold-derived FM% with FM% measured by DEXA using statistical analyses including correlation, concordance correlation, and Bland-Altman analysis.
Main Results:
- Skinfold thickness equations demonstrated good correlation with DEXA (correlation coefficients 0.85-0.92).
- However, Lin's concordance correlation coefficients indicated only moderate agreement (0.702-0.876).
- Wide Bland-Altman limits of agreement (over 10%) and significant differences in means/variances (Bradley-Blackwood test) highlight poor agreement.
Conclusions:
- While skinfold thickness equations correlate well with DEXA in adolescents with IBD, their agreement is poor.
- These equations are not sufficiently accurate for assessing body composition in pediatric IBD patients.
- Clinical recommendations advise against using skinfold thickness equations for body composition assessment in this population.
Aim:
To assess the agreement of commonly used skinfold thickness equations to estimate percentage of Fat Mass (FM%) in paediatric patients with IBD, in comparison with dual energy X-ray absorptiometry (DEXA).
Methods:
Twenty-one paediatric IBD patients were included: 11 females and 10 males; mean age for the entire group: 14.3 years, range 12-16 years, 16 with Crohn's disease, five with ulcerative colitis. The FM% was calculated using six established paediatric skinfold thickness equations and compared to the results obtained by DEXA. The statistical analysis was performed using Spearman's correlation, Lin's concordance correlation coefficient and corresponding 95% confidence interval, Bland-Altman's limits of agreement method and the Bradley-Blackwood test.
Results:
Correlation between skinfold and DEXA values ranged between 0.85 (Deurenberg) and 0.92 (Durnin and Rahaman and Johnston), all P < 0.001. Lin's concordance correlation coefficients and (95% confidence interval) ranged between 0.702 (0.512-0.891) for the Deurenberg equation and 0.876 (0.779-0.972) for the Brook equation. Average differences between skinfold and DEXA values ranged between -3.6% (Deurenberg) and 2.5% (Weststrate). Bland-Altman limits of agreement were wide, spanning over 10%. Finally, the Bradley-Blackwood test of equality of means and variances was significant in all but the Durnin and Rahaman equation.
Conclusion:
In adolescents with IBD, fat mass calculated from six skinfold thickness equations showed good correlation but poor agreement with reference values from DEXA. Assessment of body composition using skinfold thickness equations cannot be recommended in paediatric patients with IBD.
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