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Body composition and bone mineral density by Dual Energy X-ray Absorptiometry: Reference values for young children
Inge A L P van Beijsterveldt1, Manouk van der Steen2, Kirsten S de Fluiter1
1Department of Pediatrics, Subdivision of Endocrinology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands.
Insights
New reference charts for children aged 2-5 years provide crucial body composition data. These sex-specific values for fat mass and lean body mass help identify childhood obesity risks.
Area of Science:
- Pediatric Endocrinology
- Public Health Nutrition
- Body Composition Analysis
Background:
- Childhood obesity is a growing global health concern with significant short- and long-term health consequences.
- Accurate assessment of body composition in early childhood is vital for identifying excess adiposity and associated risks.
- A critical gap exists in reference values for children aged 2-5 years, hindering accurate interpretation of body composition measurements.
Purpose of the Study:
- To establish sex-specific reference values and charts for key body composition parameters in children aged 2-5 years.
- To address the lack of normative data for fat mass (FM), fat mass percentage (FM%), fat mass index (FMI), lean body mass (LBM), lean body mass index (LBMI), and total body less head bone mineral density (BMD TBLH).
- To utilize Dual-Energy X-ray Absorptiometry (DXA) for precise body composition assessment in this age group.
Main Methods:
- Conducted 599 DXA measurements in 340 healthy, term-born children aged 2-5 years.
- Utilized Lunar Prodigy with Encore software (V14.1) for accurate data acquisition.
- Employed Generalized Additive Models for Location, Scale and Shape (GAMLSS) to construct sex-specific reference values and charts.
Main Results:
- Developed sex-specific reference values and charts for FM, FM%, FMI, LBM, LBMI, and BMD TBLH for children aged 2-5 years.
- Observed increases in FM and LBM with age in both sexes, while body size-corrected FM% and FMI decreased.
- Identified sex differences: girls exhibited higher FM, FM%, and FMI, and lower LBM and LBMI compared to boys. BMC and BMD TBLH increased with age and were similar between sexes.
Conclusions:
- Presented novel, sex-specific DXA-derived reference values and charts for body composition and bone mineral density in healthy children aged 2-5 years.
- These longitudinal references are valuable tools for clinical practice and research in monitoring pediatric body composition and bone health.
- The established references aid in identifying children at risk for excess adiposity and related health issues.
Background & Aims:
Childhood obesity is a global public health threat, with an alarming rise in incidence. Obesity at young age has short-term and long-term morbidity. It is, therefore, important to accurately assess body composition throughout infancy and childhood to identify excess adiposity. However, reference values for age 2-5 years, needed to interpret measurements and identify young children at risk, are lacking. Our primary objective was to fill the current gap in reference values by constructing sex-specific body composition reference values and charts for fat mass (FM), fat mass percentage (FM%), fat mass index (FMI), lean body mass (LBM), lean body mass index (LBMI) and total body less head bone mineral density (BMDTBLH) for children aged 2-5 years using Dual-Energy X-ray Absorptiometry (DXA).
Methods:
We performed 599 accurate DXA-measurements in 340 term-born children aged 2-5 years, using Lunar Prodigy with Encore software (V14.1). Using GAMLSS, sex-specific reference values and charts were created for FM, FM%, FMI, LBM, LBMI and BMDTBLH.
Results:
Sex-specific body composition reference values and charts for age 2-5 years were constructed. In boys and girls, FM and LBM increased from age 2-5 years (all p ≤ 0.001), but body size-corrected FM% and FMI decreased (all p ≤ 0.023). LBMI remained similar between 2 and 5 years of age. Girls had higher FM, FM% and FMI and lower LBM and LBMI compared to boys. BMC and BMDTBLH increased with age between 2 and 5 years of age (all p < 0.001) and were similar for boys and girls.
Conclusions:
We present sex-specific reference values and charts for body composition and total body bone mineral density measured by DXA, based on a large cohort of healthy children aged 2-5 years. These longitudinal references can be used for clinical practice and research purposes to monitor body composition and bone mineral density development and identify children at risk for excess adiposity.
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