Assessment of body composition in pediatric intestinal failure: A comparison study

Area of Science:

• Pediatric Gastroenterology
• Clinical Nutrition
• Body Composition Analysis

Background:

• Assessing body composition is crucial for managing pediatric intestinal failure.
• Dual energy x-ray absorptiometry (DXA) is the gold standard but may not be practical for frequent monitoring.
• Exploring alternative methods like bioelectrical impedance analysis (BIA) and skinfolds is essential.

Purpose of the Study:

• To compare the accuracy of bioelectrical impedance analysis (BIA) and skinfold measurements against dual energy x-ray absorptiometry (DXA) for body composition assessment in children with intestinal failure.
• To evaluate the clinical utility of BIA and skinfolds as accessible alternatives to DXA.

Main Methods:

• A study involving 68 children (aged 1-18 years) with intestinal failure undergoing routine DXA scans.
• Body composition parameters, including fat mass (%FM) and fat-free mass (%FFM), were measured using BIA and skinfold methods on the same day as DXA.
• Statistical analyses included paired t-tests and Bland-Altman analysis to assess differences and agreement between methods, with marginal linear models examining the influence of age, sex, and feeding method.

Main Results:

• No statistically significant differences were found between BIA and DXA for %FFM and %FM (P=0.26).
• A mean bias of -0.69% for %FFM was observed between BIA and DXA, influenced by age and sex (P<0.05).
• Significant differences were detected between skinfold measurements and DXA (P<0.05).

Conclusions:

• Bioelectrical impedance analysis (BIA) is a clinically acceptable tool for assessing body composition in pediatric patients with intestinal failure.
• Skinfold measurements demonstrated significant discrepancies compared to DXA, suggesting lower reliability in this population.
• BIA offers a viable, less invasive alternative for routine body composition monitoring in this vulnerable group.