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Updated: Sep 9, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Associations Between Body Composition Measurements and Muscle Ultrasound Parameters Amongst Children and Adolescents
Andrea Domínguez-Barbosa1,2, Dana Reyes-Romo1,3, Mariel Salvador-Quezada1,4
1Departamento de Metodología de la Investigación, Instituto Nacional de Pediatría, Ciudad de México 04530, Mexico.
Insights
Pediatric obesity is linked to poorer muscle quality in children, with higher body fat correlating to increased echo intensity and intramuscular fat. Ultrasound can help detect these musculoskeletal changes early.
Area of Science:
- Pediatric Endocrinology
- Musculoskeletal Health
- Medical Imaging
Background:
- Pediatric obesity adversely affects metabolic and musculoskeletal health, impacting muscle quality and function.
- Ultrasound measures (muscle thickness, echo intensity) and body composition offer comprehensive muscle status assessment in children.
- Understanding these relationships is crucial for managing pediatric obesity's long-term health consequences.
Purpose of the Study:
- To investigate the associations between anthropometric measurements, muscle strength, and bioelectrical impedance with ultrasound-derived indicators of muscle quality in Hispanic children with overweight or obesity.
- To examine the relationship between body fat, muscle thickness, and echo intensity using ultrasound.
- To identify predictors of muscle quality in this pediatric population.
Main Methods:
- Cross-sectional study of 294 Hispanic children (6 to <18 years) with overweight or obesity (BMI ≥ 85th percentile).
- Participants underwent standardized nutritional assessment.
- Ultrasound imaging assessed subcutaneous fat and quadriceps femoris thickness; echo intensity measured muscle quality.
Main Results:
- Significant sex differences observed: girls had higher intramuscular adipose tissue (IMAT), boys had greater lean mass.
- Body fat percentage strongly correlated with muscle echo intensity (R²=0.242-0.264) and IMAT (R²=0.268), particularly in girls.
- Linear models indicated body fat and BMI percentile are key predictors of muscle quality (p < 0.001).
Conclusions:
- Increased body fat in pediatric overweight/obesity is associated with diminished muscle quality, evidenced by higher echo intensity and IMAT.
- Ultrasound is a valuable non-invasive tool for early detection of musculoskeletal changes in children.
- Comprehensive assessment of both muscle size and quality is essential in managing pediatric obesity.
Abstract:
Background/Objective: Pediatric obesity negatively impacts metabolic and musculoskeletal health, particularly muscle quality and function. Ultrasound-derived measures like muscle thickness and echo intensity, combined with body composition data, provide a more comprehensive assessment of muscle status in this population. The purpose of our study was to examine the relationship between anthropometric measurements, muscle strength, and bioelectrical impedance estimations with ultrasound-derived indicators such as subcutaneous fat and quadriceps femoris thickness, as well as muscle quality, through EI. Methods: This cross-sectional study included Hispanic children aged 6 to under 18 years with overweight or obesity (BMI ≥ 85th percentile per CDC standards). Participants were recruited consecutively from outpatient visits. All eligible children were invited for a standardized nutritional assessment, and those who consented were included. Results: The study included 294 children and adolescents (153 boys, 141 girls) with overweight or obesity, showing significant sex differences in anthropometric and body composition variables. Girls had higher intramuscular adipose tissue (IMAT) (p < 0.001), while boys had more lean and musculoskeletal mass. Body fat percentage was significantly correlated with muscle echo intensity (EI corrected: R2 = 0.264, p < 0.001; EI uncorrected: R2 = 0.242, p < 0.001) and with IMAT (R2 = 0.268, p < 0.001). These associations were stronger in girls. Linear models identified body fat and BMI percentile as key predictors of muscle quality indicators (p < 0.001). Conclusions: This study found that higher body fat in children and adolescents with overweight or obesity is linked to poorer muscle quality, and especially increased echo intensity and intramuscular fat. Ultrasound proves useful for early, non-invasive detection of musculoskeletal changes, emphasizing the need to assess both muscle size and quality.
