Related Experiment Video
Updated: Oct 1, 2026
Clinical Anthropometrics and Body Composition from 3-Dimensional Optical Imaging
Published on: June 7, 2024
Development and Validation of Ultrasound-based Prediction Equations for Fat and Lean Mass in Adults With Obesity
Dionne Sizoo1, Lise F E Beumeler2, Loek J M de Heide3
1Centre Obesity Northern Netherlands (CON), Department of Surgery, Frisius MC Leeuwarden, Leeuwarden, the Netherlands; Department of Sustainable Health, Campus Fryslân, University of Groningen, Leeuwarden, the Netherlands.
Background & Aims:
Obesity treatment is measured by total weight loss or BMI loss, neither of which accurately reflects fat mass. Ultrasound (US) offers a non-invasive, portable alternative for measuring subcutaneous adipose tissue (SAT) thickness. The aim of this study was to (1) assess the reliability of US-derived SAT measurements, and (2) develop and validate prediction equations for fat mass (FM) and lean mass (LM) based on SAT thickness at multiple sites.
Methods:
Two separate observational studies were performed. To investigate reliability, the intra- and interrater reliability of the SAT measurements was assessed. For the development and validation of prediction equations, linear regression was used to generate a seven- and three-point model for the estimation of both lean and fat mass. Validity was assessed in the validation cohort using Bland-Altman plots, intraclass correlation coefficients (ICC), and linear regression to detect proportional bias.
Results:
US measurements showed high intra- and good interrater reliability (resp. ICC = 0.948; ICC = 0.859). All models demonstrated a high predictive accuracy for DXA-based body composition (R2>0.71 for fat mass assessment, R2>0.90 for lean mass assessment). There was a strong agreement with DXA across all models (ICC > 0.846).
Conclusion:
Ultrasonography-based measurement of SAT provides a cheap, easy-to-use, and reliable tool to assess fat and lean mass in a population with class II/III obesity.
