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Pitfalls of body fat assessments in premature infants by anthropometry
H P Sheng1, P B Muthappa, W W Wong
1USDA/ARS Children's Nutrition Research Center, Baylor College of Medicine, Houston, Tex.
Insights
Estimating fat mass in preterm infants is crucial. Subscapular skinfold thickness accurately predicts total fat mass, making it ideal for field studies and developing countries.
Area of Science:
- Neonatal physiology
- Body composition analysis
- Pediatric nutrition
Background:
- Accurate assessment of fat deposition is vital for preterm infant health.
- Subcutaneous fat mass (SFM) and total fat mass (TFM) are key indicators.
- Estimating body composition in preterm infants presents unique challenges.
Purpose of the Study:
- To evaluate methods for estimating SFM and TFM in preterm infants.
- To determine the relationship between SFM and TFM.
- To identify the most reliable anthropometric predictor of TFM.
Main Methods:
- SFM was estimated using anthropometric measurements (skinfold thicknesses, circumferences, body lengths).
- TFM was determined via total body water measurements using H2(18)O dilution.
- Data were collected from 16 preterm infants at approximately 8 days postnatal age.
Main Results:
- The proportion of TFM as SFM decreased with increasing TFM.
- Infants with <100g TFM had 74% SFM, versus 35% for those with >100g TFM.
- Subscapular skinfold thickness was the best predictor of TFM (r = 0.78), with no improvement from additional measurements.
Conclusions:
- Subscapular skinfold thickness is a reliable and practical method for estimating fat deposition in preterm infants.
- This method is particularly suitable for field studies and resource-limited settings.
- Accurate body composition assessment aids in optimizing care for preterm neonates.
Abstract:
Subcutaneous fat mass (SFM) and total fat mass (TFM) were estimated in 16 preterm infants at 8 +/- 2 days postnatal age. SFM was estimated from anthropometric measurements: 5 skinfold thicknesses, 5 body circumferences, and regional body lengths. TFM was estimated from total body water measurements using dilution of isotopic water, H2(18)O. The proportion of TFM that was SFM decreased with an increase in TFM. In infants with less than 100 g of TFM (5% body weight), 74% of TFM is in the subcutaneous layer compared with only 35% in infants with higher TFM (more than 100 g). Subscapular skinfold thickness is the best predictor of TFM (r = 0.78). Additional skinfold thickness measurements (triceps, biceps, supra-iliac and thigh) do not improve the predictability of TFM by the subscapular skinfold thickness. We conclude that measurement of subscapular skinfold thickness is an appropriate choice for estimating fat deposition in preterm infants, particularly in field studies and in developing countries.