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Body composition, energy expenditure and physical activity

A comparison of body composition estimates using dual-energy X-ray absorptiometry and air-displacement plethysmography in South African neonates

Abstract

Background/Objectives:

Neonatal body composition is an important predictor of future metabolic risk; however, the comparability of objective assessment techniques, particularly in African populations undergoing rapid health transition, is not known. This paper compares body composition estimates by air-displacement plethysmography (ADP) and dual-energy X-ray absorptiometry (DXA) in South African neonates.

Subjects/Methods:

Fat mass, fat-free mass and body fat percentage (%fat) estimates by ADP and DXA were compared in 88 urban, black South African neonates. The level of agreement between the techniques was assessed using Bland–Altman analyses.

Results:

Significant correlations were observed between ADP and DXA measurements of fat mass (r=0.766), fat-free mass (r=0.942) and %fat (r=0.630); however, ADP estimates of fat mass (408±172 g vs 337±165 g; P<0.001) and %fat (12.9±4.4% vs 9.9±4%; P<0.001) were significantly higher and fat-free mass (2681±348 g vs 2969±375 g; P<0.001) significantly lower than those by DXA. Fat-free mass estimates showed greater consistency in the level of agreement between the techniques compared with fat and %fat estimates where the differences between methods were less predictable.

Conclusion:

Although ADP and DXA body composition estimates are highly correlated in neonates, significant differences are observed between the techniques. This is particularly relevant for fat mass and %fat estimates, where differences are highly variable between methods. Further investigation is needed to minimise inter-method differences to ensure accurate and comparable assessment of body composition at birth and across longitudinal study follow-up.

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Acknowledgements

We acknowledge funding from the UK MRC/DfID African Research Leader Scheme and the South African Medical Research Council. We also acknowledge the support of the DST-NRF Centre of Excellence (CoE) in Human Development at the University of the Witwatersrand, Johannesburg, South Africa.

Author contributions

SVW, PTP and SAN conceptualised and designed the work towards submission of this paper. SVW analysed the data. All authors contributed to interpretation and writing of the manuscript and approved the final version for submission.

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Correspondence to S V Wrottesley.

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Wrottesley, S., Pisa, P., Micklesfield, L. et al. A comparison of body composition estimates using dual-energy X-ray absorptiometry and air-displacement plethysmography in South African neonates. Eur J Clin Nutr 70, 1254–1258 (2016). https://doi.org/10.1038/ejcn.2016.91

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