Relación entre la Temperatura de Superficie, la Composición Corporal e Indicadores Antropométricos de Obesidad y Sobrepeso / Relationship Between Surface Temperature, Body Composition and Anthropometric Indicators of Obesity and Overweight

La termografía por infrarrojo (TI) permite evaluar la temperatura corporal, medir los cambios en la disipación del calor corporal en superficie y relacionarlos con las características de composición corporal e índices antropométricos. Aumentar el número de registros de zonas corporales evaluadas con TI y establecer las relaciones de estas temperaturas (32 áreas corporales) con variables de composición corporal e índices antropométricos, como el índice de masa corporal (IMC), índice cintura cadera, índice cintura estatura, en hombres adultos divididos según su estado ponderal. Participaron 60 hombres, adultos sanos, divididos en 2 grupos: grupo 1 (n=30), con IMC ≤ 24,9, edad 23,2 ± 3,9 años, masa corporal 66,5 ± 6,5 kg, y talla 170,5 ± 7,4 cm; y, grupo 2 (n= 30), con IMC > 24,9, edad 29,4 ± 9,9 años, masa corporal 84,5 ± 11,9 kg, y talla 172,0 ± 7,18 cm. Se realizaron evaluaciones antropométricas y de TI. Sujetos con IMC ≤ 24,9 kg/ m2 presentaron valores mayores de temperatura superficial, en todas las zonas estudiadas, a diferencia de los sujetos con niveles de IMC > 24,9 kg/m2, donde la disipación del calor corporal fue menor. Existe una estrecha relación entre la temperatura superficial de la piel y el IMC, donde sujetos con un IMC normal mostraron una disipación de calor y valores de temperatura superficial mayores, en todas las zonas evaluadas, a diferencia de los sujetos con un IMC que se encontraba por encima del límite de normalidad.

SUMMARY: Infrared thermography (IT) makes it possible to assess body temperature, measure changes in body heat dissipation on the surface, and relate them to body composition characteristics and anthropometric indices. The objective of this study was to increase the number of records of body areas evaluated with IT and establish the relationships of these temperatures (32 body areas) with body composition variables and anthropometric indices, such as body mass index (BMI), waist-hip ratio, waist-height ratio, in adult men divided according to their weight status. A total of 60 healthy adult men participated, divided into 2 groups: group 1 (n=30), with a body mass index (BMI) ≤ 24.9, age 23.2 ± 3.9 years, body mass 66.5 ± 6.5 kg, and height 170.5 ± 7.4 cm; and, group 2 (n = 30), with BMI > 24.9, age 29.4 ± 9.9 years, body mass 84.5 ± 11.9 kg, and height 172.0 ± 7.18 cm. Anthropometric and IT assessments were performed. Subjects with BMI ≤ 24.9 kg/ m2 presented higher values of surface temperature in all areas studied, unlike subjects with BMI levels > 24.9 kg/m2, where body heat dissipation was lower. There is a close relationship between skin surface temperature and BMI, where subjects with a normal BMI showed higher heat dissipation and surface temperature values, in all evaluated areas, unlike subjects with a BMI that was above the normal limit.

Estimation of fat mass in Southern Brazilian female adolescents: development and validation of mathematical models / Estimativa da massa gorda em adolescentes do sexo feminino do sul do Brasil: desenvolvimento e validação de modelos matemáticos

abstract This study aimed to develop and validate the first mathematical models, based on anthropometric properties, to estimate fat mass (FM) in a heterogeneous sample of female adolescents. A cross-sectional and quantitative study conducted with 196 individuals aged 12 to 17 years from the metropolitan region of Curitiba, Paraná, Brazil. The participants were randomly divided into two groups: regression sample (n = 169) and validation sample (n = 27). Dual-energy X-ray absorptiometry (DXA) was used as the reference method to determine body fat in relative and absolute values. Stature, body mass, waist girth and triceps, subscapular, biceps, iliac crest, abdominal, front thigh and medial calf skinfold thickness were defined as independent variables and measured according to an international technical protocol. Statistical analyzes used the Ordinary Least Square (OLS) regression model, paired t test and Pearson correlation. Four multivariate mathematical models with high determination coefficients (R2 ≥90%) and low estimated standard errors (SEE = ≤2.02 kg) were developed. Model 4 stands out for its low number of independent variables and significant statistical performance (R2 = 90%; SEE = 1.92 kg). It is concluded that the four mathematical models developed are valid for estimating FM in female adolescents in southern Brazil.

resumo Este estudo teve como objetivo desenvolver e validar os primeiros modelos matemáticos, baseados em propriedades antropométricas, para estimar a massa gorda (MG) em uma amostra heterogênea de adolescentes do sexo feminino. Estudo transversal e quantitativo conduzido com 196 indivíduos de 12 a 17 anos da região metropolitana de Curitiba, Paraná, Brasil. Os participantes foram divididos aleatoriamente em dois grupos: amostra de regressão (n = 169) e amostra de validação (n = 27). A absorciometria de raios X de dupla energia (DXA) foi usada como método de referência para determinar a gordura corporal em valores relativos e absolutos. A estatura, a massa corporal, o perímetro da cintura e a espessura das dobras cutâneas do tríceps, subescapular, bíceps, crista ilíaca, abdominal, coxa anterior e panturrilha medial foram definidas como variáveis independentes e mensuradas de acordo com um protocolo técnico internacional. As análises estatísticas utilizaram modelo de regressão Ordinary Least Square (OLS), teste t pareado e correlação de Pearson. Foram desenvolvidos quatro modelos matemáticos multivariados com altos coeficientes de determinação (R2 ≥90%) e baixos erros padrão estimados (SEE = ≤2,02 kg). O modelo 4 destaca-se pelo baixo número de variáveis independentes e desempenho estatístico significativo (R2 = 90%; SEE = 1,92 kg). Conclui-se que os quatro modelos matemáticos desenvolvidos são válidos para estimar a MG em adolescentes do sexo feminino do sul do Brasil

Pinch size can affect the skinfold thickness measurement and interfere in the estimation and classification of body adiposity / O tamanho da pinça pode afetar a medida de espessura das dobras cutâneas e interferir na estimativa e classificação da adiposidade corporal

Abstract The aim of this study was to verify the effect of pinch size on skinfold thickness measurement and the consequent interference in the estimation and classification of body adiposity components. Cross-sectional and quantitative study carried out with a sample of 29 subjects recruited from a university in the city of Fortaleza, Ceará, Brazil. Four measurement steps were performed at each site of the eight chosen skinfolds. The first step was performed with a subjective-landmark and the three subsequent steps with fixed-landmarks defined with an expanding secondary line at 2 cm intervals. Body adiposity components were determined from the skinfold thickness measured at each landmark. Repeated measures ANOVA and Bland-Altman agreement analysis were applied. The subjective-landmark was chosen as the dependent variable. The 6 cm-landmark showed similarity and statistical agreement with the subjective-landmark for all skinfolds except the thigh, and with the sums of five and eight skinfolds. All fixed-landmarks showed agreement below the cut-off point for the percentile classification of subcutaneous adiposity and normative relative body fat. Variation in pinch size is an important source of TEM that can affect the reproducibility of skinfold thickness measurements and interfere in the estimation and classification of the molecular and tissue component of body adiposity.

Resumo O objetivo deste estudo foi verificar o efeito do tamanho da pinça na medida de espessura das dobras cutâneas e a consequente interferência na estimativa e classificação dos componentes da adiposidade corporal. Estudo transversal e quantitativo realizado com amostra de 29 sujeitos recrutados em uma universidade da cidade de Fortaleza, Ceará, Brasil. Quatro etapas de medição foram realizadas em cada sítio das oito dobras cutâneas escolhidas. A primeira etapa foi realizada com um marco subjetivo e as três etapas subsequentes com marcos fixos definidos com uma linha secundária expansiva em intervalos de 2 cm. Os componentes da adiposidade corporal foram determinados a partir da espessura de dobras cutâneas mensuradas em cada marco. ANOVA de medidas repetidas e análise de concordância de Bland-Altman foram aplicadas. O marco subjetivo foi escolhido como variável dependente. O marco de 6 cm apresentou semelhança e concordância estatística com o marco subjetivo para todas as dobras cutâneas, exceto a coxa, e com as somas de cinco e oito espessuras de dobras cutâneas. Todos os marcos fixos mostraram concordância abaixo do ponto de corte para a classificação percentílica de adiposidade subcutânea e gordura corporal relativa normativa. A variação no tamanho da pinça é uma importante fonte de ETM que pode afetar a reprodutibilidade de medida de espessura das dobras cutâneas e interferir na confiabilidade da estimativa e classificação do componente molecular e tecidual da adiposidade corporal.

What anthropometric indicators are associated with insulin resistance? Cross-sectional study on children and adolescents with diagnosed human immunodeficiency virus

ABSTRACT BACKGROUND: Studies that test associations between anthropometric indicators and insulin resistance (IR) need to provide better evidence in the context of the pediatric population (children and adolescents) with human immunodeficiency virus (HIV), as anthropometric indicators present a better explanation of the distribution of body fat. OBJECTIVE: To test the associations between anthropometric indicators and insulin resistance (IR) among children and adolescents diagnosed with HIV. DESIGN AND SETTING: Cross-sectional study on 65 children and adolescents (8-15 years) infected with HIV through vertical transmission conducted at the Joana de Gusmão Children's Hospital, Florianópolis, Brazil. METHODS: The anthropometric indicators measured were the abdominal (ASF), triceps (TSF), subscapular (SSF) and calf (CSF) skinfolds. The relaxed arm (RAC), waist (WC) and neck (NC) circumferences were also measured. Body mass index (BMI) was calculated from the relationship between body mass and height. IR was calculated through the Homeostasis Model Assessment for Insulin Resistance (HOMA-IR). Simple and multiple linear regression analyses were used. RESULTS: After adjustment for covariates (sex, bone age, CD4+ T lymphocytes, CD8+ T lymphocytes, viral load, and physical activity), associations between IR and models with SSF and CSF remained. Each of these explained 20% of IR variability. For females, in the adjusted analyses, direct associations between IR and models with ASF (R² = 0.26) and TSF (R² = 0.31) were observed. CONCLUSIONS: SSF and CSF in males and ASF and TSF in females were associated with IR in HIV-infected children and adolescents.

A century of skinfolds for body composition estimation: what we learned? / Um século das dobras cutâneas para estimativa da composição corporal: o que aprendemos?

abstract In 2021, we reached the centenary of the creation of the first body composition assessment model based on the use of skinfolds. A hundred years after Matiegka's application in 1921 to the analysis of "human efficiency", this point of view study seeks to bring reflections on the continuous applicability of the method, historical points, relevant advances, and possible projections for the future. Indeed, the comparability of skinfolds with multicompartmental reference methods shows several advantages and disadvantages; if on the one hand we have low cost, speed, and reproducibility, on the other hand we have problems associated with the quality of the equipment, the evaluator's skill and mainly the adequate choice of the predictive model. Thus, when it comes to the assessment of body composition, skinfolds are still a good option for application in different contexts by health professionals as long as the evaluator pays attention to the critical aspects that may represent sources of errors (for example, the level of training/experience, correct skinfold location). Even with the numerous advances in the area, there is solidity and continuity for the application of skinfolds for the future.

resumo No ano de 2021 chegamos ao centenário da criação do primeiro modelo de avaliação da composição corporal a partir do uso de dobras cutâneas. Passado cem anos da aplicação por Matiegka em 1921 para análise da "eficiência humana", esse estudo de ponto de vista busca trazer reflexões sobre a contínua aplicabilidade do método, pontos históricos, avanços relevantes e possíveis projeções para o futuro. De fato, a comparabilidade das dobras cutâneas com métodos de referência multicompartimanentais mostra diversas vantagens e desvantagens; se por um lado temos o baixo custo, rapidez, reprodutibilidade, por outro lado temos problemas associados a qualidade do equipamento, habilidade do avaliador e principalmente a escolha adequada do modelo preditivo. Deste modo, em se tratando de avaliação da composição corporal, as dobras cutâneas continuam sendo uma boa opção de aplicação em diferentes contextos por profissionais da saúde desde que o avaliador se atente aos aspectos críticos que podem representar fontes de erros (por exemplo o nível de treinamento/experiência, local correto da prega cutâneas). Mesmo com os inúmeros avanços da área, percebe-se uma solidez e continuidade para a aplicação das dobras cutâneas para o futuro.

Asociación entre la termografía por infrarrojo, parámetros antropométricos y gasto energético de reposo en hombres / Association between infrared thermography, anthropometry parameters and rest energy expenditure in men

RESUMEN: Es reconocido que un incremento de la grasa corporal subcutánea es capaz de alterar el patrón de liberación de calor a través de la piel. Sin embargo, la asociación con otras variables antropométricas y la influencia del gasto energético en reposo (GER), han sido escasamente abordadas. Este estudio determinó la relación de la temperatura de la piel con variables antropométricas, peso corporal y GER de hombres adultos sanos. Participaron en el estudio un total de 24 varones sanos de 33,9±8,7 años de edad, 85,8±9,7 kg de peso corporal, 172,5±6,1 cm de estatura y 28,9±3,4 kg/m2 de índice de masa corporal (IMC). Se realizaron evaluaciones antropométricas, de termografía por infrarrojo y del GER por calorimetría indirecta, con analizador de gases. La temperatura promedio de los 6-pliegues, y las individuales (toracoabdominales, supra-espinal y abdominal), tuvieron correlaciones negativas con el IMC, perímetro de cintura, índice cintura cadera, índice cintura estatura, y la sumatoria de 6 pliegues; todos con p<0,05. Además, la temperatura del pliegue supraespinal tuvo una correlación negativa con el porcentaje de masa adiposa (MA%), r=0,47(p=0,0194). La MA% y el IMC tuvieron correlaciones negativas con el GER, con r=-0,59 (p=0,002) y r=-0,53 (p=0,006), respectivamente. El promedio de temperatura de los 6-pliegues presentó una correlación positiva con el GER (r=0,44; p=0,02). La composición corporal causa una modificación en los patrones de termografía superficial local, sin afectar la relación entre el promedio de la temperatura superficial total con el GER, pudiendo éste ser un factor predictor.

SUMMARY: It is known that an increase in the subcutaneous body fat can alter the pattern of heat release through the skin. However, the relationship with other anthropometric variables and the influence of the Resting Energy Expenditure (REE) have scarcely been addressed. To determine the relationship of skin temperature with different anthropometric variables, body weight, and the REE of healthy adult males. The participants were a total of 24 healthy males of 33.9±8.7 years-old, 85.8±9.7 kg of body mass, 172.5±6.1 cm of height, and 28.9±3.4 kg/m2 of body mass index (BMI). Anthropometric, infrared thermography, and indirect calorimetry REE assessments were performed with gas analyzer. The six skinfolds average temperature, as well as the individual skinfolds (thoracoabdominal, supraspinal, and abdominal), had negative correlations with the BMI, waist circumference, waist- hip ratio, waist-to-height ratio, and the sum of the six skinfolds, all with p<0.05. In addition, the temperature of the supraspinal fold had a negative correlation with the percentage of fat mass (MA%), r=0.47 (p=0.0194). MA% and BMI had negative correlations with REE, with r=-0.59 (p=0.002) and r=-0.53 (p=0.006), respectively. The six-skinfolds average temperature presented a positive correlation with the REE (r=0.44; p=0.02). Body composition changes cause a modification in the local surface thermography patterns without affecting the relationship between the average total body surface temperature with the REE; therefore, this could act as a predictive factor.

Can skinfold thickness equations be substituted for bioimpedance analysis in children?

Abstract Objective: The aim of the present study was to evaluate the agreement between the most used skinfold thickness equations with multi-frequency bioimpedance analysis in the prediction of body fat levels in children. Method: A cross-sectional study of healthy Brazilian community-dwelling individuals. The anthropometric assessment included height, body mass, arm circumference, and waist circumference. The percentage of body fat was obtained by measuring skinfold thickness equations and using bioimpedance analysis, and skinfold thickness was measured using a scientific skinfold caliper. Bland-Altman plot analysis was used to verify the agreement between the methods. Results: There were 439 children and adolescents evaluated, with a mean age of 11.6 ± 3.7 years. The mean body fat by bioimpedance analysis was 22.8% ± 10.4%, compared to 22.4% ± 8.8% by Slaughter (1), 20.4% ± 9.2% by Slaughter (2), 19.6% ± 4.4% by Goran, and 24.7% ± 10.0% by Huang equations. Bland-Altman plot analysis revealed limits of agreement greater than 8% between the bioimpedance analysis approach and equations, exceeding the clinically acceptable limit predefined a priori. None of the equations had good agreement with bioimpedance analysis. Conclusion: It was concluded that skinfold thickness and bioimpedance analysis should not be used interchangeably in children and adolescents.

Somatotype profiles of male and female Montenegrin judokas / Perfiles somatotípicos de judokas montenegrinos masculinos y femeninos

SUMMARY: The objective of this research was to establish the anthropometric characteristics and somatotype profiles of Montenegrin male and female judokas, divided by weight categories. The sample was composed of 170 Montenegrin judokas, 92 male judo athletes (21.8 ± 3.9 years) and 78 female judo athletes (20.5 ± 3.1 years). All athletes were of national level, divided by official weight categories. This study provides normative data of anthropometric and somatotype profiles in relation to gender and weight categories of Montenegrin judo athletes. The anthropometric profiles changed according to weight category, whereas, anthropometric parameters were highest in the heaviest category as compared to other weight categories. In the domain of male somatotype profiles, three different types of somatotype in relation to weight category were obtained. The three weight categories were endomorphic mesomorphs (-90 kg, -100 kg, >100 kg), ectomorphic mesomorphs (-60 kg, -73 kg, -81 kg) and judo athletes of -66 kg were mesomorphic ectomorphs. All the female athletes were endomorphic mesomorphs, except for category 52. Representatives from the -52 kg were mesomorphic endomorphs. This study highlights how somatotype profiles of national judo athletes differ between weight categories. It is likely that some changes could be used in applying proper training methods with a focus on the athletes' physical abilities, which could result in a decrease in somatotype diversity among weight categories.

RESUMEN: El objetivo de esta investigación fue establecer las características antropométricas y los perfiles somatotípicos de judokas Montenegrinos de ambos sexos, divididos por categorías de peso. La muestra estuvo compuesta por 170 judokas montenegrinos, 92 hombres (21,8 ± 3,9 años) y 78 mujeres (20,5 ± 3,1 años). Todos los atletas eran de nivel nacional, divididos por categorías de peso oficiales. Este estudio proporcionó datos normativos de perfiles antropométricos y somatotipos en relación con las categorías de sexo y peso de los atletas de judo Montenegrinos. Los perfiles antropométricos cambiaron según la categoría de peso, mientras que los parámetros antropométricos fueron más altos en la categoría más pesadas en comparación con otras categorías. En el dominio de los perfiles de somatotipo masculino, se obtuvieron tres tipos diferentes en relación con la categoría de peso. Las tres categorías fueron mesomorfos endomórficos (-90 kg, -100 kg, > 100 kg), mesomorfos ectomórficos (-60 kg, -73 kg, -81 kg) y ectomorfos mesomórficos (-66 kg). Todas las atletas femeninas fueron mesomorfas endomórficas, excepto la categoría 52. Los representantes de los -52 kg eran endomorfos mesomórficos. Este estudio destaca cómo los perfiles de somatotipo de los atletas nacionales de judo difieren entre las categorías de peso. Es probable que puedan aplicarse algunos cambios en los métodos de entrenamiento, con un enfoque en las habilidades físicas de los atletas, lo que podría resultar en una disminución en la diversidad de somatotipos entre las categorías de peso.

Concordance in prediction body fat percentage of Brazilian women in reproductive age between different methods of evaluation of skinfolds thickness

ABSTRACT Objective To assess the utility of bioimpedance (BIA) and skinfolds thickness (SF) in body fat percentage measuring (%BF) compared to the reference method dual-energy x-ray absorptiometry (DXA) in Brazilian reproductive age women, as well as to estimate of inter- and intra-observer precision for SF. Subjects and methods 170 women aged 18-37 years with BMI between 18 and 39.9 kg/m2 were selected for this cross-sectional study. Body density was evaluated through equations proposed by Jackson, Pollock and Ward (1980) (EqJPW) and Petroski (1995) (EqPET), and %BF was estimated by BIA, DXA and Siri's formula (1961). The SF were measured by two separate observers: A and B (to determine inter-observer variability), who measured the folds at three times with 10-minute interval between them (to determine intra-observer variability - we used only observer A). Results The %BF by DXA was higher than those measured by SF and BIA (p<0.01, for all) of 90 volunteers. The Lin coefficient of agreement was considered satisfactory for %BF values obtained by EqJPW and BIA (0.55) and moderate (0.76) for sum of SF (ΣSF) values obtained by EqJPW and EqPET. No agreement was observed for the values obtained by SF (EqJPW and EqPET), BIA and DXA. Analysis of inter- and intra-observer of 59 volunteers showed that different measures of SF thickness met acceptability standards, as well as the % BF. Conclusion BIA and SF measurements may underestimate %BF compared with DXA. In addition, BIA and SF measurements are not interchangeable with DXA. However, our results suggest the equation proposed by Jackson, Pollock and Ward (three skinfolds) compared to BIA are interchangeable to quantify the %BF in Brazilian women in reproductive age. Furthermore, our results show acceptable accuracy for intra- and inter-observer skinfold measurements. Arch Endocrinol Metab. 2020;64(3):257-68

Effects of low molecular weight galactomannans based standardized fenugreek seed extract in subjects with high fat mass: A randomized, double-blind, placebo-controlled clinical study

The present investigation evaluated the effects of low molecular weight galactomannans-based standardized fenugreekseeds extract (LMWGAL-TF) on human subjects with high-fat mass for 8-weeks using a prospective, randomized,double-blind, placebo-controlled design. Twenty-four subjects with percent body fat were randomized to ingest acapsule of LMWGAL-TF (500 mg, once a day) or the matching placebo at a 1:1 ratio for 8 weeks. The outcomemeasurements were recorded at baseline, week-4, and week-8 (end of the treatment). The efficacy outcome includedfat mass (absolute, non-fat mass and %) by skinfold thickness method (along with triceps, suprailiac, and abdominal)and bioelectrical impedance analysis method, body weight, body mass index, and abdominal girth. The standardsafety parameters were measured, such as adverse events, vital signs, hematology, and biochemistry. Eight weeksof LMWGAL-TF supplementation showed significant reduction in suprailiac skinfold thickness (v/s baseline) andabdominal skinfold thickness (v/s baseline and v/s placebo), and percent fat mass, (v/s baseline). The LMWGAL-TFsupplementation was found to be safe and well-tolerated. In conclusion, LMWGAL-TF supplementation showedsafety and efficacy in reducing skinfold thickness (abdominal and suprailiac) and percent body fat in subjects with ahigh fat mass

Ultrasonic observation on impact of plateau sunlight radiation on skin thickness and hardness of normal subjects / 中国医学影像技术

Objective: To observe the impact of plateau sunlight radiation on skin thickness and hardness with high frequency ultrasound and shear wave elastography (SWE). Methods: Totally 30 volunteers from plateau areas (plateau area group) and 48 volunteers from non-plateau areas (non-plateau area group) were enrolled. Skin thickness and skin hardness of right middle finger, right forearm, anterior chest wall and abdominal wall were measured with high frequency ultrasound and SWE and then compared between two groups. Diagnostic test of the above parameters which showed significant differences were performed, and ROC curve were drawn. Results: Skin thickness, maximum elastic value (Emax), average elastic value (Emean), minimum elastic value (Emin) and standard deviation (Esd) of right middle fingers, skin Emax, Emean, Emin of right forearms and anterior chest walls, skin Emax, Emean, Emin, Esd of abdominal walls of plateau area group were all higher than those of non-plateau area group (all P0.95. Taken skin Emax=13.30 kPa, Emean=12.45 kPa, Emin=11.50 kPa of abdominal wall as cut off values, the sensitivities in diagnosis of plateau skin were all 100%, and specificities were 85.40%, 87.50% and 85.40%, respectively. Conclusion: Plateau sunlight radiation lead to changes of skin thickness and make the skin harden. Skin Emax, Emean, Emin of abdominal wall have the highest diagnostic efficiencies.

High-frequency ultrasound combined with modified Rodnan skin score in systemic sclerosis / 中华风湿病学杂志

Objective The purpose of this study was to evaluate the degree of skin thickening of patients with systemic sclerosis (SSc) by high-frequecy ultrasound,as well as the value of ultrasound.Methods Thirty-one patients with SSc and 31 age-matched and sex-matched healthy control subjects were enrolled.Skin thickness,modified Rodnan skin score (mRss),disease activity index (DA1) and other clinical parameters within and between groups were compared using SPSS 21 software.Student's t test,x2 test or nonparametric testing was performed to compare between groups.The Pearson or Spearman methods were used to test correlation.Sensitivity and specificity of skin thickness detection by high-frequecy ultrasound were evaluated by using receiver operating characteristic (ROC) curve analysis.Results Total thickness of skin (TST) of patientswith SSc were positively correlated to the total mRss (r=0.416,P=0.020) and DAI (r=0.436,P=0.014).The skin thickness of patients with mRss 0,1,2 was higher than CNT [1.45(0.60),1.70(0.30) mm,1.60 (0.30) mm vs 1.30 (0.35) mm,Z=-3.242,-6.577,-5.090,P＜0.01].The cut-off value of TST used as the evaluation of skin change was 7.4 mm by ROC curve analysis,and the sensitivity and specificity of them was 77.40％ and 87.10％ respectively,and patients with thickened skin were more likely to suffer interstitial lung disease (ILD) (16 vs 1,x2=26.004,P=0.014),higher mRss [10(6) vs 4(5),Z=-2.499,P=0.031],DAI [(5.2±2.4) vs (2.3±1.7),t=-3.104,P＜0.01)] and CRP [(8.60 (10.48) mg/L vs 3.52 (4.93) mg/L,Z=-2.276,P=0.038].Conclusion US combined with mRss are helpful to evaluate the changes of skin and disease activity of patients in SSc.US can identify the early and subclinical skin involvement that may precede mRss,providing a more reliable tool for diagnosis,treat efficacy and prediction of organ damage.

Uso da ultrassonografia para avaliar a espessura muscular e a gordura subcutânea em crianças e adolescentes com fibrose cística / The use of ultrasonography to evaluate muscle thickness and subcutaneous fat in children and adolescents with cystic fibrosis

RESUMO Objetivo: Comparar a espessura muscular e a gordura subcutânea entre pacientes com fibrose cística (FC) e controles saudáveis e correlacionar os achados ultrassonográficos com variáveis nutricionais, clínicas e de função pulmonar. Métodos: Foram incluídos sujeitos (6 a 18 anos) com o diagnóstico de FC e indivíduos saudáveis. Foram realizadas medidas antropométricas, avaliação ultrassonográfica da espessura muscular e da gordura subcutânea do tríceps, quadríceps e da região do gastrocnêmio, além da quantificação das pregas cutâneas. O percentual de gordura corporal foi estimado pelas pregas cutâneas. Osindivíduos com FC também tiveram a função pulmonar avaliada por espirometria. Resultados: Foram incluídos 39 pacientes com FC e 45 controles. Ossujeitos com FC apresentaram do índice de massa corporal menor (p=0,011). Acomposição corporal e a espessura muscular foram similares entre os grupos. Apenas a circunferência da panturrilha (p=0,023) e o diâmetro do fêmur (p<0,001) foram menores nos pacientes com FC. Embora sem diferença na comparação dos achados ultrassonográficos da gordura subcutânea, os pacientes com FC apresentaram redução das dobras cutâneas do tríceps (p=0,0031) e do quadríceps (p=0,019). Além disso, observaram-se correlações fracas e moderadas da espessura do quadríceps pelo ultrassom com a capacidade vital forçada (CVF) e massa magra, respectivamente. Também houve correlações moderadas das pregas cutâneas do tríceps, quadríceps e gastrocnêmio com a gordura subcutânea avaliada pela ultrassonografia. Conclusões: Pacientes com FC apresentaram menor espessura da gordura subcutânea. A espessura muscular se correlacionou com a CVF e os parâmetros nutricionais, e a ultrassonografia apresentou correlação positiva com as pregas cutâneas.

ABSTRACT Objective: To compare muscle thickness and subcutaneous fat in cystic fibrosis (CF) patients and healthy controls using ultrasonography (US), and to correlate US findings with nutritional, clinical and functional variables. Methods: Patients aged 6 to 18 years old with a diagnosis of CF and healthy controls were included. Participants underwent anthropometric measurements, an ultrasonographic evaluation of muscle thickness and subcutaneous fat in the triceps, quadriceps, and gastrocnemius regions, and skinfold thickness measurements. Body fat percentage was estimated using skinfold measurement. Subjects with CF also underwent a pulmonary function assessment using spirometry. Results: We studied 39 CF patients and 45 controls. Alower body mass index was observed in CF patients (p=0.011). Body composition and muscle thickness were similar between the groups. Only calf (p=0.023) circumference and femur diameter (p<0.001) were lower in CF patients. Although there were no significant between-group differences in the comparison of US measurements of subcutaneous fat, CF patients exhibited decreased skinfold thickness in the triceps (p=0.031) and quadriceps (p=0.019). Moreover, there were weak and moderate correlations of US quadricep thickness with forced vital capacity (FVC) and lean mass, respectively. Moderate correlations of the triceps, quadriceps and gastrocnemius between US subcutaneous fat and skinfold measurements were found. Conclusions: Patients with CF presented a reduction in subcutaneous fat content. Muscle thickness correlated with FVC and nutritional parameters. In addition, US findings correlated positively with skinfold measurements.

Anthropometry and body composition of adolescents in Macedonia / Antropometría y composición corporal de adolescentes en Macedonia

The aim of this research was to determine the level of adiposity and obesity among Macedonian adolescents and to compare the results with previous studies conducted in this population, as well as those conducted in other populations. The sample included 2390 adolescents from four urban different regions of R. Macedonia aged between 11 to 18 years; 1238 males and 1152 females. Weight, height, waist, and hip circumference (WC, HC) as well as triceps, calf, subscapular, and suprailiac skinfold thickness (SFT) were measured. Body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), subscapular/triceps skinfold ratio (STR), and percentage body fat were computed. The prevalence of overweight and obesity defined by the IOTF children growth reference were calculated and age-dependent and gender-specific smoothed percentile curves for BMI and ROC curves were generated. The boys have statistically significantly higher values of WC, WHR and WHtR in all adult categories (except WHtR at 18 years old), greater body weight at the age of 12 to 18, and body weight 13 to 18 years (p<0.001). Weight, height and BMI are increasing with age in both, boys and girls, and decreases in girls. The level of adiposity of Macedonian adolescents has increased over the past 20 years and has reached the level of developed countries that face an obesity epidemic.

El objetivo de esta investigación consistió en determinar el nivel de adiposidad y obesidad entre los adolescentes macedonios y comparar los resultados con estudios previos realizados en esta población, así como aquellos realizados en otras poblaciones. La muestra incluyó a 2390 adolescentes de cuatro regiones urbanas diferentes de R. Macedonia con edades comprendidas entre 11 y 18 años (1238 hombres y 1152 mujeres). Se midieron el peso, la altura, la cintura y la circunferencia de la cadera (WC, HC), así como el grosor del pliegue cutáneo tríceps, pantorrilla, subescapular y suprailíaco (SFT). Se calcularon el índice de masa corporal (IMC), la relación cintura-cadera (WHR), la relación cintura-altura (WHtR), la relación de pliegue subcutáneo / tríceps (STR) y el porcentaje de grasa corporal. Se calcularon las prevalencias de sobrepeso y obesidad definidas por la referencia de crecimiento de niños IOTF y se generaron curvas percentiles suavizadas dependientes de la edad y de sexo para las curvas BMI y ROC. Los niños tuvieron valores estadísticamente significativamente más altos de WC, WHR y WHtR en todas las categorías de adultos (excepto WHtR a los 18 años), mayor peso corporal a la edad de 12 a 18 años y peso corporal de 13 a 18 años (p <0,001). El peso, la estatura y el IMC aumentan con la edad tanto en niños como en niñas y disminuyen en las niñas. El nivel de adiposidad de los adolescentes macedonios ha aumentado en los últimos 20 años y ha alcanzado el nivel de los países desarrollados que enfrentan una epidemia de obesidad.

Development and validation of anthropometric equations to estimate body composition in adult women / Desarrollo y validación de ecuaciones antropométricas para estimar la composición corporal en mujeres adultas

Abstract Objective: To develop anthropometric equations to predict body fat percentage (BF%). Methods: In 151 women (aged 18-59) body weight, height, eight- skinfold thickness (STs), six- circumferences (CIs), and BF% by hydrodensitometry were measured. Subjects data were randomly divided in two groups, equation-building group (n= 106) and validation group (n= 45). The equation-building group was used to run linear regression models using anthropometric measurements as predictors to find the best prediction equations of the BF%. The validation group was used to compare the performance of the new equations with those of Durnin-Womersley, Jackson-Pollock and Ramirez-Torun. Results: There were two preferred equations: Equation 1= 11.76 + (0.324 x tricipital ST) + (0.133 x calf ST) + (0.347 x abdomen CI) + (0.068 x age) - (0.135 x height) and Equation 2= 11.37 + (0.404 x tricipital ST) + (0.153 x axilar ST) + (0.264 x abdomen CI) + (0.069 x age) - (0.099 x height). There were no significant differences in BF% obtained by hydrodensitometry (31.5 ±5.3) and Equation 1 (31.0 ±4.0) and Equation 2 (31.2 ±4.0). The BF% estimated by Durning-Womersley (35.8 ±4.0), Jackson-Pollock (26.5 ±5.4) and Ramirez-Torun (32.6 ±4.8) differed from hydrodensitometry (p <0.05). The interclass correlation coefficient (ICC) was high between hydrodensitometry and Equation 1 (ICC= 0.77), Equation 2 (ICC= 0.76), and Ramirez-Torun equation (ICC= 0.75). The ICC was low between hydrodensitometry and Durnin-Womersley (ICC= 0.51) and Jackson-Pollock (ICC= 0.53) equations. Conclusion: The new Equations-1 and 2, performed better than the commonly used anthropometric equations to predict BF% in adult women.

Resumen Objetivo: Desarrollar ecuaciones antropométricas para predecir el porcentaje de grasa corporal (%GC). Métodos: En 151 mujeres (18-59 años) se midieron peso corporal, estatura, ocho pliegues cutáneos (PCs), seis perímetros (PEs) y el %GC por hidrodensitometría. Se formaron dos grupos al azar, desarrollo de ecuaciones (n=106) y validación (n= 45). En el grupo desarrollo ecuaciones se calcularon modelos de regresión lineal, con las medidas antropométricas como predictores, para encontrar la mejor ecuación de predicción del %GC. El grupo validación se utilizó para comparar el desempeño de las nuevas ecuaciones con las de Durnin-Womersley, Jackson-Pollock y Ramírez-Torun. Resultados: Se seleccionaron dos ecuaciones: Ecuación-1= 11.76 + (0.324 x tríceps PC) + (0.133 x pantorrilla-medial PC) + (0.347 x abdomen PE) + (0.068 x edad-años) - (0.135 x estatura) y Ecuación-2= 11.37 + (0.404 x tríceps PC) + (0.153 x axilar PC) + (0.264 x abdomen PE) + (0.069 x edad-años) - (0.099 x estatura). No hubo diferencias significativas en el %GC obtenido por hidrodensitometría (31.5 ±5.3) y Ecuación-1 (31.0 ±4.0) o Ecuación-2 (31.2 ±4.0). Los %GC estimados por Durning-Womersley (35.8 ±4.0), Jackson-Pollock (26.5 ±5.4) y Ramírez-Torun (32.6 ±4.8) fueron diferentes del obtenido por hidrodensitometría (p <0.05). El coeficiente de correlación intraclase (ICC) fue alto entre hidrodensitometría y las Ecuaciones 1 (ICC= 0.77), 2 (ICC= 0.76), y Ramírez-Torun (ICC= 0.75). El ICC fue bajo entre hidrodensitometría y Durnin-Womersley (ICC= 0.51) y Jackson-Pollock (ICC= 0.53). Conclusión: Las nuevas ecuaciones 1 y 2 presentaron mejor rendimiento que las ecuaciones tradicionales para predecir el %GC en mujeres adultas.

Validez del porcentaje de grasa corporal por pliegues cutáneos comparado con la dilución de óxido de deuterio en escolares costarricenses / Validity of percent body fat by skinfold thickness comparated with deuterium oxide dilution in Costa Rican school children

El objetivo del estudio fue determinar la validez del porcentaje de grasa corporal (% GC) estimado por la ecuación de Slaughter en escolares costarricenses. Participaron 54 niños y 49 niñas con una edad promedio 7.8 ± 1.0 años. El óxido de deuterio (D2O) fue el método de referencia para determinar la masa grasa (FM) expresada como % GC. Se utilizó un análisis de regresión lineal y prueba t para determinar la asociación y las diferencias entre el %GC por la ecuación de Slaughter y D2O. La concordancia entre métodos se determinó por el coeficiente de correlación de concordancia (CCC) de Lin. La medición de acuerdo entre los métodos se analizó mediante el procedimiento de Bland-Altman. El % GC entre métodos fue significativamente diferente en niños (26.3 ± 7.4% vs 22.4 ± 7.0%) y niñas (33.2 ± 5.7% vs 26.1 ± 5.7%). La asociación entre métodos no fue significativa en niños (R2 = 0.76, p <0.0001) y niñas (R2 = 0.24, p <0.0001). Los gráficos de Bland-Altman mostraron que la ecuación de Slaughter subestimó el % GC en 6,0% en niños y 3,5% en niñas, en comparación con D2O. El CCC de Lin identificó una fuerza de concordancia pobre entre métodos, niños ρc= 0.87 y niñas ρc= 0.56. Con los resultados se concluye que la ecuación de Slaughter registró baja concordancia del % GC en comparación con el D2O en escolares costarricenses(AU)

The aim of the study was to determine the validity of the body fat percentage (% GC) estimated by the Slaughter equation in Costa Rican school children. The sample consisted of 54 male and 49 female, mean age 7.8 ± 1.0 years. Deuterium oxide dilution (D2O) was the reference method to determine the fat mass (FM) expressed as BF%. Linear regression analyses and paired sample t-tests were used to test association and mean differences between Slaughter equation and D2O BF%. Concordance between Slaughter equation and D2O BF% was determined by Lin's concordance correlation coefficient (CCC). Measurement of agreement between the two methods was analyzed using the Bland-Altman procedure. Measurements of BF% by Slaughter equation and D2O were significantly different for boys (26.3 ± 7.4% vs 22.4 ± 7.0%) and for girls (33.2 ± 5.7% vs 26.1 ± 5.7%). Non-significant association between methods was found in males (R2 = 0.76, p <0.0001) and females (R2 = 0.24, p <0.0001). Bland-Altman plots showed that Slaughter equation underestimated the %BF in a 6.0% for boys and in a 3.5% for girls compared with D2O. Lin's CCC identified poor strength of concordance between the two methods, for boys ρc= 0.87 and for girls ρc= 0.56. With the results we conclude that the Slaughter equation registered low agreement of BF% compared against the one obtained by D2O in Costa Rican school children(AU)

Correlation between dermal thickness and scar formation in female patients after thyroidectomy

BACKGROUND: Minimizing scarring has long been a challenge in plastic surgery. Factors affecting scar formation are well known, but the effect of some patient-specific factors such as dermal thickness remains unverified. Management of factors predictive of scarring can improve postoperative patient satisfaction and scar treatment. METHODS: For 3 years, we used ultrasonography to measure dermal thickness in female patients who had undergone thyroidectomy for cancer at our hospital. We confirmed the influence of dermal thickness on hypertrophic scar formation and the Patient and Observer Scar Assessment Scale scar score 6 months after surgery. RESULTS: There was a positive correlation between dermal thickness and scar score (p < 0.05), and dermal thickness appears to be a cause of hypertrophic scar formation (p < 0.05). CONCLUSION: Thick dermis was found to cause poor scar formation and hypertrophic scarring. Prediction of factors that can influence scar formation can be used to educate patients before surgery and can help in scar management and improvement in patient satisfaction.

Adiposity Measurements and Related Characteristics of Young Children Born Prematurely

PURPOSE: This study was conducted to measure adiposity and to investigate related factors in preschoolers born prematurely. METHODS: A longitudinal follow-up study was conducted with 52 preschoolers at 5 years of corrected age among 343 preterm infants. Their adiposity status was evaluated based on measurements of body mass index, subscapular and triceps skin fold thickness (SFT), waist circumference, waist-to-height ratio, and mid-arm circumference at a home visit. RESULTS: The findings showed that SFT measurements, particularly at the triceps, reflected the degree of adiposity more accurately than other conventional measures. A shorter gestation, older maternal age, and the mother having more years of formal education were associated with higher levels of adiposity in the preschoolers. CONCLUSION: The adiposity of children born prematurely needs to be thoroughly monitored with additional SFT measurements, considering the risk of accelerated growth patterns overriding regular catch-up growth in children born prematurely.

Are traditional body fat equations and anthropometry valid to estimate body fat in children and adolescents living with HIV?

Abstract The aim of this study was to assess the validity of traditional anthropometric equations and to develop predictive equations of total body and trunk fat for children and adolescents living with HIV based on anthropometric measurements. Forty-eight children and adolescents of both sexes (24 boys) aged 7-17 years, living in Santa Catarina, Brazil, participated in the study. Dual-energy X-ray absorptiometry was used as the reference method to evaluate total body and trunk fat. Height, body weight, circumferences and triceps, subscapular, abdominal and calf skinfolds were measured. The traditional equations of Lohman and Slaughter were used to estimate body fat. Multiple regression models were fitted to predict total body fat (Model 1) and trunk fat (Model 2) using a backward selection procedure. Model 1 had an R2 = 0.85 and a standard error of the estimate of 1.43. Model 2 had an R2 = 0.80 and standard error of the estimate = 0.49. The traditional equations of Lohman and Slaughter showed poor performance in estimating body fat in children and adolescents living with HIV. The prediction models using anthropometry provided reliable estimates and can be used by clinicians and healthcare professionals to monitor total body and trunk fat in children and adolescents living with HIV.

Prognóstico e avaliação nutricional de doentes com doença hepática crônica com recurso à antropometria e avaliação global subjetiva / Outcome and nutritional assessment of chronic liver disease patients using anthropometry and subjective global assessment

ABSTRACT BACKGROUND: Protein-calorie malnutrition is common in chronic liver disease (CLD) but adequate clinical tools for nutritional assessment are not defined. OBJECTIVE: In CLD patients, it was aimed: 1. Characterize protein-calorie malnutrition; 2. Compare several clinical, anthropometric and functional tools; 3. Study the association malnutrition/CLD severity and malnutrition/outcome. METHODS: Observational, prospective study. Consecutive CLD ambulatory/hospitalised patients were recruited from 01-03-2012 to 31-08-2012, studied according with age, gender, etiology, alcohol consumption and CLD severity defined by Child-Turcotte-Pugh. Nutritional assessment used subjective global assessment, anthropometry, namely body-mass index (BMI), triceps skinfold, mid upper arm circumference, mid arm muscular circumference and handgrip strength. Patients were followed during two years and survival data was recorded. RESULTS: A total of 130 CLD patients (80 men), aged 22-89 years (mean 60 years) were included. Most suffered from alcoholic cirrhosis (45%). Hospitalised patients presented more severe disease ( P <0.001) and worst nutritional status defined by BMI ( P =0.002), mid upper arm circumference ( P <0.001), mid arm muscular circumference ( P <0.001), triceps skinfold ( P =0.07) and subjective global assessment ( P <0.001). A third presented deficient/low handgrip strength. Alcohol consumption ( P =0.03) and malnutrition detected by BMI ( P =0.03), mid upper arm circumference ( P =0.001), triceps skinfold ( P =0.06), mid arm muscular circumference ( P =0.02) and subjective global assessment ( P <0.001) were associated with CLD severity. From 25 patients deceased during follow-up, 17 patients were severely malnourished according with triceps skinfold. Malnutrition defined by triceps skinfold predicted mortality ( P <0.001). CONCLUSION: Protein-calorie malnutrition is common in CLD patients and alcohol plays an important role. Triceps skinfold is the most efficient anthropometric parameter and is associated with mortality. Nutritional assessment should be considered mandatory in the routine care of CLD patients.

RESUMO CONTEXTO: A desnutrição calórico-proteica é frequente na doença hepática crônica (DHC), no entanto, ferramentas clínicas adequadas para avaliação nutricional destes doentes não estão definidas. OBJETIVO: Em doentes com DHC, pretendeu-se: 1. Caracterizar a desnutrição calórico-proteica; 2. Comparar diferentes ferramentas clínicas, antropométricas e funcionais de avaliação nutricional; 3. Estudar a associação desnutrição/gravidade da DHC e desnutrição/prognóstico. MÉTODOS: Estudo observacional e prospetivo. Foram recrutados doentes ambulatórios/hospitalizados de 01-03-2012 a 31-08-2012 e estudados tendo em conta a idade, gênero, etiologia, consumo alcoólico e gravidade da DHC definida pelo score Child-Turcotte-Pugh. A avaliação nutricional incluiu a utilização da avaliação global subjetiva, antropometria nomeadamente índice de massa corporal (IMC), perímetro braquial, circunferência muscular do braço, prega cutânea tricipital e dinamometria. Os doentes foram seguidos durante 2 anos e foi registada a respectiva sobrevida. RESULTADOS: Foram incluídos 130 doentes com DHC (80 homens) com idade 22-89 anos (média 60 anos). A maioria apresentava cirrose alcoólica (45%). Os doentes hospitalizados apresentaram doença hepática mais severa ( P <0,001) e pior estado nutricional, definido pelo IMC ( P =0,002), perímetro braquial ( P <0,001), circunferência muscular do braço ( P <0,001), prega cutânea tricipital ( P =0,07) e avaliação global subjetiva ( P <0,001). Um terço apresentava força de preensão manual deficiente/baixa. O consumo alcoólico ( P =0,03) e a desnutrição detetada pelo IMC ( P =0,03), perímetro braquial ( P =0,001), prega cutânea tricipital ( P =0,06), circunferência muscular do braço ( P =0,02) e avaliação global subjetiva ( P <0,001) encontraram-se associados à gravidade da DHC. Dos 25 doentes que faleceram durante o seguimento, 17 apresentavam desnutrição severa definida pela prega cutânea tricipital. A desnutrição definida pela prega cutânea tricipital revelou ser um fator preditivo de mortalidade ( P <0,001). CONCLUSÃO: A desnutrição calórico-proteica é comum na DHC para a qual o álcool desempenha um papel importante. A prega cutânea tricipital é o parâmetro antropométrico mais eficiente e encontra-se associado à mortalidade. A avaliação nutricional deve ser considerada mandatória na abordagem rotineira de doentes com DHC.