Gender differences in body fat content are present well before puberty

To determine whether gender differences in body fat could be detected in prepubertal children using dual energy X-ray absorptiometry (DEXA), body composition was measured in 20 healthy boys aged 3-8 y matched for age, height and weight with 20 healthy girls. Although boys and girls did not differ in age, height, weight, body mass index (BMI) or bone mineral content, the boys had a lower percentage of body fat (13.5 +/- 5.1 vs 20.4 +/- 6.1%, P < 0.01), a lower fat mass (3.2 +/- 2.0 vs 4.9 +/- 3.1 kg, P < 0.01), and a higher bone-free lean tissue mass (18.6 +/- 4.3 vs 17.0 +/- 3.5 kg, P < 0.01) than the girls. Girls had approximately 50% more body fat than the boys. This is the first DEXA study to show that boys aged 3-8 y have less body fat than girls of similar age, height and weight. Thus, this technology demonstrates that significant gender differences in body composition are evident, well before the onset of puberty.     

Body composition in normal subjects: relation to lipid and glucose variables

OBJECTIVE: To describe sex- and age-dependent values of total and regional body composition as determined by dual-energy X-ray absorptiometry (DXA) in normal subjects, and furthermore to relate body composition measurements to blood lipids, glucose and insulin concentrations. DESIGN: A cross-sectional study. SUBJECTS: 173 (84 male and 89 female) healthy subjects, BMI < 30 kg/m2. MEASUREMENTS: Body composition parameters including data on total bone mineral content (TBMC), total bone mineral density (TBMD), lean body soft tissue mass (LTM), total and regional fat mass (FM) were estimated in all subjects. In 87 of the subjects fasting blood glucose, S-insulin and lipid profile were measured. RESULTS: The study population was for each sex divided into five decades for which results on body composition and blood lipids are presented. Body weight increased 2 kg per age decade, representing a significant increase in both total FM and relative FM (FM%BW) with age, and in males a central accumulation of FM. LTM decreased significantly in males but not in females, whereas TBMC and TBMD remained constant in males, but decreased in females. A significant correlation between relative FM and S-cholesterol, S-triglyceride, and in males S-insulin was found. CONCLUSION: The present study gives coherent data on bone mineral content, lean body soft tissue mass total and regional fat mass for 173 healthy subjects with a BMI below 30 kg/m2. Total body fat mass increases, and lean mass decreases with age. In males a simultaneous central accumulation of fat mass is observed. The well-known relationship between central obesity and lipids is confirmed even in non-obese subjects.     

Changes in body composition during growth in healthy school-age children

Bone-mineral-free lean body mass (LBM) and fat mass (FM) were determined by DXA scanning in 343 healthy children and adolescents (142 males) aged 4.9-19.3 yr. The main sex difference was the earlier flattening of the LBM according to age curve for girls compared to boys and the higher increase in FM with age in girls. 332 persons (140 males) were examined again after 1 yr and accretion rates for LBM and FM were calculated. The main sex difference was a later and higher peak in LBM accretion in boys compared to girls and a nearly constant increase in FM throughout puberty in girls, while boys had no increase in FM during puberty. The differences may reflect the higher androgen production in male puberty.     

Differences in body composition of black and white girls

Adults have racial differences in body composition that may modulate risks resulting from obesity. Although black and white children have been shown previously to have differences in bone mineral density and subcutaneous body fat, differences in visceral adipose tissue have not been evaluated. We studied 20 black and 20 white normal-weight girls aged 7-10 y, who were matched for weight, body mass index (BMI), bone age, chronological age, Tanner breast stage, and socioeconomic status. Each underwent anthropometric measurements, bioelectrical impedance analysis, dual-energy X-ray absorptiometry (DXA), and abdominal magnetic resonance imaging (MRI) for determination of total (TAT), visceral (VAT), and subcutaneous (SAT) adipose tissue. Serum lipids and fasting and 2-h oral-glucose-tolerance test (OGTT) glucose and insulin concentrations were also measured. There were no differences between groups in absolute waist circumference or waist-to-hip ratio, but waist-to-thigh ratio was smaller in black than in white girls. Black girls had greater bone mineral density and less TAT, VAT, and SAT than whites. VAT was not significantly correlated with any measure of insulin, or with serum lipids. However, both basal and 2-h OGTT serum insulin were significantly correlated with SAT as assessed by MRI in black girls (r2 = 0.46 for basal insulin, P = 0.001: r2 = 0.31 for 2-h insulin, P = 0.01) but not in white girls (r2 < 0.05, for basal and 2-h insulin, NS). We conclude that there are significant racial differences in body composition and differences in the strength of association between abdominal adipose tissue depots and insulin sensitivity in black and white girls.     

Composition analysis of pork carcasses by dual-energy x-ray absorptiometry

Dual-energy x-ray absorptiometry (DXA) was used as a noninvasive method to measure the composition of pig carcasses. A total of 181 half-carcasses (10 to 51 kg, from pigs slaughtered at approximately 30, 60, 90, and 120 kg) were scanned using a Lunar (Madison, WI) DPX-L densitometer. The DXA measurements of fat, lean, bone mineral, and total tissue mass were compared with chemical analysis for fat, water, protein, total ash, and scale weight. The mean value for total tissue mass by DXA was slightly less than the mean carcass weight (32.3 kg vs 33.6 kg, P > .05, R2 = .998). Although highly correlated (R2 = .81), the DXA measurement of the percentage of fat in the half-carcass was less (P < .001) than the chemical measurement (19.5 vs 24.9%). The DXA measurement of lean tissue mass (total mass less fat and bone mineral) was correlated with carcass protein (R2 = .97) and water (R2 = .99) content. The correlation (R2) between DXA bone mineral content and carcass ash content was only .68; however, DXA bone mineral content was more highly correlated with carcass weight (R2 = .93) than was carcass ash content (R2 = .70). When we used the DXA R value (ratio of the attenuation coefficients for fat and lean) to predict percentage of fat in the carcass, the mean value for predicted carcass fat was 25.9% (P > .05). Similarly, carcass protein and water content were predicted from DXA lean. Using DXA region of interest analysis, estimates of the fat content of the shoulder and ham regions were close to chemical values; however, DXA underestimated the fat content of the loin and side regions by 20 and 28%, respectively. When prediction equations were used to evaluate DXA measurements of the half-carcasses of 28 gilts and 37 boars slaughtered at approximately 120 kg, the half-carcasses of gilts contained more fat (33.9 vs 27.8%, P < .001), less protein (14.1 vs 16.1%, P < .001), and less water (45.9 vs 52.1%, P < .001) than those of boars. These results indicate that DXA could be a valuable research tool for measuring the composition of pig carcasses. On the basis of the results of this study, prediction equations were revised for the DXA estimation of fat, protein, and water content of the half-carcass: Fat (%) = 450 - (315 x DXA R value), Protein (g) = -145 + (.23 x DXA lean), and Water (g) = 150 + (.73 x DXA lean). Furthermore, it seems that separate prediction equations are needed for regional analysis.     

Impact of hydration status on body composition as measured by dual energy X-ray absorptiometry in normal volunteers and patients on haemodialysis

To evaluate the influence of hydration status on the estimation of body composition using dual-energy X-ray absorptiometry (DXA), six normal volunteers and seven patients on maintenance haemodialysis were investigated using two different DXA machines (Lunar DPX, Hologic QDR 1000/W). Normal volunteers were studied (Hologic QDR 1000/W) before and 1 h after ingestion of breakfast, lunch and dinner (drinking various amounts of liquids at each meal, 0.5-2.4 kg). Whereas bone mineral content and body fat mass did not change, lean body mass of the trunk increased as a consequence of the meals. Conversely in patients on haemodialysis (Lunar DPX), lean body mass decreased in all segments of the body as a consequence of removal of 0.9-4.4 kg of salt-containing fluid by haemodialysis (trunk 61%, legs 30%, arms 5.5% and rest of the body 3.5%), whereas bone mineral content and body fat mass remained unchanged. However, this finding(s) did not hold true in one particular patient with bilateral hip prostheses. Measurement of body composition in eight normal volunteers on the same day with both machines showed similar results for lean and fat mass, whereas bone mineral content was found to be 17% higher using the Lunar DPX. In summary, in centres where both machines are available, follow-up of one individual patient should always be performed using the same equipment. In addition, hydration status and food intake must be taken into account when repetitive measurements of lean body mass are performed in the same patient.     

Concrete/mortar water phase transition studied by single-point MRI methods

A total of 231 pigs were anesthetized and then scanned by DXA using a Lunar DPXL instrument. The weight of the pigs ranged from 5 to 97 kg (av. = 37.7 kg). Of the total, 98 pigs were scanned using the pediatric mode and 133 pigs were scanned using the adult mode. After scanning, the pigs were euthanized, the entire body homogenized by grinding, and analyzed chemically for fat, water, protein and total body mineral content. The mean value for the DXA total tissue mass (37.1 kg) was not significantly (P > 0.05, n = 231) different from the mean body weight. The mean DXA value for percent fat was 14.6 and was significantly less (P < 0.05) than the mean value (17.6%) measured by CHEM analysis. The greatest discrepancy occurred in pigs with < 15% body fat. From a prediction equation using the DXA R value [% fat = 493-349(DXA R value)], the DXA estimated percent fat was 18.0%, compared to 17.6% by CHEM analysis (P > 0.05). Using a prediction equation [g protein = -1.062 + 0.22(g DXA lean)], the DXA estimate for body protein content was 17.8%, compared to 17.1% (P < 0.05, n = 131) by CHEM analysis. The DXA estimate for body water content [g water = 508 + 0.74 (g DXA lean)] was 63.8%, compared to 62.6% (P < 0.05, n = 231) by CHEM analysis. The bone mineral content of 83 of the pigs measured by DXA was 2.40%, compared to 2.54% (P < 0.05, n = 83) estimated from CHEM analysis of total body ash [g bone mineral = g total body ash -0.0085(g DXA lean)].     

Evaluation of modified multicompartment models to calculate body composition in healthy males

Body volume was measured by underwater weighing (UWW) or with a skinfold caliper; bone mineral by dual energy X-ray absorptiometry (DXA); and body water by bioelectrical impedance analysis (BIA) in 22 healthy males. The percentage of water and bone mineral in fat-free mass had a significant effect on the calculated amount of fat using a two-compartment model. A three-compartment model based on field-adapted methods (skinfold thickness + BIA) to calculate body fat, correlated significantly with a more complex four-compartment model (UWW + BIA + DXA) (r = 0.95, p < 0.001). The advantages of three- and four-compartment equations are that they reduce the number of assumptions.     

Body composition analysis by dual energy X-ray absorptiometry in female diabetics differ between manufacturers

OBJECTIVE: Comparison of body composition results by two dual energy X-ray absorptiometry (DXA) instruments, namely QDR-2000 from Hologic Inc and from Lunar in subpopulations of lean and obese subjects. DESIGN: Cross-sectional study with 85 female diabetics (BMI 18-43 kg/m2) measured with both DXA instruments. RESULTS: The regression lines for fat tissue mass (FTM), FAT% and total body bone mineral content (TBMC), but not lean tissue mass (LTM), were different from the line of identity (P < 0.01). However, the relationships were high (r2 > 0.95), and the corresponding SEE%'s were low (0.8-4.8%), and were independent of BMI. FTM and FAT% measured by the QDR-2000 were 10% higher, and LTM and TBMC 6% lower, than by DPX (P < 0.001). CONCLUSIONS: There were lack of agreements between total body composition results by DPX Lunar, and QDR-2000 Hologic Inc. Individual results on the two systems cannot be directly compared. Standardization of body composition measurements by DXA is strongly needed.     

Monte Carlo modelling of an extended DXA technique

The precision achieved in measuring bone mineral density (BMD) by commercial dual-energy x-ray absorptiometry (DXA) machines is typically better than 1%, but accuracy is considerably worse. Errors, due to inhomogeneous distributions of fat, of up to 10% have been reported. These errors arise because the DXA technique assumes a two-component model for the human body, i.e. bone mineral and soft tissue. This paper describes an extended DXA technique that uses a three-component model of human tissue and significantly reduces errors due to inhomogeneous fat distribution. In addition to two x-ray transmission measurements, a measurement of the path length of the x-ray beam within the patient is required. This provides a third equation, i.e. T = ts + tb + tf where T, ts, tb and tf are the total, lean soft tissue, bone mineral and fatty tissue thicknesses respectively. Monte Carlo modelling was undertaken to make a comparison of the standard and extended DXA techniques in the presence of inhomogeneous fat distribution. Two geometries of varying complexity were simulated. In each case the extended DXA technique produced BMD measurements that were independent of soft tissue composition whereas the standard technique produced BMD measurements that were strongly dependent on soft tissue composition. For example, in one case, the gradients of the plots of BMD versus fractional fat content were for standard DXA (-0.183+/-0.037) g cm(-2) and for extended DXA (0.027+/-0.044) g cm(-2). In all cases the extended DXA method produced more accurate but less precise results than the standard DXA technique.     

Antiperistaltic transverse colostomy for massive bowel necrosis following surgery for an abdominal aortic aneurysm: report of a case

We investigated the reproducibility of total and regional body composition measurements performed on a dual energy X-ray absorptiometer (DXA). A group of 58 women aged 21-81 (mean 52.4) years was scanned twice with repositioning to determine intraobserver reproducibility of measurements of bone mineral density (BMD, g.cm-2), bone mineral content (BMC, g), lean mass (LM, kg) and fat mass (FM, kg) of the total body and of the major subregions of the body. In addition, the ability of the DXA machine to detect changes in LM and FM (simulated by placing 11.1 and 22.3 kg porcine lard on the body of 11 subjects) was examined. Coefficients of variations calculated from the root mean square averages of individual standard deviations were as follows (BMD, BMC, LM, FM) [corrected]: 1.4%, 1.1%, 1.4%, 1.7% (total body), 2.2%, 2.1%,-,- (head), 2.8%, 2.8%, 2.0%, 2.2% (trunk), 3.6%, 3.9%, 4.0%, 4.9% (arms), 2.7%, 1.3%, 2.6%, 2.8% (legs). Percentage fat (%fat) of exogenous lard was 81.3 (SD 3.5)% as assessed by the absorptiometer which corresponded well with the result of chemical analysis (82.8%). Estimated %fat of exogenous lard was not influenced by initial body mass or percentage body fat. Percentages of expected mean values with 11.1 kg lard placed on the body were 99.9 (SD 0.3) for body mass, 100.5 (SD 2.1) for LM, and 99.5 (SD 3.5) for FM. BMD was overestimated by 3.2% (P < 0.005) with 11.1 kg lard on the body. BMD as well as BMC increased significantly with 22.3 kg lard on the body (P < 0.005). The results showed that BMD, BMC, LM, and FM of the total body were precisely estimated by the DXA machine used. Regional measurements were less precise. Changes in total body soft tissue composition were precisely and accurately estimated. The lard placed on the body falsely affected BMD and BMC measurements. Changes in body mass could have a similar effect.     

Changes in bone mineral density, body composition, and lipid metabolism during growth hormone (GH) treatment in children with GH deficiency

Adults with childhood onset GH deficiency (GHD) have reduced bone mass, increased fat mass, and disorders of lipid metabolism. The aim of the present study was to evaluate bone mineral density (BMD), bone metabolism, body composition, and lipid metabolism in GHD children before and during 2-3 yr of GH treatment (GHRx). Forty children with GHD, mean age 7.9 yr, participated in the study of bone metabolism and body composition; and an additional group of 17 GHD children, in the study of lipid metabolism. Lumbar spine BMD, total body BMD, and body composition were measured with dual-energy x-ray absorptiometry. Volumetric BMD (bone mineral apparent density, BMAD) was calculated to correct for bone size. BMD, BMAD, lean tissue mass, bone mineral content, fat mass, and percentage body fat were expressed as SD scores (SDS), in comparison with normative data of the same population. Lumbar spine BMD and BMAD and total body BMD were all decreased at baseline. All BMD variables increased significantly during GHRx, lumbar spine BMD SDS, already after 6 months of treatment. Lean tissue mass SDS increased continuously. Bone mineral content SDS started to increase after 6 months GHRx. Fat mass SDS decreased during the first 6 months of GHRx and remained stable thereafter. Biochemical parameters of bone formation and bone resorption did not differ from normal at baseline and increased during the first 6 months of GHRx. Serum 1,25 dihydroxyvitamin D increased continuously during GHRx, whereas PTH and serum calcium remained stable. Lipid profile was normal at baseline: Atherogenic index had decreased and apolipoprotein A1(Apo-A1) had increased after 3 yr of treatment. In conclusion, children with GHD have decreased bone mass. BMD, together with height and lean tissue mass, increased during GHRx. GHRx had a beneficial effect on lipid metabolism.     

Expression of cellular adhesion regulatory molecule in hepatocellular carcinoma

OBJECTIVE: Studying gender differences in fat mass and distribution in a homogeneous group of children. DESIGN: Cross-sectional study. SUBJECTS: 610 children aged 5-7 y in Kiel, Germany. METHODS: Anthropometric measures, bioelectrical impedance analysis (BIA). RESULTS: Although boys had increased body weights (P<0.05), body mass indexes (BMI's) (P<0.001) and waist/hip ratios (WHRs) (P<0.001), the %fat mass as assessed by BIA (P<0.05) was increased in girls. Although the increased BMI in boys was independent of the percentile used, gender differences (that is, lower values for boys than for girls at the same age) in WHR, the sum of four skinfolds and %fat were seen up to the 90th percentile. By contrast, above the 90th percentile there were no differences in skinfold thickness and %fat between boys and girls. Studying 42 BMI-matched pairs (boys and girls) also showed that the %fat estimated by BIA (P<0.001) was increased in girls. Plotting the average of %fat as obtained from skinfold- and BAI-measurements against the difference between data obtained by the use of the two methods shows that BIA %fat overestimates skinfold %fat at low or normal percent fat mass (that is, up to 20%) in both genders. By contrast, at increased fat mass, BIA %fat seems to underestimate skinfold %fat in both genders. CONCLUSIONS: Gender differences in fat mass and fat distribution are obvious in children aged 5-7 y. These differences are independent of gender differences in body weight. However, the nutritional state has an influence and gender differences cannot be detected in overweight and obese children. Our data also suggest that a children-specific formula used to calculate %fat from skinfold measurements is inappropriate.     

An evaluation of dual-energy X-Ray absorptiometry and underwater weighing to estimate body composition by means of carcass analysis in piglets

To evaluate the use of dual-energy X-ray absorptiometry (DXA) and underwater weighing (UWW) for body-composition measurements, the carcasses of eight piglets (12-wk old, 15-22 kg in weight) were dissected into muscle, fat and bone. Thereafter, the components were homogenized and chemically analyzed for fat and bone mineral mass. Body components as measured by DXA correlated closely to the carcass analysis (r = 0.90-1.0). However, DXA still overestimated significantly the bone mineral mass, lean mass and total weight, and underestimated fat mass. The reproducibility of measurements, expressed as the CV for fat mass was 13.5%, whereas for total weight, lean mass and bone mineral mass, the CV was 0.74-1.9%. Fat mass was overestimated by UWW using the equations of Siri or Kraybill (r = 0. 77), but not by the equation of Lohman et al. (r = 0.69). The difference between the estimation of fat by chemical analysis and estimations by DXA and UWW was significantly affected by the amount of water in lean mass and fat-free mass.     

Effect of sex and age on bone mass, body composition and fuel metabolism in humans

The mechanism(s) governing the gain of upper-body fat and its relationship to the decrease in bone mass with age is still unclear. Therefore, four groups of subjects matched for weight, height, and body mass index (n = 119; 60 women, 59 men), but differing in age (above and below 50 y) and sex were investigated using dual energy x-ray absorptiometry (DXA) to assess body composition (bone, lean, and fat mass as well as its distribution) and indirect calorimetry to determine resting fuel metabolism. Fat mass of trunk and arms (P < 0.01), but not legs, increased with advancing age in males, resulting in a continuous increase in the ratio of upper- to lower-body fat (r = 0.45, P < 0.001). In contrast, total fat mass remained stable in women, irrespective of menopause, but a redistribution of fat occurred with advancing age (r = 0.43, P < 0.001), resulting in a higher upper- to lower-body fat ratio (P < 0.05) in older than in younger women. Total lean soft-tissue mass of all segments of the body was greater in men than in women irrespective of age (P < 0.001), and lower in the older groups than in the younger ones irrespective of sex. In males, but not females, lean soft-tissue mass in arms and legs decreased (r = 0.57, P < 0.001), whereas the ratio of total fat to lean soft-tissue mass increased (r = 0.53, P < 0.001) with age. Bone mineral content correlated with total body fat in both groups of women and in young males (r > 0.5, P < 0.001), but not in older males. With advancing age, the proportion of lean soft-tissue mass occupied by total skeleton declined in women (n = 59, P < 0.001), but remained stable in males. Resting energy expenditure decreased with age in both sexes. Protein and carbohydrate oxidation were similar in all four groups of subjects. Total fat oxidation and fat oxidation per kilogram of lean soft-tissue mass decreased with age (r > 0.36, P < 0.01) in males, but not in females, whereas it increased with increasing fat mass in females (r > 0.32, P < 0.03), but not in males. In contrast, fat oxidation per kilogram of fat mass decreased with fat mass in males (r = 0.61, P < 0.001), but not in females. Our results suggest that aging affects body composition and fuel metabolism differently in each gender, leading to reduced fat oxidation and accumulation of upper-body fat with loss of striated muscle in men, and to an increased ratio of upper- to lower-body fat and bone loss in women, the latter depending on fat mass.     

Urinary bombesin-like peptide levels in infants and children with bronchopulmonary dysplasia and cystic fibrosis

OBJECTIVE: Changes in body composition during a weight loss program have not been described in children. We wanted to test the hypothesis that weight loss can be achieved while maintaining total body fat-free mass. RESEARCH METHODS AND PROCEDURES: We determined body composition changes by using dual-energy X-ray absorptiometry measured at baseline and after the first 10 weeks of a multidisciplinary weight loss program. The program consisted of 10 weekly group sessions where the children were provided instruction in lifestyle modification, including diet and exercise. Program leaders included a pediatrician, psychologist, registered dietitian, and exercise instructor. RESULTS: We studied 59 obese children, mean (+/-SD) age 12.8+/-2.6 years, 29% boys and 71% girls, 49% Caucasian, and 51% African American. At enrollment, the children's mean height and body mass index were 157 cm and 38.9 kg/m2, respectively. The children's dual-energy X-ray absorptiometry-derived mean at baseline and at 10 weeks and corresponding p values were: weight (94.6 kg vs. 92.3 kg, p<0.0001), total body fat mass (46.9 kg vs. 44.3 kg, p<0.0001), percentage total body fat (49.2% vs. 47.5%, p<0.0001), total trunk mass (43.0 kg vs. 41.5 kg, p<0.0001), total trunk fat (21.2 kg vs. 20.0 kg, p<0.0001), total body fat-free mass (47.6 kg vs. 47.9 kg, p=0.33), total body bone mass (2.7 kg vs. 2.7 kg, p=0.99), and total body bone mineral density (1.14 g/cm2 vs. 1.15 g/cm2, p=0.0119). The children's race, gender, or Tanner stage did not affect these changes. DISCUSSION: Decreases in total body fat mass was achieved, and total body fat-free mass was maintained among boy and girl Caucasian and African American children participating in this lifestyle modification weight loss program.     

Emotional status does not alter exercise tolerance in patients with chronic obstructive pulmonary disease

Major changes in bone mineral density (BMD) and body composition occur during puberty. In the present longitudinal study, we evaluated BMD and calculated volumetric BMD [bone mineral apparent density (BMAD)], bone metabolism, and body composition of children (32 girls and 2 boys) with central precocious and early puberty before and during treatment with GnRH agonist (GnRH). Patients were studied at baseline and during treatment for 6 months (n = 34), 1 yr (n = 33), and 2 yr (n = 16). Lumbar spine and total body BMD and body composition were measured with dual-energy x-ray absorptiometry. The variables were compared with age- and sex-matched reference values of the same population and expressed as SD score (SDS). Bone age was assessed. Serum calcium, phosphate, alkaline phosphatase, osteocalcin, the carboxyterminal propeptide of type I collagen (PICP), cross-linked telopeptide of collagen I (ICTP), 1,25 dihydroxyvitamin D and urinary hydroxyproline/creatinine, and calcium/ creatinine ratios were measured. Mean lumbar spine BMD SDS was significantly higher than zero at baseline (P < 0.02) and did not differ from normal, after 2 yr of treatment. Mean spinal BMAD SDS and total body BMD SDS were not significantly different from zero at baseline and had not changed significantly after 2 yr of treatment. During therapy, fat mass and percentage body fat SDS increased, whereas lean tissue mass SDS decreased. Mean lumbar spine BMD and BMAD and total body BMD SDS, calculated for bone age, were all lower than zero at baseline (BMD P < 0.001 and BMAD P < 0.05) and also after 2 yr treatment (respectively, P < 0.001, P < 0.05, and P < 0.01). Biochemical bone parameters were significantly higher than prepubertal values at baseline, and they decreased during treatment. In conclusion, patients with central precocious and early puberty had normal BMD for chronological age but low BMD for bone age, after 2 yr of treatment with GnRH. Bone turnover decreased during treatment. Changes in body composition resembled those seen in patients with GH deficiency.     

Egg handling and storage

The relative importance of fat and lean tissue mass in determining bone mineral mass among postmenopausal women was examined in this 1-year longitudinal study. Fifty postmenopausal Caucasian women entered the study; 45 of them completed a 1-year follow-up. Dual-energy X-ray absorptiometry was employed for measuring total and regional bone mineral density (BMD) and bone mineral content (BMC), fat tissue mass (FTM), lean tissue mass (LTM), and body weight. Results from linear regression analysis using the cross-sectional data (n = 50) of the study indicated that LTM explained a larger percentage of variation in bone mineral mass than did FTM. FTM and LTM were found to be moderately correlated (r = 0.55); when FTM was entered in the same predicting regression models, LTM was a significant predictor (p < 0.05) of the total and regional BMC, but not BMD. The percent FTM (and inversely %LTM) was correlated with BMD and BMC, but significant correlation was primarily found only for total body BMD (or BMC). Weight was the best predictor of total body BMD and BMC. Longitudinally (n = 45), annual changes in both FTM and weight were significantly associated with annual changes in regional BMD after adjustment for initial bone mineral values (p < 0.05). We conclude that bone mineral mass is more closely related to LTM than to FTM, while annual changes in regional BMD are more closely correlated with changes in FTM in healthy postmenopausal women. Meanwhile, increased body weight is significantly associated with increased bone mineral mass.     

The reliability of upper limb anthropometry in older Chinese people

OBJECTIVE: To evaluate the validity of the Durnin-Womersley equations and to derive our local predictive equations for body fat from upper limb skinfold thicknesses in older Chinese people in Hong Kong. To evaluate the validity of mid-arm circumference and corrected arm muscle area in predicting lean tissue mass in the same population. DESIGN: Comparison of fat percentages predicted by Durnin-Womersley (D-W) equations with those estimated by Dual energy X ray absorptiometry (DXA). Predictive equations derived from regression between upper limb skinfold thicknesses and fat percentages estimated by DXA were similarly evaluated in internal and external validation groups. Mid-arm circumference (MAC) and corrected arm muscle area (CAMA) were correlated with the limb lean tissue mass, body lean tissue mass and fat percentage. SUBJECTS: 354 female and 263 male, apparently well, community dwelling subjects, aged 69-82 y; of which 40 subjects of each sex were randomly selected from the study population for internal validation of the local predictive equations; 60 female and 33 male hospital medical outpatients, aged 61-87 y, were recruited for external validation. MEASUREMENTS: Triceps and biceps skinfold thicknesses, mid-arm circumference, body mass index, fat percentages, limb and whole body lean tissue masses estimated by Hologic QDR-2000 bone densitometer. RESULTS: Fat percentages calculated by D-W equations were significantly different from those estimated by DXA (average difference -2.4 (s.d. 4.8)% and +2.1 (5.2)% in females and males respectively). The corresponding differences for our local predictive equations were not significant (-0.9 (4.7)% and -0.5 (5.0)% in females and males respectively). There was a trend of under-estimation of body fat with increasing fatness. In the hospital medical outpatients, there was a significant difference between fat percentages predicted by our equation and those by DXA in female (-2.9(5.3)%), but not in male (+0.3(4.3)%) subjects. In males, MAC correlated with limb and body lean tissue masses as well as with fat percentage (r = 0.60, 0.68, 0.65 respectively). CAMA correlated similarly well with lean tissue masses but was more independent of fat percentage (r = 0.61, 0.65, 0.44 respectively). In females, both MAC and CAMA correlated poorly with limb and body lean tissue masses. Moreover, MAC correlated well with fat percentage (r = 0.80). CONCLUSION: Upper limb skinfold thicknesses measurement is a valid means of predicting body fat in older Chinese people. Local predictive equations were more reliable that D-W equations. They were, however, subject to errors at the extreme ends of body fatness and in the presence of disease. In older females, MAC and CAMA were not reliable in predicting lean tissue mass, but MAC could be used to predict fat percentages. In older males, CAMA was more reliable than MAC in predicting lean tissue mass.