The importance of the compartment model of body composition analysis in women with severe obesity / La importancia del modelo compartimentai de análisis de composición corporal en mujeres con obesidad severa

Abstract Introduction. Obesity is usually diagnosed based only on body mass index (BMI), which may lead to an unreliable body composition analysis. Objective: To analyze the body characteristics of morbidly obese (class III) women referred to bariatric surgery using the compartment model of body composition analysis. Materials and methods: Cross-sectional study conducted in 2017 in 14 morbidly obese women aged between 25 and 51 years, who attended clinical and physical therapy assessment prior to undergoing bariatric surgery at a university hospital in Rio de Janeiro, Brazil. Body composition analysis was performed using an octopolar bioimpedance scale. The Pearson's correlation coefficient was used to analyze the correlation between variables, with a significance level of p<0.05. Results: A high mean percentage of fat body was observed (51.2%), mainly in the trunk. BMI was correlated with total fat in kilograms (r=0.93), total body fat percentage (TBF%) (r=0.67), total body water (r=0.63), and muscle mass (r=o.6o); besides, a moderate correlation with the waist-to-hip ratio (WHR) was found (r=0.55). WHR showed a correlation with TBF% (r=o.6o) and a moderate correlation with total fat in kilograms (r=0.57). Moreover, the sarcopenia index was correlated with muscle mass (r=0.79) and total body water (r=0.78). All these correlations were statistically significant (p<0.05). There were no sarcopenia cases. Conclusion: A higher concentration of fat in the trunk and the upper limbs was observed in the study population; however, none of the participants had sarcopenia. On the other hand, BMI showed a stronger correlation with both total fat (kg) and TBF% than with WHR. Such findings suggest that assessing these patients based only on BMI or WHR may hinder the development individualized treatment strategies.

Resumen Introducción. Por lo general, el diagnóstico de obesidad se basa en el índice de masa corporal (IMC), lo que puede resultar en un análisis de la composición corporal no confiable. Objetivo. Analizar las características corporales de mujeres mórbidamente obesas (Clase III) remitidas a cirugía bariátrica mediante el modelo compartimental de análisis de composición corporal. Materiales y métodos. Estudio transversal realizado en 2017 en 14 mujeres con obesidad mórbida con edades entre los 25 y 51 años que se encontraban en valoración clínica y por fisioterapia antes de someterse a cirugía bariátrica en un hospital universitario de Rio de Janeiro, Brasil. El análisis de la composición corporal se realizó mediante una balanza de bioimpedancia octopolar. Se utilizó el coeficiente de correlación de Pearson para analizar la correlación entre variables, con un nivel de significancia de p<0.05. Resultados. Se observó un alto porcentaje promedio de grasa corporal (51.2%), principalmente en el tronco. El IMC se correlacionó con la grasa total en kilogramos (r=0.93), el porcentaje de grasa corporal total (r=0.67), el agua corporal total (r=0.63) y la masa muscular (r=0.60); además, se encontró una correlación moderada con el índice cintura-cadera (IC-C) (r=0.55). Por su parte, el IC-C mostró una correlación con el porcentaje de grasa corporal total (r=0.60) y una correlación moderada con la grasa total en kilogramos (r=0.57). Además, el índice de sarcopenia se correlacionó con la masa muscular (r=0.79) y el agua corporal total (r=0.78). Todas estas correlaciones fueron estadísticamente significativas. No se observó sarcopenia en la muestra. Conclusión. Se observó una mayor concentración de grasa en el tronco y las extremidades superiores, pero ninguna de las participantes tuvo sarcopenia. Por otra parte, el IMC mostró una mayor correlación con la cantidad de grasa (tanto en kilogramos como en porcentaje de grasa total) que con el IC-C. Estos hallazgos sugieren que evaluar este tipo de pacientes basándose únicamente en el IMC o el I-CC puede dificultar el desarrollo de estrategias de tratamiento individualizado.

[Profile of body composition in women with class III obesity by multipolar bioimpedance method]. / Perfil da composição corporal de mulheres com obesidade grau III pelo método de bioimpedância multipolar.

OBJECTIVE: To analyze a body composition profile in women with class III obesity using the multipolar bioimpedance method. METHODS: Thirteen sedentary women aged between 20 and 40 years were evaluated. RESULTS: The results show that the patients had a fat percentage of 51.9±1.50 % and lean mass of 48.1±1.50 %. Regarding fat mass and lean mass per body region, figures of 26.3±3.62kg and 26.2±2.91kg in the upper body, 9.1±0.06kg and 8.4±0.14kg in the lower limbs, and 3.3±0.02kg and 7.6±0.01kg in the upper limbs were obtained. Patients had a good symmetry between the left and right sides in both upper and lower limbs, besides of a muscular mass of 32.1±5.08kg, with a muscular mass index of 12.7±1.05kg/m2. CONCLUSION: Higher fat accumulation was observed in the upper body region, followed by lower and upper limbs. Total muscular mass was apparently preserved, although sarcopenic obesity was not verified. Since this is a group of people that is still understudied, there is a need for further research on genetic and physical profile and caloric expenditure during exercise and rest.