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Abstract Objective: To present an updated and evidence-based guideline for the use of dual-energy x-ray absorptiometry (DXA) to assess body composition in clinical practice. Materials and methods: This Official Position was developed by the Scientific Committee of the Brazilian Association of Bone Assessment and Metabolism ( Associação Brasileira de Avaliação Óssea e Osteometabolismo , ABRASSO) and experts in the field who were invited to contribute to the preparation of this document. The authors searched current databases for relevant publications in the area of body composition assessment. In this second part of the Official Position, the authors discuss the interpretation and reporting of body composition parameters assessed by DXA and the use of DXA for body composition evaluation in special situations, including evaluation of children, persons with HIV, and animals. Conclusion: This document offers recommendations for the use of DXA in body composition evaluation, including indications, interpretation, and applications, to serve as a guiding tool in clinical practice and research for health care professionals in Brazil.
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Abstract Data comparing anthropometric measurements, bioelectrical impedance analysis (BIA) and dual-energy X-ray absortiometry (DXA) parameters are somehow limited and conflicting. The objective of this study was to correlate anthropometric, BIA and DXA parameters among obese Brazilian adults with focus on the comparison with visceral adipose tissue (VAT) obtained from DXA and in the value of antropometric measurements. Fifty voluntary participants were enrolled. The Spearman correlation test was used to assess the correlation of VAT with anthropometric measurements, BIA and other DXA parameters. The intra-class correlation coefficient (ICC) was used to evaluate concordance between lean mass (LM), fat mass (FM), %body fat (%BF) and %upper body fat (%UBF) obtained from BIA and DXA. Most were female (80%) and had an average body index mass (BMI) of 39.0 (± 6.4) kg/m2. The only anthropometric measurements showing a strong correlation with VAT were abdominal circumference (AC) and waist-to-height ratio (WHtR), but just in females. There was a very good correlation for LM [ICC = 0.951 (CI = 0.913 - 0.972)], FM [ICC = 0.987 (CI = 0.977 - 0.993)], %BF [ICC = 0.961 (CI = 0.931-0.978)], and %UBF [ICC = 0.873 (CI = 0.776 - 0.928)], between data collected through BIA and DXA. Among the anthropometric measurements assessed, only AC and WHtR seems to estimate patients with abdominal fat distribution and higher VAT in females. DXA and BIA proved similar for the evaluation of LM, FM, %BF and %UBF, although DXA has the advantage of estimating VAT.
Resumo Dados comparando medidas antropométricas, análise de impedância bioelétrica (BIA) e parâmetros de absorciometria de raios-X de dupla energia (DXA) são de alguma forma limitados e conflitantes. O objetivo deste estudo foi correlacionar parâmetros antropométricos de BIA e de DXA entre adultos obesos brasileiros, com foco na comparação com tecido adiposo visceral (TAV) obtido na DXA e no valor das medidas antropométricas. Cinquenta participantes voluntários foram inscritos. O teste de correlação de Spearman foi utilizado para avaliar a correlação do TAV com medidas antropométricas, da BIA e de outros parâmetros da DXA. O coeficiente de correlação intra-classe (ICC) foi usado para avaliar a concordância entre massa magra (MM), massa gorda (MG), % de gordura corporal (%GC) e % de gordura corporal na parte superior do corpo (%GSC) obtidos por BIA e DXA. A maioria era do sexo feminino (80%) e apresentava índice de massa corporal médio (IMC) de 39,0 (± 6,4) kg / m2. As únicas medidas antropométricas que mostraram uma forte correlação com o TAV foram a circunferência abdominal (CA) e a relação cintura / estatura (RCE), mas apenas no sexo feminino. Houve uma correlação muito boa para MM [ICC = 0,951 (IC = 0,913 - 0,972)], MG [ICC = 0,987 (IC = 0,977 - 0,993)], % GC [ICC = 0,961 (IC = 0,931-0,978)], e % GSC [ICC = 0,873 (IC = 0,776 - 0,928)], entre os dados coletados através de BIA e DXA. Dentre as medidas antropométricas avaliadas, apenas a CA e a RCE parecem estimar pacientes com distribuição de gordura abdominal e maior TAV no sexo feminino. A DXA e a BIA mostraram-se semelhantes para a avaliação de MM, MG,% GC e % GSC, embora a DXA tenha a vantagem de estimar o VAT.
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With the evolution of bone densitometry, differences in technologies, acquisition techniques, reference databases, reporting methods, diagnostic criteria and terminology have developed and the International Society for Clinical Densitometry (ISCD) periodically holds Position Development Conferences, the latest in 2007. The Brazilian Society for Clinical Densitometry (SBDens), with support from many Brazilian societies interested in bone health, gathered numerous specialists to discuss the ISCD proposals and to evaluate the validity of the extension of those norms to Brazilian population. The SBDens reunion of consensus made a very useful document to help the understanding and interpretation of bone densitometry and other methods of bone assessment.
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Densidad Ósea , Densitometría/métodos , Adolescente , Adulto , Brasil , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sociedades Médicas , Adulto JovenRESUMEN
A evolução dos métodos de avaliação da massa óssea trouxe diferentes tecnologias, modos de aquisição de imagens, bancos de dados de referência, terminologias, critérios diagnósticos fez com que a International Society for Bone Densitometry (ISCD) tomasse a iniciativa de promover reuniões periódicas de consenso, a última em 2007. A Sociedade Brasileira de Densitometria Clínica (SBDens), com apoio de várias sociedades brasileiras ligadas ao estudo da saúde óssea, reuniu diversos especialistas para discutir as propostas da ISCD e validar a aplicação destas normas à população brasileira. A reunião de Posições Oficiais da SBDens produziu um documento extremamente útil para a compreensão e interpretação da densitometria e de outros métodos de avaliação da massa óssea.
With the evolution of bone densitometry, differences in technologies, acquisition techniques, reference databases, reporting methods, diagnostic criteria and terminology have developed and the International Society for Clinical Densitometry (ISCD) periodically holds Position Development Conferences, the latest in 2007. The Brazilian Society for Clinical Densitometry (SBDens), with support from many Brazilian societies interested in bone health, gathered numerous specialists to discuss the ISCD proposals and to evaluate the validity of the extension of those norms to Brazilian population. The SBDens reunion of consensus made a very utile document to help the understanding and interpretation of bone densitometry and other methods of bone assessment.
Asunto(s)
Adolescente , Adulto , Niño , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto Joven , Densidad Ósea , Densitometría/métodos , Brasil , Sociedades Médicas , Adulto JovenRESUMEN
Os autores apresentam tres casos de lipomas nao-complicados do colon, destacando a importancia da colonoscopia e da tomografia computadorizada para o diagnostico pre-operatorio de certeza, possibilitando, desta maneira, a observaçao ou a excisao local dos mesmos, impedindo que cirurgias mais radicais que as necessarias sejam realizadas
