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BODY COMPOSITION AND FAT DISTRIBUTION USING DUAL-ENERGY X RAY ABSORTIOMETRY (DEXA) IN OBESE CHILDREN. COMPARISON WITH DEUTERIUM DILUTION (D20), ANTHROPOMETRY AND BIA

Recently dual-energy x ray absortiometry has been proposed for body composition analysis. Using a low dosage of x-ray it gives an accurate estimation of total body mineral content and a direct measurement of fat and lean mass both as total and regional amount. In order to evalute feasibility in childhood obesity we studied 17 obese children (7 males and 10 females), aged 7-13.7 years, BMI 21.4-29.6, using DEXA, D2O, anthropoplicometry and bioelectrical impedance (BIA). Fat distribution was not affected by sex; after the age of 10 years we observed an increase in trunk fat amount which was significantly different from the previous ages (p<0.01). Legs fat content was the best index of total fat mass(r=0.73, p<0.001). Total fat content estimated by DEXA was significantly correlated with ponderal excess estimated according to Tanner (r=0.6, p<0.02) and to Rolland-Cachera (r=0.7, p<0.001), as well as with triceps skinfold (r=0.73, p<0.001). Fat free mass estimated by D2O and by BIA, using Baltistini's formula specific for obese children, was highly related to lean mass detected by DEXA (r=0.89 p<0.0002 and r=0.94, p<0.001, respectively), while fat mass was not (r=0.29). Our data confirm feasibility of DEXA for body composition and fat distribution studies, even in children. Among standard anthropometric indexes of adiposity, triceps skinfold seems to assure the best prediction of total fat amount and BIA appears to be an accurate method for total body water estimation. Further investigations on fat hydration are needed for a more precise measurement of fat mass using indirect tecniques.