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      Análise comparativa de métodos de avaliação da composição corporal em homens sadios e em pacientes com doença pulmonar obstrutiva crônica: antropometria, impedância bioelétrica e absortiometria de raios-X de dupla energia


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          O trabalho teve, como objetivo principal, verificar se a antropometria (ANT) e a impedância bioelétrica (BIA) fornecem resultados concordantes com os obtidos pela absortiometria de raios-X de dupla energia (DXA), quanto à massa (MG) e à porcentagem de gordura (%GC), à massa livre de gordura corporal (MLG) e ao índice de MLG (IMLG= MLG/estatura²), em indivíduos adultos (³ 50 anos), do sexo masculino, sadios (n=23) e em pacientes com doença pulmonar obstrutiva crônica (DPOC) (n=24). As comparações entre as técnicas de composição do corpo foram feitas utilizando ANOVA por medidas repetidas; para análise de concordância, utilizou-se o procedimento de Bland & Altman. Resultados e Conclusões: 1) valores obtidos no grupo sadio foram significantemente diferentes dos observados no grupo com DPOC; 2) não foram observadas diferenças significantes, nos indivíduos sadios, entre DXA ´ BIA e entre DXA ´ ANT; em DPOC, a comparação entre DXA ´ BIA revelou, para BIA, valores estatisticamente maiores para MG e %GC e menores para MLG e IMLG; na comparação DXA ´ ANT, não houve diferenças significantes entre as variáveis; 3) a aplicação do teste de Bland & Altman, em ambos os grupos, mostrou falta de concordância na comparação da BIA com DXA e, também, da ANT com DXA; verificou-se, também, superestimação da gordura corporal e subestimação da MLG pela BIA, em relação à DXA.

          Translated abstract

          Comparative analysis of body composition assessment methods in healthy men and in chronic obstructive pulmonary disease patients: anthropometry, bioelectrical impedance and dual-energy X-ray absorptiometry. The aim of this study was to examine the agreement between the results of body fat (BF and BF%), fat-free mass (FFM) and FFM index (FFMI= FFM/height²) as estimated by skinfold anthropometry (ANT), bioelectrical impedance (BIA) and dual-energy X-ray absorptiometry (DXA) in two groups of men (³ 50 y), one comprising healthy individuals (n=23) and the other, patients with chronic obstructive pulmonary disease (COPD) (n=24). Comparisons between body composition techniques were done by repeated measures ANOVA; the Bland & Altman procedure was used to analyse agreement. Results and Conclusions: 1) comparison between healthy and COPD groups showed significant differences between all studied variables; 2) in the healthy group, values for BF, BF% , FFM and FFMI were not significantly different when BIA or ANT was compared to DXA; however, in COPD, values for BF and BF% were significantly higher and for FFM and FFMI significantly lower when BIA was compared to DXA; in contrast, no differences were shown between values for these variables when ANT was compared with DXA; 3) Bland & Altman test, in both groups, showed no agreement between BIA and DXA and between ANT and DXA; it was also shown that body fat was overestimated and fat free mass underestimated by BIA in relation to DXA.

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          Most cited references51

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          Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. NHLBI/WHO Global Initiative for Chronic Obstructive Lung Disease (GOLD) Workshop summary.

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            Sarcopenia and increased adipose tissue infiltration of muscle in elderly African American women.

            Aging is associated with metabolic, physiologic, and functional impairments, in part through age-related changes in body composition. During the later adult years, skeletal muscle mass decreases and body fat becomes centralized. The goal of the study was to investigate body composition over time ( +/- SD: 2.04 +/- 0.6 y) in healthy, ambulatory, elderly African American women. The hypothesis that a reduction in total-body skeletal muscle (SM) and increases in visceral adipose tissue (VAT), subcutaneous adipose tissue (SAT), and intermuscular adipose tissue (IMAT) are ongoing in healthy, weight-stable elderly was tested. The study was a longitudinal evaluation of 26 women (age at baseline: 75.5 +/- 5.1 y) with a body mass index (in kg/m(2)) of 27.0 +/- 4.0. Body composition was measured by using whole-body magnetic resonance imaging for the quantification of SM, total adipose tissue (TAT), VAT, SAT, and IMAT. SM (P < 0.001) and bone (P < 0.05) masses decreased, and regional analyses showed a decrease in dual-energy X-ray absorptiometry-derived leg SM (P < 0.05). VAT (P = 0.011) and IMAT (P < 0.001) increased. No changes occurred in TAT (P = 0.45), SAT (P = 0.96), physical function, or food intake. These data show an age-related remodeling of body composition with reductions in SM and corresponding increases in VAT and IMAT. Changes in the previously unstudied depot of IMAT may be involved in the deterioration of metabolic values frequently observed during aging.
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              Weight stability masks sarcopenia in elderly men and women.

              Skeletal muscle loss or sarcopenia in aging has been suggested in cross-sectional studies but has not been shown in elderly subjects using appropriate measurement techniques combined with a longitudinal study design. Longitudinal skeletal muscle mass changes after age 60 yr were investigated in independently living, healthy men (n = 24) and women (n = 54; mean age 73 yr) with a mean +/- SD follow-up time of 4.7 +/- 2.3 yr. Measurements included regional skeletal muscle mass, four additional lean components (fat-free body mass, body cell mass, total body water, and bone mineral), and total body fat. Total appendicular skeletal muscle (TSM) mass decreased in men (-0.8 +/- 1.2 kg, P = 0.002), consisting of leg skeletal muscle (LSM) loss (-0.7 +/- 0.8 kg, P = 0.001) and a trend toward loss of arm skeletal muscle (ASM; -0.2 +/- 0.4 kg, P = 0.06). In women, TSM mass decreased (-0.4 +/- 1.2 kg, P = 0.006) and consisted of LSM loss (-0.3 +/- 0.8 kg, P = 0.005) and a tendency for a loss of ASM (-0.1 +/- 0.6 kg, P = 0.20). Multiple regression modeling indicates greater rates of LSM loss in men. Body weight in men at follow-up did not change significantly (-0.5 +/- 3.0 kg, P = 0.44) and fat mass increased (+1.2 +/- 2.4 kg, P = 0.03). Body weight and fat mass in women were nonsignificantly reduced (-0.8 +/- 3.9 kg, P = 0.15 and -0.8 +/- 3.5 kg, P = 0.12). These observations suggest that sarcopenia is a progressive process, particularly in elderly men, and occurs even in healthy independently living older adults who may not manifest weight loss.

                Author and article information

                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Archivos Latinoamericanos de Nutrición
                Sociedad Latinoamericana de Nutrición (Caracas )
                June 2005
                : 55
                : 2
                : 124-131
                [1 ] Facultad de de Ciências e Tecnologia de Presidente Brasil



                SciELO Venezuela

                Self URI (journal page): http://www.scielo.org.ve/scielo.php?script=sci_serial&pid=0004-0622&lng=en
                NUTRITION & DIETETICS

                Nutrition & Dietetics
                Bioelectric impedance,dual energy X-ray absorptiometry,anthropometry,fat-free mass,,fat mass,COPD.,Impedância bioelétrica,absortiometria de raios-X de dupla energia,livre de gordura,massa de gordura,DPOC


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