Body Composition Assessment in Mexican Children and Adolescents. Part 1: Comparisons between Skinfold-Thickness, Dual X-ray Absorptiometry, Air-Displacement Plethysmography, Deuterium Oxide Dilution, and Magnetic Resonance Imaging with the 4-C Model

Abstract

The evaluation of body composition (BC) is relevant in the evaluation of children's health-disease states. Different methods and devices are used to estimate BC. The availability of methods and the clinical condition of the patient usually defines the ideal approach to be used. In this cross-sectional study, we evaluate the accuracy of different methods to estimate BC in Mexican children and adolescents, using the 4-C model as the reference. In a sample of 288 Mexican children and adolescents, 4-C body composition assessment, skinfold-thickness (SF), dual-energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP), and deuterium dilution (D₂O) were performed, along with MRI in a subsample (52 participants). The analysis of validity was performed by correlation analysis, linear regression, and the Bland-Altman method. All methods analyzed showed strong correlations for FM with 4-C values and between each other; however, DXA and MRI overestimated FM, whereas skinfolds and ADP under-estimated FM. Conclusion: The clinical assessment of BC by means of SF, ADP, DXA, MRI and D₂O correlated well with the 4-C model and between them, providing evidence of their clinical validity and utility. The results from different methods are not interchangeable. Preference between methods may depend on their availability and the specific clinical setting.

Keywords: MRI 6; air-displacement plethysmography (ADP); body composition; children and adolescents; deuterium dilution; dual X-ray absorptiometry (DXA); skinfold-thickness.

Figure 1

Bland–Altman plots for FM estimation by SF, DXA, ADP, D₂O, and MRI in contrast with the 4-C model for the total sample. A positive trend indicates an increasing underestimation of FM at high FM levels; a negative trend indicates an increasing overestimation of FM at high FM levels.

Figure 2

Bland–Altman plots for FFM estimation by SF, DXA, ADP and D₂O in contrast with the 4-C model for all ages and sex groups. A positive trend indicates an increasing underestimation of FFM at high FFM levels; a negative trend indicates an increasing overestimation of FFM at high FFM levels.