BIOIMPENDANCEMETRIA AS A METHOD FOR DIAGNOSIS OF VISCERAL OBESITY IN PEDIATRIC PRACTICE

DOI: https://doi.org/10.29296/24999490-2019-06-05

Yu.G. Samoilova(1), D.A. Kudlay(2), D.V. Podchinenova(1), O.S. Kobyakova(1), M.V. Koshmeleva(1), O.A. Oleynik(1) 1-Siberian State Medical University, Moskovsky trakt, 2, Tomsk, 634050, Russian Federation; 2-National Research Center – Institute of Immunology Federal Medical-Biological Agency of Russia, Kashirskoye highway 24, Moscow, 115522, Russian Federation. Е-mail: [email protected]

Introduction. Visceral obesity is a key factor in the development of metabolic syndrome, which can lead to early disability and lower quality of life. The body mass index, which is widely used as a method of diagnosing obesity, does not allow for the differentiation of visceral fatty tissue. Radiation-based visceral obesity diagnostic methods, which are the gold standard, cannot be used as a screening method due to radiation exposure and high costs. Therefore, there is a need for early diagnosis of visceral obesity, which can be used in outpatient care. Objective. To develop a non-invasive method of early diagnosis of visceral obesity in children and adolescents. Methods. The study was conducted among children and adolescents aged 3 to 18 years (n=1914). A complex examination was carried out on everyone, including anthropometry and analysis of body composition by Inbody 770. A group of patients with and without visceral obesity (n=227) was identified among those studied (n=210). From both groups, the examined patients (n=88) were randomly selected for a CT scan to determine the visceral fat area. The data obtained were used by the IBM Watson cognitive system to build a multivariate statistical model of the decision support system. Results. A model for screening visceral obesity among children and adolescents was obtained, comparable in accuracy to CT (Sensitivity 91%, specificity 80%.). Conclusion. The obtained model for screening visceral obesity among children and adolescents can be used for the annual medical examination, as it is easy to use, has an accuracy comparable to CT, but lacks its drawbacks, such as radiation exposure, high cost, inability to use outpatient.
Keywords: 
visceral obesity, bioimpedancemetry, childhood obesity, chronic non-infectious diseases
Список литературы: 
  1. Johansson A.G., Forslund A., Sjödin A., Mallmin H., Hambraeus L., Ljunghall S. Determination of body composition-a comparison of dual-energy x-ray absorptiometry and hydrodensitometry. Am. J. Clin. Nutr. 1993; 57 (3): 323–6. http://doi.org/10.1093/ajcn/57.3.323
  2. Demura S., Sato S., Kitabayashi T. Percentage of total body fat as estimated by three automatic bioelectrical impedance analyzers. J. Physiol. Anthropol. Appl. Hum. Sci. 2004; 23 (3): 93–9. https://doi.org/10.2114/jpa.23.93
  3. Malavolti M., Mussi C., Poli M. Cross-calibration of eightpolar bioelectrical impedance analysis versus dual-energy X-ray absorptiometry for the assessment of total and appendicular body composition in healthy subjects aged 21–82 years. Ann. Hum. Biol. 2003; 30 (4): 380–91. http://doi.org/10.1080/0301446031000095211
  4. Ellis K.J. Measuring body fatness in children and young adults: Comparison of bioelectrical impedance analysis, total body electrical conductivity, and dual-energy x-ray absorptiometry. Int. J. Obes. 1996; 20 (9): 866–73.
  5. Boot A.M., Bouquet J., de Ridder M.A., Krenning E.P., de Muinck Keizer-Schrama S.M. Determinants of body composition measured by dual-energy X-ray absorptiometry in Dutch children and adolescents. Am. J. Clin. Nutr. 1997; 66 (2): 232–8. http://doi.org/10.1093/ajcn/66.2.232
  6. Okasora K., Takaya R., Tokuda M., Fukunaga Y., Oguni T., Tanaka H., Konishi K., Tamai H. Comparison of bioelectrical impedance analysis and dual energy X-ray absorptiometry for assessment of body composition in children. Pediatr Int. 1999; 41 (2): 121–5. https://doi.org/10.1046/j.1442-200X.1999.4121048.x
  7. Eisenmann J.C., Heelan K.A., Welk G.J. Assessing body composition among 3- to 8-year-old children: Anthropometry, BIA, and DXA. Obes. Res. 2004; 12 (10): 1633–40. https://doi.org/10.1038/oby.2004.203
  8. Pascot A., Lemieux S., Lemieux I. , Prud’homme D., Tremblay A., Bouchard C., Nadeau A., Couillard C., Tchernof A., Bergeron J., Després J.P. Age-related increase in visceral adipose tissue and body fat and the metabolic risk profile of premenopausal women. Diabetes Care. 1999; 22 (9): 1471–8. https://doi.org/10.2337/diacare.22.9.1471
  9. Samojlova Ju.G., Rotkank M.A., Zhukova N.G., Matveeva M.V., Tolmachev I.V., Kudlaj D.A. Variabel'nost' glikemii u patsientov s saharnym diabetom 1-go tipa: svjaz' s kognitivnoj disfunktsiej i dannymi magnitno-rezonansnyh metodov issledovanija. Problemy Endokrinologii. 2018; 64 (5): 286–91. [Samoilova Yu.G., Rotkank M.A., Zhukova N.G., Matveeva M.V., Tolmachev I.V., Kudlay D.A. Variabel’nost’ glikemii u pacientov s saharnym diabetom 1-go tipa: svyaz’ s kognitivnoj disfunkciej i dannymi magnitno-rezonansnyh metodov issledovaniya. Problemy Endokrinologii. 2018; 64 (5): 286–91 (in Russian)]
  10. Samojlova Ju.G., Rotkank M.A., Zhukova N.G., Matveeva M.V., Tolmachev I.V., Kudlaj D.A. Markery kognitivnyh narushenij i variabel'nost' glikemii u patsientov s saharnym diabetom 1-go tipa. Zhurnal nevrologii i psihiatrii im. S.S. Korsakova. 2018; 118 (4): 48–51. [Samoilova Yu.G., Rotkank M.A., Zhukova N.G., Matveeva M.V., Tolmachev I.V., Kudlay D.A. Markery kognitivnyh narushenij i variabel’nost’ glikemii u pacientov s saharnym diabetom 1-go tipa. ZHurnal nevrologii i psihiatrii im. S.S. Korsakova. 2018; 118 (4): 48–51 (in Russian)]
  11. Ogden C.L., Carroll M.D., Kit B.K., Flegal K.M. Prevalence of obesity in the United States, 2009-2010. NCHS Data Brief. 2012; 82: 1–8.
  12. Ogden C.L., Carroll M.D., Kit B.K., Flegal K.M. Prevalence of childhood and adult obesity in the United States, 2011-2012. JAMA. 2014; 311: 806–14.
  13. Ahluwalia N., Dalmasso P., Rasmussen M., Lipsky L., Currie C., Haug E., Kelly C., Damsgaard M.T., Due P., Tabak I., Ercan O., Maes L., Aasvee K., Cavallo F. Trends in overweight prevalence among 11-, 13- and 15-year-olds in 25 countries in Europe, Canada and USA from 2002 to 2010. Eur. J. Public Health. 2015; 25 (suppl. 2): 28–32.
  14. Olds T., Maher C., Zumin S., Peneau S., Lioret S., Castetbon K., Bellisle F., de Wilde J., Hohepa M., Maddison R., Lissner L., Sjoberg A., Zimmermann M., Aeberli I., Ogden C., Flegal K., Summerbell C. Evidence that the prevalence of childhood overweight is plateauing: data from nine countries. Int. J. Pediatr. Obes. 2011; 6: 342–60.
  15. Nagel G., Wabitsch M., Galm C., Berg S., Brandstetter S., Fritz M., Klenk J., Peter R., Prokopchuk D., Steiner R., Stroth S., Wartha O., Weiland S.K., Steinacker J. Secular changes of anthropometric measures for the past 30 years in South-West Germany. Eur. J. Clin. Nutr. 2009; 63: 1440–3.
  16. Staiano A., Marker A., Liu M., Hayden E., Hsia D., & Broyles S. Childhood Obesity Screening and Treatment Practices of Pediatric Healthcare Providers. The Journal of the Louisiana State Medical Society: official organ of the Louisiana State Medical Society. 2017; 169 (1): 2–10.
  17. Copeland K.C, Silverstein J., Moore K.R., Prazar G.E., Raymer T., Shiffman R.N., Springer S.C., Thaker V.V., Anderson M., Spann S.J, Flinn S.K. Management of Newly Diagnosed Type 2 Diabetes Mellitus (T2DM) in Children and Adolescents. Pediatrics Feb 2013, 131 (2): 364–82. https://doi.org/10.1542/peds.2012-3494
  18. Perrin E.M., Skinner A.C., Steiner M.J. Parental recall of doctor communication of weight status national trends from 1999 through 2008. Archives of Pediatrics & Adolescent Medicine. 2012; 166: 317–22.
  19. Sesselberg T.S., Klein J.D., O’Connor K.G., Johnson M.S. Screening and counseling for childhood obesity: results from a national survey. The J. of the Am. Board of Family Medicine. 2010; 23: 334–42. https://doi.org/10.3122/jabfm.2010.03.090070
  20. Reyes I. An evaluation of the identification and management of overweight and obesity in a pediatric clinic. J. of Pediatric Health Care. 2015; 29: 9–14.
  21. Mamaev A.N., Kudlaj D.A. Vizualizatsija dannyh v prezentatsijah, otchetah i issledovanijah. M.: Prakticheskaja meditsina, 2011; 39. [Mamaev A.N., Kudlay D.A. Vizualizatsiya dannykh v prezentatsiyakh, otchetakh i issledovaniyakh. M.: Prakticheskaya meditsina, 2011; 39 (in Russian)]