Ultrasonic and skinfold caliper measures of subcutaneous adipose tissue thickness in elderly men and women

Ultrasonic and skinfold caliper measures of subcutaneous adipose tissue were taken in a sample of elderly men and women, 65 to 99 years of age with an A-mode Ithaco Body Composition Meter and a Holtain skinfold caliper. For most of the measurements, standard deviations for the ultrasonic measurements were three or more times larger than corresponding caliper measurements. Also, mean absolute interobserver errors for the ultrasonic measurements were considerably larger than those for skinfold calipers. At best, the interobserver reliability for the ultrasound machine was 68% while the poorest reliability for the skinfold caliper was 88%. In the form tested, the Ithaco Body Composition Meter is not as accurate for measuring subcutaneous adipose tissue thickness in the elderly as a Holtain skinfold caliper.     

Measurement of subcutaneous adipose tissue using ultrasound images.

The objectives of this paper are to explore the potential of the ultrasound technique to quantify subcutaneous adipose tissue, and to explain the differences between skinfolds and ultrasound measurements across a large range of ages and levels of adiposity. The sample consisted of 115 men and 117 women aged 35 to 51 years, 132 girls and 145 boys aged 12 to 20 years. Subcutaneous fat thickness was measured at four sites using skinfolds calipers, and at seven sites using a real-time B-mode ultrasound scanner. Anthropometric measurements were obtained, and percent body fat was estimated using electric impedance. The agreement between skinfolds and ultrasound measurements was calculated for each age and sex group. The agreement between techniques, and the levels of correlation between body composition and fatness measurements were high in the sample of young men. However, the results were less consistent in the other groups. Site specific differences were also noted.     

Ultrasonic measurements of subcutaneous adipose tissue thickness in man

Subcutaneous adipose tissue thickness (SCATT) has for many years been measured using skinfold calipers, but calipers have several disadvantages, not least that they compress the skinfold. Measuring SCATT using ultrasound was validated by comparing thicknesses at 12 sites with soft-tissue radiographs in 24 adults and with depth gauge measurements on a cadaver. Correlation coefficients ranged from 0.87 to 0.99, and the regression statistics showed no significant difference between ultrasound and the other procedures. The standard errors of estimate of body density from SCATT measured by calipers and ultrasound in 63 young men was +/- 7.8 and 7.3 kg X m-3, respectively. Although problems in the identification of the adipose tissue-muscle interface can arise, ultrasound is a viable alternative to skinfold calipers and is to be preferred when measuring uncompressed SCATT.     

Comparison of ultrasound and skinfold measurements in assessment of subcutaneous and total fatness

Ultrasound (A-scan mode) and skinfold methods were evaluated in the measurement of subcutaneous fat thickness and prediction of total fat weight (by whole body potassium counting). Based on intraobserver correlations on 39 men at 15 body sites, skinfold caliper measurements were more reproducible than ones obtained by ultrasound. Measurements made with the two techniques at the same site typically produced different mean estimates of fat thickness. However, scores were often highly correlated with each other, indicating similar relative rankings of subjects by each technique. Skinfolds were more highly correlated with total fat weight than were ultrasound measurements, but body weight and anthropometric measures had even higher correlations with total fat weight. Anthropometric measurements were highly correlated with fatness because of their association with body weight, and when this relationship was statistically controlled for, they typically lost their predictive effectiveness. Multiple regression analyses revealed that the best predictors of fat weight were body weight along with skinfold and ultrasound measurements. These results suggest that skinfolds are a more effective means of assessing subcutaneous fat than ultrasound, especially when the large difference in cost of equipment is considered.     

Design of lymphedema ultrasound phantom with 3D-printed patient-specific subcutaneous anatomy: A-mode analysis approach for early diagnosis

The secondary lymphedema is mostly caused due to injury of lymphatic system during cancer treatment and its psychological and cosmetic issues are very critical for patients since it can cause severe thickening and swelling of lesions, mostly upper and lower limbs. Therefore, early diagnosis of the secondary lymphedema is more important to treat the symptoms in advance. The amplitude-mode (A-mode) ultrasound is suggested as an early diagnostic modality because it is relatively more cost-effective, portable, and easy to use than other previous diagnostic modalities. In order to see features of the A-mode ultrasound forearly diagnosis of lymphedema, ultrasound lymphedema phantoms were designed and fabricated with patient-specific subcutaneous honeycomb structures at the sub-stages of the international society of lymphedema (ISL) stage II and gelatin- or gelatin-salt based phantom materials. The patent-specific honeycomb structures were segmented from computed tomography (CT) venography images using various image process technologies and printed using a three dimensional (3D) printer for which its printing material shows similar acoustic impedance range with human subcutaneous tissues. The lymphedema phantoms showed similar subcutaneous anatomical features to those of patient's imagesin brightness mode (B-mode) ultrasound examination, and acoustic information originated from the stage-specific honeycomb structures was well represented in A-mode ultrasound examination. In particular, the A-mode wave form well represented stage-specific honeycomb information even with higher impedance value of fibrous fat region. Such stage-specific wave form information of A-mode ultrasound for the corresponding stage-specific lymphedema phantoms at the ISL stage II can be useful for further development of an A-mode ultrasound applications for early diagnosis of the secondary lymphedema.     

Ultrasonic observation on distribution of subcutaneous fat in Japanese young adults with reference to sexual difference

Utilizing an ultrasonic device (B-mode, 7.5MHz), the thickness of subcutaneous fat was measured at 54 different points in the bodies of 59 males (aged 20-25) and 66 females (aged 20-23). The results were as follows: 1. The females had significantly thicker subcutaneous fat than those of the males at every point measured. 2. The thick subcutaneous fats were observed at the abdomen, buttocks, and the anterior and medial parts of the thigh in the males, and at the breast, buttocks, abdomen, the posterior, medial, and anterior parts of the thigh, and the anterior, medial, and posterior parts of the upperarm in the females, respectively. 3. The subcutaneous fat of both sexes was more likely to be thicker in body parts closer to the trunk than the extremities. 4. The correlation coefficient between the percent body fat and the mean thickness of subcutaneous fat obtained from data was 0.91 for the males and 0.83 for the females.     

THE RELIABILITY OF SKINFOLD-CALIPERS FOR MEASURING BLUBBER THICKNESS OF STELLER SEA LION PUPS (EUMETOPIAS JUBATUS)

Twelve dead Steller sea lion pups ( Eumetopias jubatus ) aged 3-14 d were recovered from rookeries in Southeast Alaska. They had a wide range of body sizes and conditions (small to large and fat to no fat). The ability of calipers to estimate the thickness of their blubber layer was assessed with a set of skinfold calipers. Average error of measurement for skin and blubber thickness was an acceptable 5.4%, but the skin and blubber of the pups were highly compressible. Skinfold thickness increased with body mass but did not necessarily reflect the development of blubber, given that pups with no blubber also showed an increase in skinfold thickness with increases in body mass. Skinfold thickness of sea lion pups appears to predict body size better than it predicts blubber thickness, making it difficult if not impossible to develop a simple index of body condition or a calculation of percent body fat for Steller sea lion pups from skinfold caliper measurements.     

Fat distribution in lean and obese young indian women: A densitometric and anthropometric evaluation

The pattern of fat distribution in lean and obese young Indian women was studied using seven girths and ten skinfold thicknesses. Though the lean and obese subjects differed significantly with respect to their body weight and total body fat content, body girths indicated that the proportion of fat distributed between the extremities and over the trunk region was essentially similar. By comparing skinfold thicknesses, it was observed that the fat women were merely an exaggeration of the fat profile pattern of the lean women. Although the pattern of subcutaneous fat distribution was similar in lean and obese subjects, the rate of fat deposition differed on different parts of the body with increase in total adiposity.     

Influences of probe application on the measurement of subcutaneous thickness using A-mode ultrasonography

The purpose of the present study was to investigate the effects of the way of probe application on the values of subcutaneous fat thickness by use of A-mode ultrasonography . Subjects were six healthy male adults ranging in age from 19 to 35 years. Scapular, triceps, supra-iliac, abdomen, and thigh were chosen for the measurement sites. Observed values of subcutaneous fat decreased with the increase of pressure at scapular, supra-iliac, and abdomen for relatively fatty subjects, but not for lean subjects. However, the values showed little change at triceps and thigh for all subjects. There was no relation between the pressure of probe and the stability of the value. The values were also influenced by the displacement of the probe on skin. Moreover, it was shown that the difference of the angle between probe and skin influenced the values of subcutaneous fat thickness. A-mode ultrasonography++ has many advantages, if it is properly operated considering the above problems.     

湖南土家族成人的皮褶厚度和体成分分析

本项目采用人体测量法,测量了976名(男性528人,女性448人)湖南土家族成人的身高、体质量以及肱三头肌、肩胛下、髂前上和小腿内侧皮褶的厚度,并根据公式计算体密度、体脂率、脂肪质量、脂肪质量指数、瘦体质量和瘦体质量指数。结果显示随年龄增长,小腿内侧皮褶厚度值逐渐减小,肱三头肌、肩胛下和髂前上棘皮褶以及体脂率、脂肪质量、瘦体质量、体质量指数、脂肪质量指数和瘦体质量指数值先增大后减小,体密度值先减小后增大;各年龄组中体密度、瘦体质量及其指数值女性明显低于男性,4项皮褶厚度值以及体脂率、脂肪质量及其指数值女性高于男性;与布朗族等24个族群比较,湖南土家族成人皮褶厚度处于中等水平,与门巴族、珞巴族、僜人、彝族等族群的亲缘关系较近。     

DNA Polymorphisms in the α2- and β2 Adrenoceptor Genes and Regional Fat Distribution in Humans: Association and Linkage Studies

The aim of this study was to investigate the relationships between DNA restriction fragment length polymorphisms (RFLP) in the α₂- and β₂-adrenoceptor genes and body fat distribution in humans. Skinfold thickness measurements and genetic analyses (Southern blot) were performed on 280 individuals (142 parents and 138 offsprings) from the Québec Family Study. Using the association study design in unrelated adults, women but not men carrying the 6.3-kb allele of an α_2A-adrenoceptor/DraI RFLP had a significantly higher trunk to extremity skinfold ratio (= sum of subscapular + suprailiac + abdominal skinfolddsum of biceps + triceps + medial calf skinfolds) compared to women without the allele (1.44 ± 0.52 vs. 1.12 ± 0.33; p<0.005 after adjustment for age, p<0.002 after adjustment for age and body mass index or for age and subcutaneous fat). Using the sib-pair linkage procedure, a significant inverse relationship was found between the proportion of alleles identical by descent shared by sibs at the α2A RFLP marker locus and the squared differences of thetrunk to extremity skinfold ratio (p = 0.02 after adjustment for age or for age and body mass index or for age and subcutaneous fat). For a β-adrenoceptor/ BanI RFLP, no significant association or linkage was found between fat distribution indicators and the marker. These results suggest that α_2A-adrenoceptor gene variability detected with DraI is associated with a relative subcutaneous fat pattern favoring accumulation of truncal-abdominal fat in women, and that the α_2A-adrenoceptogr ene, or a locus in close proximity, may be linked to body fat distribution in humans independently of the overall level of fatness.     

Association between body mass index and muscularity in healthy older Japanese women and men

Background

Body mass index (BMI), expressed as the ratio of body mass to height squared (kg/m²), involves not only fat but also lean mass. The present study aimed to clarify how BMI is associated with total muscle mass (TMM) in older Japanese women and men.

Findings

Using a B-mode ultrasound apparatus, muscle thickness was measured at nine sites (forearm, upper arm anterior and posterior, thigh anterior and posterior, lower leg anterior and posterior, abdomen, and subscapular) for 346 women (BMI 16.40 to 33.11 kg/m²) and 286 men (BMI 16.86 to 31.18 kg/m²) aged 60.0 to 79.5 yrs. TMM was estimated using the product of the sum of the muscle thicknesses at the nine sites with height as an independent variable. For both sexes, the estimated TMM relative to height squared was significantly correlated with BMI (r = 0.688, P<0.0001 for women; r = 0.696, P<0.0001 for men), but the percentage of the estimated TMM in body mass was not.

Conclusion

These results indicate that, for older Japanese women and men, BMI is a simple and convenient index for assessing total muscularity.     

Smoking in pregnancy: associations with skinfold thickness,maternal weight gain,and fetal size at birth.

Skinfold thickness is an index of subcutaneous fat, and certain maternal conditions during pregnancy affect the skinfold thicknesses of the baby. A study was performed to investigate the effect of smoking on skinfold thickness, maternal weight gain, and fetal size at birth. A total of 452 mothers with normal singleton pregnancies were groups as: non-smokers, light-to-moderate smokers, or heavy smokers. Maternal age, height, parity, and duration of pregnancy were similar in the three groups. Heavy smokers gained significantly less weight than non-smokers, but there was no significant difference in skinfold thickness. Babies born to smokers had lower birth weights and smaller head circumferences and were shorter than those born to non-smokers, but skinfold thicknesses were similar. The presence of a normal layer of subcutaneous fat in babies whose mothers smoked suggests that fetal growth retardation is not caused by nutritional deficiencies.     

Gender Differences in Changes in Subcutaneous and Intra-abdominal Fat during Weight Reduction: An Ultrasound Study

WIRTH, ALFRED, AND BERIT STEINMETZ. Gender differences in changes in subcutaneous and intra-abdominal fat during weight reduction: an ultrasound study. Obes Res. 1998;6:393–399. Objective : In weight-reducing programs, men usually display greater improvement in metabolic risk factors than women. This gender difference may be related to enhanced weight and fat loss due to a greater energy deficit in men. To clarify the relationship between changes in metabolic profile, body fat composition, and weight loss, both sexes were studied under a regimen in which similar amounts of weight were lost. Research Methods and Procedures : A cross-sectional study using anthropometric (body mass index and waist-to-hip ratio), impedance (bioelectrical impedance analysis) and ultrasound measurement methods (thickness of subcutaneous fat layers, intra-abdominal sagittal diameter) were conducted. The metabolic risk profile was determined by measuring lipids, lipoproteins, and blood pressure. The weight loss program lasted 15 weeks: 3 weeks under controlled conditions in the hospital and 12 weeks on an ambulatory basis. Patients were instructed to follow a mixed diet. Calorie intake was restricted to 1500 kcal/day for the men and 1200 kcal/day for the women. Thirty-two subjects with obesity (16 men and 16 women), with a mean body mass index of 35 kg/m²—matched with regard to age, height, and body weight—took part in the study. Results : As expected, weight loss was similar for both sexes (?13.4 kg vs. ?12.8 kg). Also, body fat mass changed to the same extent in absolute and relative terms. The waist-to-hip ratio was identical before and after treatment in both sexes. The men lost more visceral fat than the women. This result is based on changes in intra-abdominal diameter as well as abdominal subcutaneous fat in relation to waist circumference. Changes in abdominal diameter were paralleled by reductions in triglycerides and increases in high-density lipoprotein-cholesterol. Subcutaneous fat loss was more pronounced in women than in men. Discussion : Where absolute and relative reductions in body weight and body fat are similar, men mobilize more intraabdominal fat than women, whereas women lose more subcutaneous fat. The greater reduction in intra-abdominal fat seen in men is accompanied by a more pronounced improvement in the metabolic risk profile. Therefore, greater improvement of risk factors in men is not only related to a greater negative energy balance, as shown in most studies, but is also sex-specific.     

Body build related body composition and nutrition in adulthood--a comparison of skinfold thickness measurement and bioelectric impedance analysis

The objective of the present study was to conduct a comprehensive analysis of body build, body composition and nutritional status. The study sample consists of 498 men and women aged from 35 to 65 years. Subjects underwent a detailed anthropometric examination incompassing thirty-one body measurements, eleven skinfold thickness measurements, and bioelectrical impedance analysis for determination of body composition. Dietary intake was assessed by a semiquantitative food frequency questionnaire. Body composition was clearly associated with age and body build. Somatometric differentiation by use of the metric index showed that percentage of body fat was significantly higher in pycnomorphic compared to leptomorphic subjects, whereas reported dietary energy intake was lower. Comparison of estimates of body fat showed considerably deviating results for skinfold thickness measurements and bioelectrical impedance analysis depending on the equations used. This was especially pronounced in obese subjects, where, on an average, bioelectrical impedance analysis resulted in higher values for percentage of body fat compared to skinfold thickness measurements. We conclude that for assessment of nutritional status body composition should be investigated taking into account body build in addition to age and sex.     

Stability of Adiposity Phenotypes from Childhood and Adolescence into Young Adulthood with Contribution of Parental Measures

Objective: The stability of several indicators of body composition and adipose tissue distribution over 12 years was quantified. Research Methods and Procedures: The participants were 77 boys and 76 girls who were evaluated along with their parents at baseline as children and adolescents (8 to 18 years of age) and remeasured as young adults 12 years later. Indicators of body composition included the body mass index, fat mass, fat free mass, percentage of body fat, sum of six skinfolds (SF6), and the first principal component of six age‐adjusted skinfold residuals. Relative adipose tissue distribution was represented by the second principal component of skinfold residuals and a trunk‐to‐extremity skinfold ratio, adjusted for SF6. Results: Partial interage correlations, controlling for initial age and length of follow‐up, were 0.65 and 0.59 for the body mass index, 0.59 and 0.64 for fat mass, 0.65 and 0.57 for fat free mass, 0.50 and 0.57 for percentage of body fat, 0.66 and 0.44 for SF6, 0.64 and 0.42 for the first principal component of six age‐adjusted skinfold residuals, 0.19 and 0.31 for the second principal component of skinfold residuals, and 0.41 and 0.47 for trunk‐to‐extremity skinfold ratio, adjusted for SF6, in men and women, respectively. Multiple regression analyses indicated that the significant partial R² values of parental measurements on the prediction of their offspring in young adulthood ranged from 2% to 9%. Discussion: The results indicate moderately high stability of indicators of body composition and somewhat lower stability of measures of adipose tissue distribution. Overall, parental measures offer less predictive value than do measures of childhood and adolescent body composition and adipose tissue distribution.     

Fatness and fat patterning in relation to age changes and menarche

The present study assesses changes with age in fatness and fat patterning in a cross-sectional sample of Spanish schoolgirls from 6 to 16 years of age living in an urban area (Madrid). Arm muscle area and arm fat area were derived from middle-upper arm anthropometry. Body mass index (weight/height²) and the sum of the skinfold thicknesses at three sites (triceps, subscapular and suprailiac) were computed as indices of adiposity; and two indices of subcutaneous fat distribution were also defined: the natural logarithms of subscapular/triceps and suprailiac/triceps skinfold thickness ratios. Changes with age in these variables are described, including some pattern changes found in amount of fatness as well as in fat distribution at pubescence. At this time, there is a plateau in fat deposition, and even a fat loss the average (at triceps site). Prior to pubescence, subcutaneous fat distribution changes from «pheripheral» to a more generalized pattern, but no well-defined pattern of change is found after the onset of menarche. Furthermore, the effect of the onset of puberty on all these variables is analyzed.     

Relationship of Anterior and Posterior Subcutaneous Abdominal Fat to Insulin Sensitivity in Nondiabetic Men

Recent studies from our group reveal that adipose tissue (AT) in the subcutaneous abdominal region is the most important determinant of peripheral and hepatic insulin sensitivity. Because of different anatomic and physiologic characteristics of anterior and posterior subcutaneous abdominal AT, we investigated the relationship of the masses of each compartment, as determined by magnetic resonance imaging, to insulin sensitivity (using euglycemic hyperinsulinemic glucose clamp technique), and other anthropometric variables. Thirty-four healthy men with varying ranges of obesity were recruited for the study. The mass of posterior subcutaneous abdominal AT was ～1.6 times more than that of the anterior compartment, and these masses accounted for 12.9% and 8.2% of the total body fat mass, respectively. All anthropometric variables, including body mass index (BMI), waist-to-hip circumference ratio (WHR), skinfold thicknesses, and intraperitoneal AT mass were more significantly related to the posterior than the anterior subcutaneous abdominal AT mass. Compared to the anterior compartment mass, the posterior compartment mass displayed stronger relationship with insulin-mediated glucose disposal (Rd) (r=-0.44, p=0.009, and r=-0.76, p=0.0001, respectively) as well as with residual hepatic glucose output during the 40 mU.^?2.min-¹ insulin infusion (r=0.39, p=0.02, and r=0.53, p=0.001, respectively). After adjusting for total body fat, the Rd values showed a significant partial correlation with the posterior subcutaneous abdominal AT mass (r=-0.52, p=0.002). To conclude, posterior subcutaneous abdominal AT mass is a more important determinant of peripheral and hepatic insulin sensitivity than the anterior subcutaneous abdominal AT.     

Ultrasound Measurements of Visceral and Subcutaneous Abdominal Thickness to Predict Abdominal Adiposity Among Older Men and Women

Accurate measures of visceral and abdominal subcutaneous fat are essential for investigating the pathophysiology of obesity. Classical anthropometric measures such as waist and hip circumference cannot distinguish between these two fat depots. Direct imaging methods such as computed tomography and magnetic resonance imaging (MRI) are restricted in large‐scale studies due to practical and ethical issues. We aimed to establish whether ultrasound is a valid alternative method to MRI for the quantitative assessment of abdominal fat depots in older individuals. The study population comprised 74 white individuals (41 men and 33 women, aged 67–76 years) participating in the Hertfordshire Birth Cohort Physical Activity trial. Anthropometry included height, weight, waist and hip circumferences. Abdominal fat was measured by ultrasound in two compartments: visceral fat defined as the depth from the peritoneum to the lumbar spine; and subcutaneous fat defined as the depth from the skin to the abdominal muscles and compared to reference measures by MRI (10‐mm single‐slice image). Ultrasound measures were positively correlated with MRI measures of visceral and subcutaneous fat (visceral: r = 0.82 and r = 0.80 in men and women, respectively; subcutaneous: r = 0.63 and 0.68 in men and women, respectively). In multiple regression models, the addition of ultrasound measures significantly improved the prediction of visceral fat and subcutaneous fat in both men and women over and above the contribution of standard anthropometric variables. In conclusion, ultrasound is a valid method to estimate visceral fat in epidemiological studies of older men and women when MRI and computed tomography are not feasible.     

Estimation of body fat in female rhesus monkeys

Measurement of height (crown–rump length), body weight, and abdominal subcutaneous fat depth, based on skinfold thickness taken from 13 female rhesus monkeys comprising two age groups were correlated with body fat values derived from tritiated water determinations of total body water. The manner with which each measure was related to percent body fat differed as a function of age of the animal. In the young, nulliparous females, crown–rump length was the single best predictor of body fat, whereas in the older, multiparous females, skinfold thickness correlated most highly with body fat. When all measurements, including the Quetelet index [(wt/ht)² × 1,000], were combined statistically and regressed against percent body fat, a significant increase in predictive ability was obtained. When each age group was considered separately, the resulting equations again reflected the agegroup biases. In addition, as an internal check on the validity of the regression equations, an additional regression analysis was performed using morphometric data from selected animals in each age group. These equations yielded accurate estimates of body fat when compared to determinations made from total body water. These analyses indicate that the predictive accuracy of morphometric data is greatly enhanced by using these measurements in concert. Furthermore, the utility of such predictions is influenced by the specific physical characteristics of the subject population.