Reference Values for Body Composition and Anthropometric Measurements in Athletes

Background

Despite the importance of body composition in athletes, reference sex- and sport-specific body composition data are lacking. We aim to develop reference values for body composition and anthropometric measurements in athletes.

Methods

Body weight and height were measured in 898 athletes (264 female, 634 male), anthropometric variables were assessed in 798 athletes (240 female and 558 male), and in 481 athletes (142 female and 339 male) with dual-energy X-ray absorptiometry (DXA). A total of 21 different sports were represented. Reference percentiles (5^th, 25^th, 50^th, 75^th, and 95^th) were calculated for each measured value, stratified by sex and sport. Because sample sizes within a sport were often very low for some outcomes, the percentiles were estimated using a parametric, empirical Bayesian framework that allowed sharing information across sports.

Results

We derived sex- and sport-specific reference percentiles for the following DXA outcomes: total (whole body scan) and regional (subtotal, trunk, and appendicular) bone mineral content, bone mineral density, absolute and percentage fat mass, fat-free mass, and lean soft tissue. Additionally, we derived reference percentiles for height-normalized indexes by dividing fat mass, fat-free mass, and appendicular lean soft tissue by height squared. We also derived sex- and sport-specific reference percentiles for the following anthropometry outcomes: weight, height, body mass index, sum of skinfold thicknesses (7 skinfolds, appendicular skinfolds, trunk skinfolds, arm skinfolds, and leg skinfolds), circumferences (hip, arm, midthigh, calf, and abdominal circumferences), and muscle circumferences (arm, thigh, and calf muscle circumferences).

Conclusions

These reference percentiles will be a helpful tool for sports professionals, in both clinical and field settings, for body composition assessment in athletes.     

Identification of Hemoglobin Levels Based on Anthropometric Indices in Elderly Koreans

ObjectivesAnemia is independently and strongly associated with an increased risk of mortality in older people and is also strongly associated with obesity. The objectives of the present study were to examine the associations between the hemoglobin level and various anthropometric indices, to predict low and normal hemoglobin levels using combined anthropometric indices, and to assess differences in the hemoglobin level and anthropometric indices between Korean men and women.MethodsA total of 7,156 individuals ranging in age from 53–90 years participated in this retrospective cross-sectional study. Binary logistic regression (LR) and naïve Bayes (NB) models were used to identify significant differences in the anthropometric indices between subjects with low and normal hemoglobin levels and to assess the predictive power of these indices for the hemoglobin level.ResultsAmong all of the variables, age displayed the strongest association with the hemoglobin level in both men (p < 0.0001, odds ratio [OR] = 0.487, area under the receiver operating characteristic curve based on the LR [LR-AUC] = 0.702, NB-AUC = 0.701) and women (p < 0.0001, OR = 0.636, LR-AUC = 0.625, NB-AUC = 0.624). Among the anthropometric indices, weight and body mass index (BMI) were the best predictors of the hemoglobin level. The predictive powers of all of the variables were higher in men than in women. The AUC values for the NB-Wrapper and LR-Wrapper predictive models generated using combined anthropometric indices were 0.734 and 0.723, respectively, for men and 0.649 and 0.652, respectively, for women. The use of combined anthropometric indices may improve the predictive power for the hemoglobin level.DiscussionAmong the various anthropometric indices, with the exception of age, we did not identify any indices that were better predictors than weight and BMI for low and normal hemoglobin levels. In addition, none of the ratios between pairs of indices were good indicators of the hemoglobin level. Finally, the Korean men tended to have higher associations between the anthropometric indices and anemia than the women.     

Evaluation of the Accuracy of Anthropometric Clinical Indicators of Visceral Fat in Adults and Elderly

BackgroundVisceral obesity is associated with higher occurrence of cardiovascular events. There are few studies about the accuracy of anthropometric clinical indicators, using Computed Tomography (CT) as the gold standard. We aimed to determine the accuracy of anthropometric clinical indicators for discrimination of visceral obesity.MethodsCross-sectional study with 191 adults and elderly of both sexes. Variables: area of visceral adipose tissue (VAT) identified by CT, Waist-to-Height Ratio (WHtR), Conicity index (C index), Lipid Accumulation Product (LAP) and Visceral Adiposity Index (VAI). ROC analyzes.ResultsThere were a strong correlation between adiposity indicators and VAT area. Higher accuracy of C index and WHtR (AUC≥0.81) than the LAP and the VAI was observed. The higher AUC of LAP and VAI were observed among elderly with areas of 0.88 (CI: 0.766–0.944) and 0.83 (CI: 0.705–0.955) in men and 0.80 (CI: 0.672–0.930) and 0.71 (CI: 0.566–0.856) in women, respectively. The cutoffs of C index were 1.30 in elderly, in both sexes, with sensitivity ≥92%, the LAP ranged from 26.4 to 37.4 in men and from 40.6 to 44.0 in women and the VAI was 1.24 to 1.45 (sens≥76.9%) in men and 1.46 to 1.84 in women.ConclusionBoth the anthropometric indicators, C Index and WHtR, as well as LAP and VAI had high accuracy in visceral obesity discrimination. So, they are effective in cardiovascular risk assessment and in the follow-up for individual and collective clinical practice.     

Feasibility,Reliability, and Validity of a Smartphone Based Application for the Assessment of Cognitive Function in the Elderly

While considerable knowledge has been gained through the use of established cognitive and motor assessment tools, there is a considerable interest and need for the development of a battery of reliable and validated assessment tools that provide real-time and remote analysis of cognitive and motor function in the elderly. Smartphones appear to be an obvious choice for the development of these “next-generation” assessment tools for geriatric research, although to date no studies have reported on the use of smartphone-based applications for the study of cognition in the elderly. The primary focus of the current study was to assess the feasibility, reliability, and validity of a smartphone-based application for the assessment of cognitive function in the elderly. A total of 57 non-demented elderly individuals were administered a newly developed smartphone application-based Color-Shape Test (CST) in order to determine its utility in measuring cognitive processing speed in the elderly. Validity of this novel cognitive task was assessed by correlating performance on the CST with scores on widely accepted assessments of cognitive function. Scores on the CST were significantly correlated with global cognition (Mini-Mental State Exam: r = 0.515, p<0.0001) and multiple measures of processing speed and attention (Digit Span: r = 0.427, p<0.0001; Trail Making Test: r = −0.651, p<0.00001; Digit Symbol Test: r = 0.508, p<0.0001). The CST was not correlated with naming and verbal fluency tasks (Boston Naming Test, Vegetable/Animal Naming) or memory tasks (Logical Memory Test). Test re-test reliability was observed to be significant (r = 0.726; p = 0.02). Together, these data are the first to demonstrate the feasibility, reliability, and validity of using a smartphone-based application for the purpose of assessing cognitive function in the elderly. The importance of these findings for the establishment of smartphone-based assessment batteries of cognitive and motor function in the elderly is discussed.     

Prediction of Visceral Adipose Tissue from Simple Anthropometric Measurements in Youths with Obesity

OWENS, SCOTT, MARK LITAKER, JERRY ALLISON, SHARON RIGGS, MICHAEL FERGUSON, AND BERNARD GUTIN. Prediction of visceral adipose tissue from simple anthropometric measurements in youths with obesity. Obes Res. 1999;7:16–22. Objective : Although visceral adipose tissue (VAT) is the component of body composition most highly associated with cardiovascular risk factors, its measurement requires expensive procedures, such as magnetic resonance imaging. This study examined the ability of simple demographic and anthropometric measurements to predict magnetic resonance imaging-derived VAT in 76 apparently healthy, black and white youths with obesity who were 7 years to 16 years of age. Research Methods and Procedures : Stepwise multiple linear regression was used to develop a prediction equation for VAT based on 13 simple anthropometric variables (height, weight, body mass index, triceps skinfold, calf skinfold, sagittal diameter, waist circumference, hip circumference, thigh circumference, waist/hip ratio, waist/thigh ratio, sagittal diameter/thigh ratio, and percent body fat from the sum of calf and triceps skinfolds) and three demographic variables (age, gender and ethnicity). Results : The stepwise multiple regression procedure yielded a final model that included two anthropometric variables (sagittal diameter and waist/hip ratio) and one demographic variable (ethnicity). The prediction equation was: VAT = ?124.06+16.67 (ethnicity)+4.15 (sagittal diameter)-+17.89 (waist/hip ratio), where ethnicity was coded as 0 = black and 1 = white. The model explained 63% of the variance in VAT and was associated with a measurement error of 23.9%. Discussion : Although the model seems to lack sufficient explanatory power for routine use in clinical settings with individual patients, it may have some utility in epidemiological studies given its relatively small (<25%) standard error of estimate.     

Prediction of Percentage Body Fat in Rural Thai Population Using Simple Anthropometric Measurements

Objective: To develop and validate sex‐specific equations for predicting percentage body fat (%BF) in rural Thai population, based on BMI and anthropometric measurements. Research Methods and Procedures: %BF (DXA; GE Lunar Corp., Madison, WI) was measured in 181 men and 255 women who were healthy and between 20 and 84 years old. Anthropometric measures such as weight (kilograms), height (centimeters), BMI (kilograms per meter squared), waist circumference (centimeters), hip circumference (centimeters), thickness at triceps skinfold (millimeters), biceps skinfold (millimeters), subscapular skinfold (millimeters), and suprailiac skinfold (millimeters) were also measured. The sample was randomly divided into a development group (98 men and 125 women) and a validation group (83 men and 130 women). Regression equations of %BF derived from the development group were then evaluated for accuracy in the validation group. Results: The equation for estimating %BF in men was: %BF(men) = 0.42 × subscapular skinfold + 0.62 × BMI ? 0.28 × biceps skinfold + 0.17 × waist circumference ? 18.47, and in women: %BF(women) = 0.42 × hip circumference + 0.17 × suprailiac skinfold + 0.46 × BMI ? 23.75. The coefficient of determination (R²) for both equations was 0.68. Without anthropometric variables, the predictive equation using BMI, age, and sex was: %BF = 1.65 × BMI + 0.06 × age ? 15.3 × sex ? 10.67 (where sex = 1 for men and sex = 0 for women), with R² = 0.83. When these equations were applied to the validation sample, the difference between measured and predicted %BF ranged between ±9%, and the positive predictive values were above 0.9. Discussion: These results suggest that simple, noninvasive, and inexpensive anthropometric variables may provide an accurate estimate of %BF and could potentially aid the diagnosis of obesity in rural Thais.     

Reliability of Protein Abundance and Synthesis Measurements in Human Skeletal Muscle

The repeatability of dynamic proteome profiling (DPP), which is a novel technique for measuring the relative abundance (ABD) and fractional synthesis rate (FSR) of proteins in humans, is investigated. LC–MS analysis is performed on muscle samples taken from male participants (n = 4) that consumed 4 × 50 mL doses of deuterium oxide (²H₂O) per day for 14 days. ABD is measured by label‐free quantitation and FSR is calculated from time‐dependent changes in peptide mass isotopomer abundances. One‐hundred one proteins have at least one unique peptide and are used in the assessment of protein ABD. Fifty‐four of these proteins meet more stringent criteria and are used in the assessment of FSR data. The median (M), lower‐, (Q₁) and upper‐quartile (Q₃) values for protein FSR (%/d) are M = 1.63, Q₁ = 1.07, and Q₃ = 3.24, respectively. The technical CV of ABD data has a median value of 3.6% (Q₁ 1.7% to Q₃ 6.7%), whereas the median CV of FSR data is 10.1% (Q₁ 3.5% to Q₃ 16.5%). These values compare favorably against other assessments of technical repeatability of proteomics data, which often set a CV of 20% as the upper bound of acceptability.     

Reliability of Corneal Dynamic Scheimpflug Analyser Measurements in Virgin and Post-PRK Eyes

Purpose

To determine the measurement reliability of CorVis ST, a dynamic Scheimpflug analyser, in virgin and post-photorefractive keratectomy (PRK) eyes and compare the results between these two groups.

Methods

Forty virgin eyes and 42 post-PRK eyes underwent CorVis ST measurements performed by two technicians. Repeatability was evaluated by comparing three consecutive measurements by technician A. Reproducibility was determined by comparing the first measurement by technician A with one performed by technician B. Intraobserver and interobserver intraclass correlation coefficients (ICCs) were calculated. Univariate analysis of covariance (ANCOVA) was used to compare measured parameters between virgin and post-PRK eyes.

Results

The intraocular pressure (IOP), central corneal thickness (CCT) and 1_st applanation time demonstrated good intraobserver repeatability and interobserver reproducibility (ICC≧0.90) in virgin and post-PRK eyes. The deformation amplitude showed a good or close to good repeatability and reproducibility in both groups (ICC≧0.88). The CCT correlated positively with 1_st applanation time (r = 0.437 and 0.483, respectively, p<0.05) and negatively with deformation amplitude (r = −0.384 and −0.375, respectively, p<0.05) in both groups. Compared to post-PRK eyes, virgin eyes showed longer 1_st applanation time (7.29±0.21 vs. 6.96±0.17 ms, p<0.05) and lower deformation amplitude (1.06±0.07 vs. 1.17±0.08 mm, p<0.05).

Conclusions

CorVis ST demonstrated reliable measurements for CCT, IOP, and 1_st applanation time, as well as relatively reliable measurement for deformation amplitude in both virgin and post-PRK eyes. There were differences in 1_st applanation time and deformation amplitude between virgin and post-PRK eyes, which may reflect corneal biomechanical changes occurring after the surgery in the latter.     

Reliability of Phase Velocity Measurements of Flexural Acoustic Waves in the Human Tibia In-Vivo

Purpose

Axial-transmission acoustics have shown to be a promising technique to measure individual bone properties and detect bone pathologies. With the ultimate goal being the in-vivo application of such systems, quantification of the key aspects governing the reliability is crucial to bring this method towards clinical use.

Materials and Methods

This work presents a systematic reliability study quantifying the sources of variability and their magnitudes of in-vivo measurements using axial-transmission acoustics. 42 healthy subjects were measured by an experienced operator twice per week, over a four-month period, resulting in over 150000 wave measurements. In a complementary study to assess the influence of different operators performing the measurements, 10 novice operators were trained, and each measured 5 subjects on a single occasion, using the same measurement protocol as in the first part of the study.

Results

The estimated standard error for the measurement protocol used to collect the study data was ∼ 17 m/s (∼ 4% of the grand mean) and the index of dependability, as a measure of reliability, was Φ = 0.81. It was shown that the method is suitable for multi-operator use and that the reliability can be improved efficiently by additional measurements with device repositioning, while additional measurements without repositioning cannot improve the reliability substantially. Phase velocity values were found to be significantly higher in males than in females (p < 10⁻⁵) and an intra-class correlation coefficient of r = 0.70 was found between the legs of each subject.

Conclusions

The high reliability of this non-invasive approach and its intrinsic sensitivity to mechanical properties opens perspectives for the rapid and inexpensive clinical assessment of bone pathologies, as well as for monitoring programmes without any radiation exposure for the patient.     

基于形态特征判定五种鹬类性别的可靠性

快速准确地鉴定两性同型鸟类个体性别在鸟类生态学研究中具有重要意义。本文选择2008年春季迁徙期在崇明东滩停歇的大滨鹬(Calidris tenuirostris)、红腹滨鹬(C.canutus)、红颈滨鹬(C.ruficollis)、尖尾滨鹬(C.acuminata)及翘嘴鹬(Xenus cinereus)5种两性同型的鹬类,用分子生物学方法进行性别鉴定,并基于个体的形态特征(体重、翅长、喙长、头喙长及跗跖长)采用判别分析方法对性别进行判定。结果表明,尖尾滨鹬雄性各形态特征均显著大于雌性,其他4种鹬类则相反。5种鹬类形态特征的性别差异指数在0.5%~25.3%之间,重叠度在29.4%~98.6%之间。5种鹬类判别分析判定性别的准确率在(0.69±0.06)~(0.96±0.01)之间,其中,尖尾滨鹬判别准确率(0.96)最高,翘嘴鹬判别准确率(0.69)最低。形态特征在两性间的差异程度影响性别的判别准确率。另外,两性性比对性别判别的准确率也有影响:性比偏雄性鸟类的雄性判别准确率高于雌性,而性比偏雌性鸟类的雌性判别准确率高于雄性。采用判别分析估测的性比与分子生物学鉴定结果相似,表明判别分析在判定种群的性比方面具有较高的可靠性。     

Symptoms of Depression in Elderly Korean Immigrants: Narration and the Healing Process

This paper explores ways in which depressive symptoms are expressed by elderly Korean immigrants in the USA. Depressed elderly Korean immigrants in the Washington DC area were interviewed in depth to explore their conceptualizations of depression in terms of explanatory models and semantic networks. The expressions of depressive symptoms were influenced by linguistic and psycho-socio-cultural factors, therapeutic behaviors, and efficacy of treatment. The data were interpreted in terms of traditional Korean medical principles, cosmological, socio-cultural, and religious influences, and an individual's family structural changes and acculturation. Findings indicate the construction of somatization among Korean elders is more complex than is generally reported: in most cases, a dynamic, holistic blend of processes appears to operate simultaneously, instead of as somatization in isolation. Informants placed different degrees of emphasis on psychologization or somatization, or the two combined. The roles of personality, value orientation, intellect, emotion, economic status, degree of acculturation, degree of dependence on children, living situation (with or not with children), and self-will or self-confidence are important influences on the depression symptoms in the psychologization-somatization continuum. The more self-directed the informants are, the more they psychologize; the more other-directed, the more they seem to somatize. Names and symptoms of depression (a Western concept) and popular illnesses (traditional Korean concepts) were used interchangeably by the informants. When informants were asked to explain the signs and symptoms of depression and sadness, some described symptoms similar to the criteria of major depression in DSM-III (American Psychiatric Association), while others gave different symptoms and ways of expressing them. Some informants believed that symptoms and signs of depression can be concealed from others if one chooses to do so. Many felt that manifestations of depression can be controlled by willpower, personality, and self-care.     

Reliability of System Identification Techniques to Assess Standing Balance in Healthy Elderly

Objectives

System identification techniques have the potential to assess the contribution of the underlying systems involved in standing balance by applying well-known disturbances. We investigated the reliability of standing balance parameters obtained with multivariate closed loop system identification techniques.

Methods

In twelve healthy elderly balance tests were performed twice a day during three days. Body sway was measured during two minutes of standing with eyes closed and the Balance test Room (BalRoom) was used to apply four disturbances simultaneously: two sensory disturbances, to the proprioceptive and the visual system, and two mechanical disturbances applied at the leg and trunk segment. Using system identification techniques, sensitivity functions of the sensory disturbances and the neuromuscular controller were estimated. Based on the generalizability theory (G theory), systematic errors and sources of variability were assessed using linear mixed models and reliability was assessed by computing indexes of dependability (ID), standard error of measurement (SEM) and minimal detectable change (MDC).

Results

A systematic error was found between the first and second trial in the sensitivity functions. No systematic error was found in the neuromuscular controller and body sway. The reliability of 15 of 25 parameters and body sway were moderate to excellent when the results of two trials on three days were averaged. To reach an excellent reliability on one day in 7 out of 25 parameters, it was predicted that at least seven trials must be averaged.

Conclusion

This study shows that system identification techniques are a promising method to assess the underlying systems involved in standing balance in elderly. However, most of the parameters do not appear to be reliable unless a large number of trials are collected across multiple days. To reach an excellent reliability in one third of the parameters, a training session for participants is needed and at least seven trials of two minutes must be performed on one day.     

Outcomes of Sustained-Release Formulation of Valproate and Topiramate Monotherapy in Patients with Epilepsy: A Multi-Centre,Cohort Study

Background

New-generation antiepileptic drugs (AEDs) tend to replace traditional AEDs as the first-line choice for epilepsy. However, whether this change results in better outcome, especially in China, remains unknown.

Methodology/Principal Findings

Two broad spectrum AEDs, the traditional drug of sustained-release formulation of valproate (SRVPA) and the new-generation drug of topiramate, were compared in patients with epilepsy as monotherapy in this multi-centre, observational cohort study from 2000 to 2011. The primary outcome was time to treatment failure. The secondary outcomes included time to first seizure, time to 12-month remission, and time to 24-month remission. Drug tolerability was assessed. Cox proportional hazard models (95% confidence interval [CI]) were used to analyse the relative risks expressed as hazard ratios (HR).Of the 1008 recruited patients, 519 received SRVPA and 489 received topiramate. SRVPA was better than topiramate (28.3% vs. 41.5%; HR = 0.62, [95% CI 0.49–0.77]; p<0.0001) in primary outcome, and in time to first seizure (56.1% vs. 69.3%; HR = 0.73, [95% CI 0.62–0.86]; p = 0.0002). No significant difference was observed between two groups in time to 12-month remission (52.6% vs. 42.5%; HR = 1.01, [95% CI 0.84–1.23]; p = 0.88) and time to 24-month remission (34.7% vs. 25.2%; HR = 1.11, [95% CI 0.88–1.42]; p = 0.38). 36 patients (6.9%) in SRVPA group and 37 patients (7.6%) in topiramate group presented treatment failure associated with intolerable adverse events, there was no significant difference between the two groups (p = 0.70).

Conclusions

The SRVPA is more suitable than topiramate for Chinese epileptic patients, and our results support the viewpoint that traditional AEDs should be the first-line choice for epilepsy rather than new-generation AEDs.     

Daily Peak Flow Measurements in the Assessment of Steroid Therapy for Airway Obstruction

Measurements of peak expiratory flow can be made by outpatients on themselves. This technique, which may be carried out at home, has proved to be valuable in assessing the effect of steroids and other bronchodilator drugs in relieving airway obstruction.     

衰弱量表在老年冠心病患者衰弱评估中的应用及其影响因素分析

目的:探讨三种衰弱评估量表对于老年冠心病患者衰弱病情评估的相关性及其影响因素。方法:选择2015年5月到2016年10月在老年医学中心确诊的120例冠心病患者作为研究对象,收集患者的临床资料,用Fried衰弱评分、临床衰弱量表(CFS)、爱特蒙特衰弱量表(EFS)对每位患者进行衰弱评估,将三种量表的评估结果进行相关性分析。结果:Fried评分、CFS评分与EFS评分判定为衰弱患者分别为6例、8例与14例,发生率为5.0%、6.7%和11.7%,组间对比无统计学意义,P0.05。直线相关分析显示Fried评分与CFS评分、EFS评分呈正向相关性(P0.05),对于冠心病患者衰弱评估具有一致性。对于冠心病衰弱程度评估中CFS评分与EFS评分之间比较差异无统计学意义(P0.05)。Cox回归分析显示文化水平、心功能分级、居住情况与睡眠障碍为Fried评分的主要影响因素(P0.05)。结论:三种衰弱评估量表对于冠心病患者衰弱病情评估具有一致性,但具有不同的临床应用价值;患者的文化水平、心功能分级、居住情况与睡眠障碍与衰弱的发生有相关性。     

Testing Reliability of Body Size Measurements Using Hind Foot Length in Roe Deer

Abstract: We quantified the repeatability of >900 individual measures of hind foot length from 2 French populations of roe deer (Capreolus capreolus) monitored by capture-recapture. We found a high repeatability (i.e., high intra-class correlation, 0.76, 95% CI = 0.72–0.83 and 0.92, 95% CI = 0.91–0.95) in both populations. We also found that inexperienced observers reached a high level of intra- (1.00, 95% CI = 0.96–1.00) and inter-observer repeatability (0.99, 95% CI = 0.98–1.00) when measuring hind foot length of harvested animals with a tool specifically designed for this task. Managers should pay particular attention to limit measurement errors because unreliable measurements require an increased sample size to assess individual variation and can mask biological patterns.