Comparison of Fat Mass Percentage and Body Mass Index in Koreans With Spinal Cord Injury According to the Severity and Duration of Motor Paralysis
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Objective To analyze the relationship of the change in fat mass percentage (FMP) and body mass index (BMI) with the change in obesity rate according to gender, extent of spinal cord injury (SCI) and the duration.Methods The retrospective study was conducted with medical records of 915 patients. FMP was calculated with BMI and bioelectrical impedance analysis (BIA). Statistical analysis of the relationship between FMP and gender, extent of SCI and the duration after SCI was done.Results FMP increased in relation to the duration. The mean FMP was higher in the motor complete tetraplegia group, as compared to the motor incomplete group. The rate of obesity was 69.8% with cutoff FMP values of over 22% and 35% for male and female patients, respectively. Rate of obesity was correlated with the duration after SCI and degree of paralysis. The rate of obesity was 17.1% with a cutoff value of BMI 25 kg/m2 and 51.3% with a cutoff value of 22 kg/m2. For evaluation of the diagnostic value of BMI to predict obesity according to FMP standards, a cutoff value of 25 kg/m2 showed a sensitivity level of 22.3% and specificity level of 94.9%. When the cutoff level for BMI was set at 22 kg/m2, the sensitivity and specificity were 59.3% and 67.0%, respectively.Conclusion In Korean SCI patients, FMP showed good correlation with the duration of SCI and the extent of SCI, while BMI did not. Especially in the motor complete tetraplegia group, the diagnostic value of BMI decreased as the duration after SCI increased. This study suggested that FMP could be used complementarily when evaluating the obesity of SCI patients.
Abstract
Objective To analyze the relationship of the change in fat mass percentage (FMP) and body mass index (BMI) with the change in obesity rate according to gender, extent of spinal cord injury (SCI) and the duration.Methods The retrospective study was conducted with medical records of 915 patients. FMP was calculated with BMI and bioelectrical impedance analysis (BIA). Statistical analysis of the relationship between FMP and gender, extent of SCI and the duration after SCI was done.Results FMP increased in relation to the duration. The mean FMP was higher in the motor complete tetraplegia group, as compared to the motor incomplete group. The rate of obesity was 69.8% with cutoff FMP values of over 22% and 35% for male and female patients, respectively. Rate of obesity was correlated with the duration after SCI and degree of paralysis. The rate of obesity was 17.1% with a cutoff value of BMI 25 kg/m2 and 51.3% with a cutoff value of 22 kg/m2. For evaluation of the diagnostic value of BMI to predict obesity according to FMP standards, a cutoff value of 25 kg/m2 showed a sensitivity level of 22.3% and specificity level of 94.9%. When the cutoff level for BMI was set at 22 kg/m2, the sensitivity and specificity were 59.3% and 67.0%, respectively.Conclusion In Korean SCI patients, FMP showed good correlation with the duration of SCI and the extent of SCI, while BMI did not. Especially in the motor complete tetraplegia group, the diagnostic value of BMI decreased as the duration after SCI increased. This study suggested that FMP could be used complementarily when evaluating the obesity of SCI patients.
참고문헌 (32)
- Malik S, "Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults", Circulation, 110, pp.1245~1250 (2004)
- Yekutiel M, "The prevalence of hypertension, ischaemic heart disease and diabetes in traumatic spinal cord injured patients and amputees", Paraplegia, 27, pp.58~62 (1989)
- Hwang J, "Relationship between socioeconomic status and type 2 diabetes: results from Korea National Health and Nutrition Examination Survey (KNHANES) 2010-2012", BMJ Open, 4, pp.e005710~ (2014)
- Ohn JH, "Unprotected daily sun exposure is differently associated with central adiposity and β-cell dysfunction by gender: the Korean National Health and Nutrition Examination Survey (KNHANES) V", Environ Res, 133, pp.253~259 (2014)
- Gupta N, "Body mass index in spinal cord injury: a retrospective study", Spinal Cord, 44, pp.92~94 (2006)
- Teixeira PJ, "Exercise motivation, eating, and body image variables as predictors of weight control", Med Sci Sports Exerc, 38, pp.179~188 (2006)
- Gater DR Jr., "Obesity after spinal cord injury", Phys Med Rehabil Clin N Am, 18, pp.333~351 (2007)
- Khalil RE, "The role of nutrition in health status after spinal cord injury", Aging Dis, 4, pp.14~22 (2013)
- Wilmet E, "Longitudinal study of the bone mineral content and of soft tissue composition after spinal cord section", Paraplegia, 33, pp.674~677 (1995)
- Yarar-Fisher C, "Body mass index underestimates adiposity in women with spinal cord injury", Obesity (Silver Spring), 21, pp.1223~1225 (2013)
- Goldberg LR, "Hydration in older adults: the contribution of bioelectrical impedance analysis", Int J Speech Lang Pathol, 16, pp.273~281 (2014)
- Vetrovska R, "Does impedance measure a functional state of the body fat?", Physiol Res, 63(Suppl 2), pp.S309~S320 (2014)
- Gater DR., "Pathophysiology of obesity after spinal cord injury", Top Spinal Cord Inj Rehabil, 12, pp.20~34 (2007)
- Nelson MD, "Metabolic syndrome in adolescents with spinal cord dysfunction", J Spinal Cord Med, 30(Suppl 1), pp.S127~S139 (2007)
- Han SH, "Comparison between dual energy X-ray absorptiometry (DEXA) and bioelectrical impedence analysis (BIA) in measurement of lean body mass and fat mass in obese adults:based Bland-Altman plot analysis", Korean J Obes, 15, pp.213~218 (2006)
- Pruijm M, "Inflammatory markers and blood pressure: sex differences and the effect of fat mass in the CoLaus Study", J Hum Hypertens, 27, pp.169~175 (2013)
- Mojtahedi MC, "Body composition assessment in athletes with spinal cord injury:comparison of field methods with dual-energy X-ray absorptiometry", Spinal Cord, 47, pp.698~704 (2009)
- 김혜진, "External cross-validation of bioelectrical impedance analysis for the assessment of body composition in Korean adults", Nutrition Research and Practice, 5(3), pp.246~252 (2011), 한국영양학회
- Eriks-Hoogland I, "Clinical assessment of obesity in persons with spinal cord injury: validity of waist circumference, body mass index, and anthropometric index", J Spinal Cord Med, 34, pp.416~422 (2011)
- Laughton GE, "SHAPE SCI Research Group. Lowering body mass index cutoffs better identifies obese persons with spinal cord injury", Spinal Cord, 47, pp.757~762 (2009)
- Spungen AM, "Measurement of body fat in individuals with tetraplegia:a comparison of eight clinical methods", Paraplegia, 33, pp.402~408 (1995)
- Buchholz AC, "The use of bioelectric impedance analysis to measure fluid compartments in subjects with chronic paraplegia", Arch Phys Med Rehabil, 84, pp.854~861 (2003)
- Lohman TG, "Perspectives in exercise science and sports medicine", pp.61~105 (1998), Cooper Publishing Group
- Tan KC., "Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies", Lancet, 363, pp.157~163 (2004)
- de Groot S, "Prospective analysis of body mass index during and up to 5 years after discharge from inpatient spinal cord injury rehabilitation", J Rehabil Med, 42, pp.922~928 (2010)
- Singh R, "Longitudinal study of body composition in spinal cord injury patients", Indian J Orthop, 48, pp.168~177 (2014)
- Dearwater SR, "Assessment of physical activity in inactive populations", Med Sci Sports Exerc, 17, pp.651~655 (1985)
- Jones LM, "Healthy body mass index values often underestimate body fat in men with spinal cord injury", Arch Phys Med Rehabil, 84, pp.1068~1071 (2003)
- 김광동, "Characteristics of Abdominal Obesity in Persons With Spinal Cord Injury", Annals of Rehabilitation Medicine, 37(3), pp.336~346 (2013), 대한재활의학회
- Modlesky CM, "Assessment of skeletal muscle mass in men with spinal cord injury using dual-energy X-ray absorptiometry and magnetic resonance imaging", J Appl Physiol (1985), 96, pp.561~565 (2004)
- Bolanowski M, "Assessment of human body composition using dual-energy x-ray absorptiometry and bioelectrical impedance analysis", Med Sci Monit, 7, pp.1029~1033 (2001)
- Ravensbergen HR, "Waist circumference is the best index for obesity-related cardiovascular disease risk in individuals with spinal cord injury", J Neurotrauma, 31, pp.292~300 (2014)
