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Am J Physiol Endocrinol Metab (February 25, 2003). doi:10.1152/ajpendo.00185.2002
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Submitted on May 1, 2002
Accepted on February 10, 2003

Body composition characterization and method validation in extreme obesity and following massive weight loss induced by gastric bypass surgery

Sai Krupa Das1, Susan B. Roberts1, Joseph J. Kehayias1, Jack Wang2, LK George Hsu3, Scott A. Shikora3, Edward Saltzman4, and Megan A. McCrory1*

1 Energy Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
2 Body Composition Unit, St. Luke's-Roosevelt Hospital Center, New York, NY, USA
3 Obesity Consult Center, Department of Psychiatry, New England Medical Center Hospital, Boston, MA, USA
4 Energy Metabolism Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA; Obesity Consult Center, Department of Psychiatry, New England Medical Center Hospital, Boston, MA, USA

* To whom correspondence should be addressed. E-mail: megan.mccrory{at}tufts.edu.

Body composition methods were examined in 20 women (BMI 48.7±8.8 kg/m2) before and after weight loss (-44.8±14.6kg; Mean±SD) following gastric bypass (GBP) surgery. The reference method, a 3-compartment (3C) model using body density by air displacement plethysmography and total body water (TBW) by H218O dilution (3C-H218O), showed a decrease in percent body fat (%BF) from 51.4 % to 34.6%. Fat-free mass hydration was significantly higher in extreme obesity (0.756; P<0.001) but not after weight reduction (0.747; P=0.16) than the reference value (0.738). %BF by H218O dilution and air displacement plethysmography differed significantly from %BF by 3C-H218O in extreme obesity (P<0.05), and 3C models using 2H2O or BIA to determine TBW improved mean %BF estimates over most other methods at both time points. Bioelectrical impedance analysis (BIA) results varied with the equation used, but BIA better predicted %BF than did BMI at both time points. All methods except BIA using the Segal equation were comparable to the reference method for determining changes over time. A simple 3C model utilizing air displacement plethysmography and BIA is useful for clinical evaluation in this population.




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