Composição corporal por bioimpedância e antropometria de idosos longevos
Data
2016-05-31
Autores
Bertolini, Audrey Andrade
Orientadores
Cendoroglo, Maysa Seabra Cendoroglo [UNIFESP]
Tipo
Dissertação de mestrado
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução O envelhecimento é acompanhado de mudanças na composição corporal tanto em homens quanto em mulheres. Nos idosos com 80 ou mais anos de idade, observamos diferenças entre os gêneros que repercutem na funcionalidade, sendo que os métodos de avaliação são importantes para dimensionar essas diferenças. Objetivo Estudar a composição corporal pelo método da bioimpedância e as alterações antropométricas em idosos independentes com 80 anos ou mais. Material e métodos Idosos com 80 ou mais anos de idade, funcionalmente independentes, residentes na cidade de São Paulo, foram convidados a participar do estudo e se submeteram a avaliação antropométrica e a avaliação de composição corporal por bioimpedância (BIA). Para a classificação do estado nutricional utilizamos os critérios da Organização Pan Americana de Saúde (OPAS) de 2003. As variáveis de massa magra foram identificadas a partir de equações preditivas de Kyle, Dey e Valencia. Para demonstrar a sensibilidade e a especificidade dos resultados do índice de massa magra (IMM) por BIA em relação às fórmulas e aos resultados de percentual de gordura corporal (%GC) em relação à prega cutânea triciptal (PCT) e à circunferência de cintura (CC), foram utilizadas as curvas ROC. Resultados Participaram do estudo 221 idosos (72 homens e 149 mulheres) com idade entre 80 e 97 anos. Os valores médios da CC foram diferentes entre os homens (95,3cm ±11,0) e as mulheres (90,9cm ±10,8), p=0,007. Do mesmo modo, o índice de massa corpórea (IMC), a circunferência de panturrilha (CP), e a circunferência muscular de braço (CMB), além do peso da gordura corporal. Porém, a PCT e o peso da massa magra (PMM) apresentaram diferenças entre os gêneros, com PCT em mulheres de 18,6mm ±5,7, e em homens de 15,4mm ±5,7, gerando p<0,001; e com PMM em mulheres de 37,0kg ±6,6, e em homens de 45,0kg ±10,4, gerando p<0,001. Encontramos uma forte correlação entre a gordura corporal e o IMC entre as mulheres (r=0,88, p<0,001) e homens (r=0,78, p<0,001), assim como CC em mulheres (r=0,76, p<0,001) e em homens (r=0,79, p<0,001); enquanto a CP apresentou uma correlação mais forte com a massa magra em mulheres do que para os homens (r=0,72, p<0,001; r= 0,64 p<0,001 respectivamente). Observamos que a CC, o IGC e o %GC estavam elevados em todos os gêneros, exceto para mulheres com baixo peso e eutrofia. A média do índice de massa magra foi baixa nas mulheres com diagnóstico nutricional de baixo peso. Ao compararmos o peso da massa magra por BIA e pelas fórmulas, o resultado mais próximo ao da BIA foi o obtido pela fórmula de Dey, para as mulheres eutróficas. Quando analisamos o índice de massa muscular esquelética (IMME), os homens de baixo peso apresentaram valores inferiores aos das mulheres. Conclusão Assim, nota-se que os métodos de antropometria e bioimpedância apresentam diferenças entre os gêneros na população estudada. Para a avaliação da composição corporal, precisamos combinar diferentes métodos de avaliação, tais como amassa muscular esquelética (MME) e o IMME e considerar as diferenças entre os gêneros
Introduction: Aging is associated with changes in body composition in both men and women. Gender differences can impact the functional fitness in elderly with 80 or more years of age, and assessment methods are important to scale these differences. Objective: to compare the assessment of body composition by bioimpedance and anthropometry of physically independent men and women aged 80 years or more. Materials and methods: Individuals above 80 years old independently living in the city of São Paulo were invited to participate in this study through written and verbal communication. The elderly individuals underwent anthropometric evaluation and body composition assessments by bioimpedance. The 2003 criteria of the Pan-American Health Organization (OPAS) was used to assess the nutritional status of the participants. Lean body mass (LBM) variables were identified from the predictive equations of Kyle, Dey, and Valencia. ROC curves were used to demonstrate the sensitivity and specificity of the LBM results by BIA versus equations, and body fat percentage (BFP) results versus tricipital cutaneous fold (TCF) and waist circumference (WC). Results: This study included 221 elderly (72 men and 149 women) aged between 80 and 97 years old. The average values of WC were not different among males 95.3 ± 11 cm and females 90.9 ± 10.8 cm (p = 0.007). Likewise, the averaged values of body mass index (BMI), calf circumference, mid-upper arm muscle circumference (MUAMC) and body fat were similar between the two gender groups. However, TCF and lean body mass (LBM) values showed differences between genders: TCF 18.6 ± 5.7 mm in females and 15.4 ± 5.7 mm in males (p <0.001); LBM 37.0 ± 6.6 kg in females and 45.0 ± 10.4 kg in males (p <0.001). We found a strong correlation between body fat and BMI among women (r = 0.88; p <0.001) and men (r = 0.78; p <0.001), as well as body fat and WC in women (r = 0.76; p <0.001) and also in men (r = 0.79; p <0.001). Calf circumference values showed a stronger correlation to muscle mass in women (r = 0.72; p < 0.001). We also observed that WC and BFP values were high for both genders, except in underweight and eutrophic women. The average LBM index was lower in women with nutritional diagnosis of low weight. The comparison between the LBM by BIA versus predictive equations showed that Dey’s equation is the best estimate of BIA results when applied to eutrophic women. The analysis of skeletal muscle mass index (SMI) revealed that low-weight men showed lower SMI values than women. Conclusion: in order to identify obesity and sarcopenic obesity, even in individuals with normal BMI, it is crucial to consider gender differences and to combine different methods of evaluation, such asskeletal muscle mass (SMM) and SMI.
Introduction: Aging is associated with changes in body composition in both men and women. Gender differences can impact the functional fitness in elderly with 80 or more years of age, and assessment methods are important to scale these differences. Objective: to compare the assessment of body composition by bioimpedance and anthropometry of physically independent men and women aged 80 years or more. Materials and methods: Individuals above 80 years old independently living in the city of São Paulo were invited to participate in this study through written and verbal communication. The elderly individuals underwent anthropometric evaluation and body composition assessments by bioimpedance. The 2003 criteria of the Pan-American Health Organization (OPAS) was used to assess the nutritional status of the participants. Lean body mass (LBM) variables were identified from the predictive equations of Kyle, Dey, and Valencia. ROC curves were used to demonstrate the sensitivity and specificity of the LBM results by BIA versus equations, and body fat percentage (BFP) results versus tricipital cutaneous fold (TCF) and waist circumference (WC). Results: This study included 221 elderly (72 men and 149 women) aged between 80 and 97 years old. The average values of WC were not different among males 95.3 ± 11 cm and females 90.9 ± 10.8 cm (p = 0.007). Likewise, the averaged values of body mass index (BMI), calf circumference, mid-upper arm muscle circumference (MUAMC) and body fat were similar between the two gender groups. However, TCF and lean body mass (LBM) values showed differences between genders: TCF 18.6 ± 5.7 mm in females and 15.4 ± 5.7 mm in males (p <0.001); LBM 37.0 ± 6.6 kg in females and 45.0 ± 10.4 kg in males (p <0.001). We found a strong correlation between body fat and BMI among women (r = 0.88; p <0.001) and men (r = 0.78; p <0.001), as well as body fat and WC in women (r = 0.76; p <0.001) and also in men (r = 0.79; p <0.001). Calf circumference values showed a stronger correlation to muscle mass in women (r = 0.72; p < 0.001). We also observed that WC and BFP values were high for both genders, except in underweight and eutrophic women. The average LBM index was lower in women with nutritional diagnosis of low weight. The comparison between the LBM by BIA versus predictive equations showed that Dey’s equation is the best estimate of BIA results when applied to eutrophic women. The analysis of skeletal muscle mass index (SMI) revealed that low-weight men showed lower SMI values than women. Conclusion: in order to identify obesity and sarcopenic obesity, even in individuals with normal BMI, it is crucial to consider gender differences and to combine different methods of evaluation, such asskeletal muscle mass (SMM) and SMI.
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Composição corporal por bioimpedância e antropometria de idosos longevos