117 DXA, ADP & SFT in preterm infants 6 Introduction Preterm infants are prone to develop risk factors for the metabolic syndrome in later life (1). Adolescents and adults born pretermhave been shown to have a higher fat mass, a higher blood pressure and an increased risk of dysglycemia compared to adolescents and adults born at term (2, 3). While some report no differences in fat distribution at younger ages (4), others have did find difference in infancy when comparing the body compostion of infants born preterm to those born at term (5). For instance, at term equivalent age, premature infants have been reported to have an increased fat mass compared to term infants (5). Term equivalent age is an important benchmark for the development of the preterm infant: a point to evaluate whether any disparities in extra-uterine development and normal fetal development bear short or long term consequences. Since in adulthood, the fat mass percentage and the fat mass index have been related to the occurrence of metabolic syndrome components (6, 7), monitoring body composition in infancy and childhood could help to signal early signs of increased disease risk. Therefore, to ensure the timely implementation of preventive measures, it is pertinent to have a validated method to assess body composition, in particular fat mass. The most frequently used methods to estimate fat mass are air displacement plethysmography (ADP) and dual-energy X-ray absorptiometry (DXA). There is no consensusonwhichreferencemethodshouldpreferentiallybeusedandat thesame time studies in term infants show poor agreement between fat mass measured with ADP compared to DXA (8-10). To our knowledge, there is no published data on the comparison of ADP and DXA in preterm infants. Therefore the purpose of the present study was to compare DXA-generated and ADP-generated whole body composition in preterm infants at term equivalent age. Even so, ADP and DXA are both expensive and immobile instruments. Therefore, it would be valuable to have a reliable and low-cost point-of-care instrument. Skinfold measurements have been suggested as a low budget tool for measuring fat mass in infants, in particular in low income countries (11, 12). Nevertheless, there are questions about the reliability and reproducibility of skinfold measurements. Moreover, despite several studies assessing predictive equations including skinfolds or the sum of skinfolds (∑SFT) to estimate fat mass, to our knowledge, only a few included preterm infants (1215). In addition, the limited publications on the predictive value of SFT for fat mass percentage in preterm infants, included mainly late preterm infants (16). All in all, at this time there are no validated predictive equations including SFT for extremely and very preterm infants. Therefore, this study assessed the potential predictive value of the ∑SFT for fat mass and fat mass percentage in preterm infants. In conclusion, the aim of this study was to assess the agreement between fat and fat-free mass measured with ADP, DXA, and estimated by the sum of skinfolds, in preterm born infants at term equivalent age.
RkJQdWJsaXNoZXIy MTk4NDMw