Clinical assessment of obesity in persons with spinal cord injury: validity of waist circumference, body mass index, and anthropometric index

Objective

To study the relationship of waist circumference (WC) and bioelectrical impedance analysis (BIA) and degree of agreement between anthropometric index (AI) and BIA, using BIA as a reference or ‘gold standard’. The second objective is to study the relationship between body mass index (BMI) and BIA in subjects with spinal cord injury (SCI).

Study design

Comparative cross-sectional study.

Setting

Convenience sample at outpatient clinic of spinal cord center.

Outcome measures

Estimation of obesity was made in 23 men with motor complete paraplegia (>1 year post-injury). Bland and Altman statistics were used to define level of agreement between AI and BIA, Pearson''s r to describe correlation between WC and BIA and BMI and BIA.

Results

Good agreement between BIA and AI with a small systematic difference in fat mass (FM) (mean difference: −0.28%, Pearson''s r: 0.91) was found. The correlation between WC and the BIA (% FM) was very high (Pearson''s r: 0.83). The correlation between WC and BMI (% FM) was just over moderate (Pearson''s r: 0.51).

Conclusion

AI seems to be a valid proxy measure to estimate obesity in males living with SCI. Measurement of obesity in persons with SCI based on WC is promising. BMI showed not to be valid to estimate obesity in persons with SCI.