Assessment of Obesity with Anthropometric and Densitometry Measurements in Spinal Cord Injury

Aim: Assessment of obesity by anthropometric and densito-metric measurements in spinal cord injury. Materials and Methods: Thirty-one subjects with complete spinal cord injury (AIS A) separated according to the neurological level in group A (n = 16, high paraplegia: above the seventh thoracic neurological levels) and group B (n = 15, low paraplegia) were compared with 33 controls. For the assessment of obesity we used body mass index (BMI) and dual energy X-ray absorptiometry (DXA, Norland) to study all subjects. Using the DXA method we calculated the total body fat in grams (fat mass). Results: BMI values for paraplegic population were statistically lower compared to control group (23.9 ± 3 and 26.2 ± 4, respectively, p = 0.025) and within the normal range of BMI. However, the comparison according to neurological level of injury revealed a significant difference between high paraplegics and controls (22.9 ± 2.2 and 26.1 ± 4, respectively, p = 0.021). Using DXA fat was increased in body composition in paraplegics compared with controls (23071.38 ± 9485 and 19015 ± 6553, respectively, p <0.05). The correlation of BMI with fat mass was statistically significant paraplegics and controls (r = 0.57, p = 0001 and r = 0.73, p = 0.0001, respectively). In paraplegics total fat measured by DXA was increased at any given BMI value compared to the control group (r2 = 0.3 vs. r2 = 0.54, respectively). Further analysis between the two paraplegic groups showed a significant correlation between BMI and fat mass only in the group of low paraplegia (r = 0.72, p = 0.004). Conclusion: The BMI is often used as a measure of obesity but assess body composition inadequately. The whole body DXA gives valuable clinical information regardless of the neurological level of injury.