DEXA or BMI: clinical considerations for evaluating obesity in collegiate division I-A American football athletes.
ABSTRACT To evaluate the relationship between body mass index (BMI) and %body fat (%Fat) in collegiate football athletes (FBA) compared with age-matched/gender-matched general population volunteers (comparison group, CG) and compare body composition and overweight/obese frequencies by BMI between FBA and CG.
Two Division I-A (D-IA) universities in Texas. Integrative Health Technologies (San Antonio, Texas) laboratory.
Football athletes (n = 156, 20.0 ± 1.3 years, 185.6 ± 6.5cm, 103.3 ± 20.4 kg). Comparison group (n = 260, 21.5 ± 2.7 years, 179.0 ± 7.6 cm, 86.3 ± 20.9 kg).
Body mass index and bone densitrometry (DEXA) body composition were assessed. Regression was used to predict %Fat from BMI in CG and FBA. To compare %Fat, fat mass (FM), fat-free mass (FFM), and weight (WT) between CG, FBA, linemen, and non-linemen, 1 × 4 analysis of variance was used. Chi-square analysis was used to compare the frequency of BMI ≥25 between groups.
Body mass index differently predicted %Fat for CG (r = 0.643, SE = 6.258) and FBA (r =0.769, SE = 4.416). Body mass index cutoffs for overweight/obese corresponded to the following %Fat in each group [BMI ≥25 = 19.9% (CG) and 11.1% (FBA); BMI ≥30 = 27.3% (CG) and 20.2% (FBA)]. Football athletes had significantly higher WT, BMI, FFM, and frequency of BMI ≥25 with lower %Fat and FM than CG (α < 0.05). Linemen had the highest WT, BMI, FFM, %Fat, and frequency of BMI ≥25.
The relationship between BMI and %Fat differed between CG and FBA. Using current BMI thresholds for obesity in FBA may result in misleading inferences about health risk.
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ABSTRACT: PURPOSE: The purpose of this study was to investigate and validate the accuracy and safety of a technique using an anterior approach for non-image-guided intra-articular injection of the hip by use of anatomic landmarks. METHODS: We enrolled 55 patients. Injections were performed before supine hip arthroscopy after landmarking and before application of traction. After the needle insertion, success was confirmed with an air arthrogram and by direct visualization after arthroscope insertion. Accuracy and difficulty achieving correct needle placement were correlated with age, weight, height, body mass index, body type, gender, and surgical indication, as well as femoral and pelvic morphology. Forty-five patients who underwent injection in the office were followed up separately to document injection side effects. Needle placement accuracy was correlated to patients' demographics. All statistical tests with P values were 2 sided, with the level of significance set at P < .05. RESULTS: There were 51 correct needle placements and 4 misses, yielding a 93% success rate. The most common location for needle placement was the upper medial head-neck junction. Female gender was correlated with a more difficult needle placement and misses in relation to group size (P = .06). The reasons for misplacements of the needle were a high-riding trochanter, increased femoral version, thick adipose tissue over the landmarks, and variant of ilium morphology. Of 45 patients in the side effect study arm, 3 reported sensory changes of the lateral femoral cutaneous nerve that resolved within 24 hours. CONCLUSIONS: Hip injections by use of the direct anterior approach, from the intersection of the lines drawn from the anterior superior iliac spine and 1 cm distal to the tip of the greater trochanter, are safe and reproducible. Patient characteristics, such as increased subcutaneous adipose tissue or osseous anatomic variants, can lead to difficulty in placing the needle successfully. These characteristics can be predicted with the aid of physical examination and careful study of the pelvic radiographs. LEVEL OF EVIDENCE: Level IV, therapeutic case series.Arthroscopy The Journal of Arthroscopic and Related Surgery 04/2013; · 3.02 Impact Factor