Inter and intra-reliability of ultrasonography for the measurement of abdominal subcutaneous & visceral adipose tissue thickness at 12 weeks gestation.


Journal

BMC medical imaging
ISSN: 1471-2342
Titre abrégé: BMC Med Imaging
Pays: England
ID NLM: 100968553

Informations de publication

Date de publication:
17 12 2019
Historique:
received: 17 06 2019
accepted: 08 11 2019
entrez: 19 12 2019
pubmed: 19 12 2019
medline: 10 5 2020
Statut: epublish

Résumé

Excess abdominal adiposity cause metabolic disturbances, particularly in pregnancy. Methods of accurate measurement are limited in pregnancy due to risks associated with these procedures. This study outlines a non-invasive methodology for the measurement of adipose tissue in pregnancy and determines the intra- and inter-observer reliability of ultrasound (US) measurements of the two components of adipose tissue (subcutaneous (SAT) and visceral adipose tissue (VAT)) within a pregnant population. Thirty pregnant women were recruited at the end of their first trimester, from routine antenatal clinic at the University Maternity Hospital Limerick, Ireland. Measurements of adipose tissue thickness were obtained using a GE Voluson E8 employing a 1-5 MHz curvilinear array transducer. Two observers, employing methodological rigour in US technique, measured thickness of adipose tissue three times, and segmented the US image systematically in order to define measurements of SAT and VAT using specifically pre-defined anatomical landmarks. Intra-observer and inter-observer precision was assessed using Coefficient of Variation (CV). Measurements of SAT and total adipose for both observers were < 5% CV and < 10% CV for VAT in measures by both observers. Inter-observer reliability was assessed by Limits of Agreement (LoA). LoA were determined to be - 0.45 to 0.46 cm for SAT and - 0.34 to 0.53 cm for VAT values. Systematic bias of SAT measurement was 0.01 cm and 0.10 cm for VAT. Inter-observer precision was also assessed by coefficient of variation (CV: SAT, 3.1%; VAT, 7.2%; Total adipose, 3.0%). Intra-observer precision was found to be acceptable for measures of SAT, VAT and total adipose according to anthropometric criterion, with higher precision reported in SAT values than in VAT. Inter-observer reliability assessed by Limits-Of-Agreement (LoA) confirm anthropometrically reliable to 0.5 cm. Systematic bias was minimal for both measures, falling within 95% confidence intervals. These results suggest that US can produce reliable, repeatable and accurate measures of SAT and VAT during pregnancy.

Sections du résumé

BACKGROUND
Excess abdominal adiposity cause metabolic disturbances, particularly in pregnancy. Methods of accurate measurement are limited in pregnancy due to risks associated with these procedures. This study outlines a non-invasive methodology for the measurement of adipose tissue in pregnancy and determines the intra- and inter-observer reliability of ultrasound (US) measurements of the two components of adipose tissue (subcutaneous (SAT) and visceral adipose tissue (VAT)) within a pregnant population.
METHODS
Thirty pregnant women were recruited at the end of their first trimester, from routine antenatal clinic at the University Maternity Hospital Limerick, Ireland. Measurements of adipose tissue thickness were obtained using a GE Voluson E8 employing a 1-5 MHz curvilinear array transducer. Two observers, employing methodological rigour in US technique, measured thickness of adipose tissue three times, and segmented the US image systematically in order to define measurements of SAT and VAT using specifically pre-defined anatomical landmarks.
RESULTS
Intra-observer and inter-observer precision was assessed using Coefficient of Variation (CV). Measurements of SAT and total adipose for both observers were < 5% CV and < 10% CV for VAT in measures by both observers. Inter-observer reliability was assessed by Limits of Agreement (LoA). LoA were determined to be - 0.45 to 0.46 cm for SAT and - 0.34 to 0.53 cm for VAT values. Systematic bias of SAT measurement was 0.01 cm and 0.10 cm for VAT. Inter-observer precision was also assessed by coefficient of variation (CV: SAT, 3.1%; VAT, 7.2%; Total adipose, 3.0%).
CONCLUSION
Intra-observer precision was found to be acceptable for measures of SAT, VAT and total adipose according to anthropometric criterion, with higher precision reported in SAT values than in VAT. Inter-observer reliability assessed by Limits-Of-Agreement (LoA) confirm anthropometrically reliable to 0.5 cm. Systematic bias was minimal for both measures, falling within 95% confidence intervals. These results suggest that US can produce reliable, repeatable and accurate measures of SAT and VAT during pregnancy.

Identifiants

pubmed: 31847832
doi: 10.1186/s12880-019-0393-6
pii: 10.1186/s12880-019-0393-6
pmc: PMC6916062
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

95

Références

Int J Obes Relat Metab Disord. 1997 Oct;21(10):948-51
pubmed: 9347415
Acad Radiol. 2013 Oct;20(10):1278-85
pubmed: 24029060
Ultrasound Obstet Gynecol. 2003 Jul;22(1):85-93
pubmed: 12858311
Diabetes Res Clin Pract. 2018 Nov;145:20-30
pubmed: 29852233
Nature. 2006 Dec 14;444(7121):881-7
pubmed: 17167477
Front Endocrinol (Lausanne). 2017 Sep 27;8:239
pubmed: 29021781
Diabetes Care. 2012 Apr;35(4):780-6
pubmed: 22357187
Diabetes Metab J. 2017 Dec;41(6):486-491
pubmed: 29199403
Acad Radiol. 2011 Sep;18(9):1133-43
pubmed: 21724427
Adipocyte. 2018;7(4):229-237
pubmed: 30246599
N Engl J Med. 2016 Feb 4;374(5):434-43
pubmed: 26840133
Aust N Z J Obstet Gynaecol. 2011 Apr;51(2):136-40
pubmed: 21466515
Diabetes Care. 2009 Jun;32(6):1068-75
pubmed: 19244087
Br J Nutr. 1967;21(2):439-51
pubmed: 4952273
Int J Obes Relat Metab Disord. 1993 Apr;17(4):209-14
pubmed: 8387970
J Matern Fetal Neonatal Med. 2020 Feb;33(3):449-454
pubmed: 29950128
Fetal Diagn Ther. 2018;43(2):143-147
pubmed: 28624818
Obes Sci Pract. 2018 Sep 04;4(5):455-467
pubmed: 30338116
Ann Nutr Metab. 2013;63(4):341-9
pubmed: 24603563
Int J Obes Relat Metab Disord. 2001 Sep;25(9):1346-51
pubmed: 11571598
BMJ. 2012 May 16;344:e2088
pubmed: 22596383
Hypertension. 2001 Sep;38(3 Pt 2):713-7
pubmed: 11566963
Diagn Interv Radiol. 2010 Jun;16(2):99-105
pubmed: 20180182
Diabetes Res Clin Pract. 1999 Jan;43(1):49-58
pubmed: 10199588
Eur J Radiol. 2016 Aug;85(8):1469-80
pubmed: 27235340
BMC Endocr Disord. 2014 Jun 13;14:47
pubmed: 24923207
Int J Obes Relat Metab Disord. 2000 Apr;24(4):502-7
pubmed: 10805509
Obesity (Silver Spring). 2007 Sep;15(9):2233-9
pubmed: 17890491
J Obes. 2013;2013:280713
pubmed: 24062944
Am J Clin Nutr. 2008 May;87(5):1212-8
pubmed: 18469241
Am J Clin Nutr. 1988 Jul;48(1):24-9
pubmed: 3389327
Ultrasound Med Biol. 2010 Nov;36(11):1769-75
pubmed: 20870342
J Obstet Gynaecol Can. 2018 Jul;40(7):883-887
pubmed: 29724492
Eur J Clin Nutr. 2018 May;72(5):645-656
pubmed: 29748651
Diabetes. 2002 Jul;51(7):2207-13
pubmed: 12086951
J Clin Ultrasound. 1990 Sep;18(7):563-7
pubmed: 2170455
BJOG. 2013 Jul;120(8):932-9
pubmed: 23530609
AJR Am J Roentgenol. 2007 Dec;189(6):1545-53
pubmed: 18029899
J Obstet Gynaecol Can. 2014 Nov;36(11):969-975
pubmed: 25574673
Nutrition. 2018 Nov;55-56:99-103
pubmed: 29980094
J Obes. 2013;2013:489187
pubmed: 23691287
Endocrine. 2014 Nov;47(2):478-84
pubmed: 24452873
Obstet Gynecol. 2004 Feb;103(2):219-24
pubmed: 14754687
Diabetes Care. 2009 Jul;32(7):1308-10
pubmed: 19389819
World Health Organ Tech Rep Ser. 2000;894:i-xii, 1-253
pubmed: 11234459
Metab Syndr Relat Disord. 2017 Mar;15(2):86-92
pubmed: 28080219
JAMA. 2012 Sep 19;308(11):1150-9
pubmed: 22990274
Am J Clin Nutr. 1990 Jun;51(6):953-7
pubmed: 2349931
Diabetes Care. 2016 Jan;39(1):24-30
pubmed: 26223239

Auteurs

Alexandra Cremona (A)

Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland. alexandra.cremona@ul.ie.
School of Allied Health (SAH), University of Limerick, Limerick, Ireland. alexandra.cremona@ul.ie.
Institute of Nutrition & Dietetics (INDI), Dublin, Ireland. alexandra.cremona@ul.ie.
Health Research Institute (HRI), University of Limerick, Limerick, Ireland. alexandra.cremona@ul.ie.
Physical Education and Sport Sciences (PESS), University of Limerick, Limerick, Ireland. alexandra.cremona@ul.ie.

Kevin Hayes (K)

Department of Statistics, University College Cork (UCC), Cork, Ireland.

Clodagh S O'Gorman (CS)

Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland.
Health Research Institute (HRI), University of Limerick, Limerick, Ireland.

Ciara Ní Laighin (CN)

Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland.
University Maternity Hospital Limerick (UMHL), Limerick, Ireland.

Khadijah I Ismail (KI)

Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland.
University Maternity Hospital Limerick (UMHL), Limerick, Ireland.

Alan E Donnelly (AE)

Health Research Institute (HRI), University of Limerick, Limerick, Ireland.
Physical Education and Sport Sciences (PESS), University of Limerick, Limerick, Ireland.

Jill Hamilton (J)

The Hospital for Sick Children, Toronto, Canada.

Amanda Cotter (A)

Graduate Entry Medical School (GEMS), University of Limerick, Limerick, Ireland.
University Maternity Hospital Limerick (UMHL), Limerick, Ireland.

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