Determination of Body Surface Area Surface Area Using the and Formulas to Estimate Body Alginate Method

The purpose of this study was to determine thc body surface arca (BSA) based on the alginate method to derive fbrmulae for estirnating BSA, and to compare the error of the present fbnnula to prcvious forrnulas obtained from other countries, We directly measured thc entire body surfacc area of 34 males (20-60 years old, l58,5-187.5 cm in height, 48.5-103.1 kg in body weight) and 31 females (20-63 year's old 140.6--173.lcvn, 36.8-106.11cg) using alginate. Thc measurements showed that the BSA had a mean of 18,339cm2 (15,416-22J53cm2) fbr maLes, and 16,452cm? (t2,825 , 22,025cnr) for fernales. Based on thesc measurernents, a regression model to estimate BSA was derived: Estimated BSA(cm2)=73.31 Height(cm)O・7'2Sxweight(kg)e・`25 (P= O,999). The rnean errer ofthe fbrmula was -O.1%, and did not show any significant diffbrence by gender or body shape. When applied to the datasets (n==506) composed of various raees (Caucasians, Africans, and Asians), the mean error efthe fbrrnula was O.496 and was srnaller than that of DuBois & DuBois's, Gehan & George's, and Mosteller's tbrmulas whcn applied to the same datasets. The errors of the three previous fbrmulas were also within 2%. Overall, fbrmulas based on the DuBois exponent (WeightOA25HcightO'725) djd not show any tendcncy of overestimation or underestimation by body shape, but other BSA-formulae showed diffbrences by body shapc. The present BSA fbrmula has shown goed accuracy in Korean adults of all weight categories compared to traditional forrnulas. J Pltysiol Anthftrpol 27(ev.' 7i-82, 2008 http:flwww.jstage.jst.go,jpfbrowseijpa2 [DOI: 10.2214ijpa2.27.71] Keywords; body surface area (BSA), estimation, body shape, gender, alginate method lntroduction Body surface area (BSA) is the total area ofa human's skin. BSA has bcen uscd as a biemetric unit in eomprehensive areas, such as physiology, cLinical medicine, pharmacology, ergonemics, environmental toxicology and the science of nutrition (Pinkcl, 1958; Smith, 1951; Krovetz, 1965). Many researchers would agree that physiological phenomena are more closely reLated to BSA than body weight or height. Hewever. BSA is still kno",n as the most dirncult item of thc human body to mcasurc. Because of this, effbrts have been conductcd to estimate BSA using formulas instead of mcasuring BSA direct] y. The rnost popular formula applied universally is the DuBois and DuBois's fbrmula (1916). Howcver, it has been suggcsted that it has a weakness because the fbrrnula was based on a small sample of only nine subjects (six malcs and three femalcs). The fbrmula's accuracy has often been questioncd (Breitman, 1932; Boyd 1935; Hayceck et al,, 1978; Verbraecken et al., 2006). Some researchers wondered whether it was surncient for cstimating BSA with just two explanatory variables, body weight and height (Takai and Shimaguchi, t986). Some other researchers thought the formula should be distinguished between gender or body shape (Choi, l956; Tikuisis et al,, 2001). Nevertheless, the reason few formulas have yet been derived based on sample populations large enough to avoid extrapolation is related to the diMculties of taking direct measurements. TYpical practices used to measure BSA include coating methods Cusing paper, inelastic tape, plaster bandage or aiuminum foil), surface integration and geometric (or triangulation) methods. One of the greatest diMculties in measuring BSA directly ig that these methods are too laborioug and tiresome fbr both subjects and researchers, Recently, some Japan Society of Physiological Anthropology NII-Electronic Library Service apanSociety fPhysiological nthropology 72 DcLcrmination of Body Surface Arett rescarchers have become interested in thrce dimensional (3D) whole body scanning fbr estimating BSA (Tikuisis et a1., 2001; Yu et a]., 2003), Howcvcr, the accuracy of studies using 3D whole body scanning have also been questiencd because the method cannot recognize ovcrlapping or shading body parts, such as fingers, armpits, toes, and under breasts, 3D scanning underestirnated the BSA of over",eight peopLe because of the skin's folds (Lee and Choi, 2005). Lee and Clhoi (2006) suggested a new method using alginate to measure BSA. This mcthod has many advantagcs that are less time-consuming than traditional coating methods and can even measure the skjn folds of the overweight and thin. in addition to small body parts such as fingers, toes, and cars. The validity and reliability ofthe alginate method was evaluated (Lee and Choi, 2006), The purpose of this study was 1) to determine the body surface area of Korean adults using this alginatc mcthod 2) to derivc a formula for estimating BSA, and 3) to cornpare the error of the formula to previous formulas obtaincd from other countries. In particular. we focused on finding the limitations ofgeneralization ofBSA by height and body ",eight,