Comparing body composition assessment tests in long-term hemodialysis patients.
ABSTRACT Protein-energy wasting is common in chronic kidney disease and is associated with decreases in body muscle and fat stores and poor outcomes. The accuracy and reliability of field methods to measure body composition is unknown in this population.
Cross-sectional observational study.
118 maintenance hemodialysis patients were seen at the General Clinical Research Center at Harbor-UCLA Medical Center, Torrance, CA.
Triceps skinfold, near-infrared interactance, and bioelectrical impedance analysis using the Segal, Kushner, and Lukaski equations.
Dual-energy x-ray absorptiometry (DEXA).
Participants (42% women, 52% with diabetes, 40% African Americans, and 38% Hispanics) were aged 49.4 +/- 11.5 (mean +/- SD) years, and had undergone dialysis therapy for 41.1 +/- 32.9 months. Body mass index was 27.0 +/- 6.0 kg/m(2). Using DEXA as the reference test, the bioelectrical impedance analysis-Kushner equation, triceps skinfold, and near-infrared interactance were most accurate of the index tests in estimating total-body fat percentage, whereas bioelectrical impedance analysis-Segal equation and bioelectrical impedance analysis-Lukaski equation overestimated total body fat percentage. Bland-Altman analyses and difference plots showed that bioelectrical impedance analysis-Kushner and near-infrared interactance were most similar to the reference test. Bioelectrical impedance analysis-Kushner, triceps skinfold, and near-infrared interactance had the smallest mean differences from DEXA, especially in women (1.6%, 0.7%, and 1.2%, respectively). Similar results were observed in African American participants (n = 47).
Measurements were performed 1 day after a hemodialysis treatment, leading to more fluid retention, which may have affected the reference and index tests differently.
Using DEXA as the reference test, both near-infrared interactance and bioelectrical impedance analysis-Kushner method yield more consistent estimates of total body fat percentage in maintenance hemodialysis patients compared with the other index tests. Near-infrared interactance is not affected by skin color. Field methods with portable devices may provide adequate precision.
Article: Agreement of skinfold measurement and bioelectrical impedance analysis (BIA) methods with dual energy X-ray absorptiometry (DEXA) in estimating total body fat in Anglo-Celtic Australians.[show abstract] [hide abstract]
ABSTRACT: To compare percentage total body fat (%BF) estimated by the four skinfold thickness measurement (SKF) and single-frequency bioelectrical impedance analysis (BIA) methods using three different sets of equations, to that assessed by the dual energy X-ray absorptiometric (DEXA) method using a Lunar DPX densitometer. Cross-sectional study. An Anglo-Celtic Australian population of 66 males and 130 females (age: 26-86 y). %BF by anthropometry, BIA using three different sets of equations and DEXA. Mean %BF assessed by DEXA (%BF(DEXA)) was similar to that estimated by SKF (%BF(SKF)) in males, while %BF(DEXA) was slightly higher in females. %BF estimated by BIA (%BF(BIA)) was significantly lower than %BF(DEXA) in females, regardless of equations used for calculation, while the level of agreement between BIA and DEXA in estimating %BF in males was dependent on prediction equations used for calculation of %BF(BIA). A better agreement was obtained from the use on the prediction equations of Segal et al (1988), compared to other two sets of equations. The agreement between SKF or BIA and DEXA declined with increasing %BF. There was a good agreement between DEXA and SKF, and slightly less so between DEXA and BIA, in estimating %BF in an Anglo-Celtic adult population. The agreement in most cases, however, was dependent on the degree of body fatness. In comparison to DEXA, both SKF and BIA, with the use of the equations of Segal et al (1988), are applicable to estimate %BF in an Anglo-Celtic Australian population.International Journal of Obesity 10/1998; 22(9):854-60. · 4.69 Impact Factor
[show abstract] [hide abstract]
ABSTRACT: A novel stress-induced gene, HEVER (Hevea ethylene-responsive) from the rubber tree, Hevea brasiliensis, has been isolated and characterised. HEVER is encoded by a multigene family. The HEVER transcript is expressed at basal levels in Hevea tissues and is developmentally regulated. In addition, the HEVER transcript and protein are induced by stress treatment with salicylic acid and ethephon. Sequence analysis shows that HEVER encodes a 33 kDa protein that has significant homology to the hypothetical protein SLEXORFA-1 from the plant, Stellaria longipes, and two bacterial proteins, BAC180K-75 from Bacillus subtilis and MVRNO3-1 from Methanococcus vannielii.Plant Molecular Biology 11/1995; 29(1):173-8. · 4.15 Impact Factor