Reliability and accuracy of segmental bioelectrical impedance analysis for assessing muscle and fat mass in older Europeans: A comparison with dual-energy X-ray absorptiometry
Department of Human Biology, Zoological Institute, Christian-Albrechts-University Kiel, Am Botanischen Garten 9, 24118, Kiel, Germany. Arbeitsphysiologie
(Impact Factor: 2.19).
08/2011; 111(8):1879-87. DOI: 10.1007/s00421-010-1795-x
Segmental determination of muscle and fat mass (MM, FM) attains growing importance for judging effects of training and malnutrition in older people. This study evaluated the reliability and accuracy of segmental bioelectrical impedance analysis (sBIA) for use in older people. In 72 (40 men, 32 women) healthy elderly (mean age 69.0 ± 4.8 years), the MM and FM of right and left arm (RA, LA), right and left leg (RL, LL), and trunk were determined by sBIA (BC-418-MA, Tanita) and dual-energy X-ray absorptiometry (DXA) as a reference method. The sBIA provided in both sexes reliable values for limb and truncal MM and FM, except for MM of RL in women. The accuracy of sBIA displayed sex-specific bias. For MM, accurate values were noted for men's trunk and women's limbs (except LA). By contrast, MM was significantly underestimated in men's limbs by 6-18% and overestimated in women's LA (13%) and trunk (14%). Estimates of FM were accurate for men's arms as well as women's legs and trunk. However, FM was significantly overestimated in men's legs (34-37%) and trunk (60%), but underestimated in women's arms (27-35%). The proportional deviations of sBIA estimates from DXA values for limbs and trunk were significantly related to the respective MM or FM. The sBIA tends to underestimate MM in men and to overestimate in women. The reverse occurs for FM. The actual equations of the Tanita device may not completely represent the European older population and should be partly revised.
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- "The validity of the estimation of whole body composition by BIA in specific cohort has been accomplished (Bosy-Westphal et al., 2008). The estimation of whole body composition in the elderly by commercial tetraelectrodes or octa-electrodes BIA measurements have also been explored (Mally et al., 2011; Mitsui et al., 2006). "
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ABSTRACT: The aim of this study was to develop new predictive equations for evaluating the fat free mass (FFM) of body segments in Taiwan elderly female. Modified bioelectrical impedance analysis with eight electrodes (BIA 8) and referenced standard dual-energy x-ray absorptiometry (DXA) was applied to measure the segment body composition. The criterion of FFM values determined by DXA and predictive values by BIA were compared. After analyzing by linear regression, we obtained the FFM predictive equations by BIA 8 for segments. The Bland-Altman analysis was used to evaluate the differences of mean estimated segmental FFM from equations by BIA 8 and by DXA. The correlation coefficient (R) of FFM between values measured by DXA and estimated by BIA 8 in whole body, lower limbs, upper limbs and trunk were 0.89, 0.64, 0.60 and 0.81, respectively, and the differences of mean FFM were 2.39, 0.94, 0.27 and 2.02 kg, respectively. With the relatively higher weight coefficient of H 2/Z (H, height; Z, impedance values), it plays a critical role in our new predictive equation. For the greater performance in prediction of fat free mass by our new BIA model, it provides potential in monitoring the body composition in female elderly by greater precision way.
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The aim of this study was to investigate the agreement between body composition measurements made with two methods-single-frequency bioelectrical impedance analysis (SF-BIA) and bioelectrical impedance spectroscopy (BIS).
The body composition measurements using SF-BIA and BIS were performed seven times during 6 months on 41 patients (13 men and 28 women) with metabolic syndrome who were taking part in a dietary intervention study.
The mean [standard deviation (SD)] fat mass (FM) and median [interquartile range (IQR)] FM% measured with SF-BIA were 32.7 (6.7) kg and 36.3 (30.3-39.3)%, respectively, compared with 38.2 (8.7) kg and 40.9 (35.5-45.6)%, respectively, using BIS. The median (IQR) fat-free mass (FFM) was 60.0 (53.3-73.5) kg according to SF-BIA and 55.4 (48.8-66.5) kg according to BIS. These results obtained with the two methods were significantly different (P<0.001). Still highly significant correlations were found between the results obtained with SF-BIA and BIS for FM and FFM (all r≥0.89, P<0.001). Using Bland-Altman analysis, the bias was found to be -5.4 (4.1) kg for FM, -5.5 (3.7)% for FM%, and 5.4 (4.1) kg for FFM. Rather wide limits of agreement were found for FM, FM%, and FFM.
Body composition data obtained using SF-BIA and BIS in subjects with metabolic syndrome were highly correlated but not interchangeable. FM was systematically lower when using SF-BIA than when using BIS.
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ABSTRACT: Cirrhosis is a state of accelerated starvation with impaired protein synthesis. Increased rate of gluconeogenesis and alterations in skeletal muscle signaling pathways result in anabolic resistance and consequent loss of muscle mass or sarcopenia in cirrhosis. Late evening snack (LES) is an intervention to reduce the postabsorptive (fasting) phase with the potential to improve substrate utilization and reverse sarcopenia. Published reports were evaluated to examine the effect of LES on regulation of substrate utilization (short-term studies) and nutritional outcomes (long-term studies).
PubMed, EMBASE, Google scholar and OVID databases were searched. All studies published on LES in cirrhosis were included. Studies that included few (n < 3) subjects and patients with hepatocellular carcinoma were excluded.
Late evening snack decreased lipid oxidation and improved nitrogen balance, irrespective of the composition or type of formulation used. Daytime isocaloric isonitrogenous snacks did not have the metabolic or clinical benefit of LES. LES decreased skeletal muscle proteolysis. No studies have examined its effect on muscle protein synthesis. There was inconsistent translation into an increase in lean body or skeletal muscle mass. Improved quality of life occurs but decreased mortality or need for transplantation has not been reported. The optimal composition of LES has not been defined, but based on mechanistic considerations, a branched chain supplemented LES holds most promise.
Late evening snack holds the most promise as an intervention to reverse anabolic resistance and sarcopenia of cirrhosis with improved quality of life in patients with cirrhosis. Long term benefit and improved survival need critical evaluation.
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