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Accuracy of direct segmental multi-frequency bioimpedance analysis in the assessment of total body and segmental body composition in middle-aged adult population

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Abstract

Body composition measurement is a valuable tool for assessing nutritional status and physical fitness in a variety of clinical settings. Although bioimpedance analysis (BIA) can easily assess body composition, its accuracy remains unclear. We examined the accuracy of direct segmental multi-frequency BIA technique (DSM-BIA) in assessing different body composition parameters, using dual energy X-ray absorptiometry (DEXA) as a reference standard. A total of 484 middle-aged participants from the Leiden Longevity Study were recruited. Agreements between DSM-BIA and DEXA for total and segmental body composition quantification were assessed using intraclass correlation coefficients and Bland-Altman plots. Excellent agreements were observed between both techniques in whole body lean mass (ICC female = 0.95, ICC men = 0.96), fat mass (ICC female = 0.97, ICC male = 0.93) and percentage body fat (ICC female = 0.93, ICC male = 0.88) measurements. Similarly, Bland-Altman plots revealed narrow limits of agreements with small biases noted for the whole body lean mass quantification but relatively wider limits for fat mass and percentage body fat quantifications. In segmental lean muscle mass quantification, excellent agreements between methods were demonstrated for the upper limbs (ICC female≥0.91, ICC men≥0.87) and lower limbs (ICC female≥0.83, ICC male≥0.85), with good agreements shown for the trunk measurements (ICC female = 0.73, ICC male = 0.70). DSM-BIA is a valid tool for the assessments of total body and segmental body composition in the general middle-aged population, particularly for the quantification of body lean mass.

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... BIA is a more portable, easy-to-use, and inexpensive tool compared with DXA. Emerging evidence supports that BIA is valid in the estimation of body composition using DXA as a reference standard (18). However, these validation studies were not conducted on the Chinese population. ...
... Appendicular skeletal muscle mass (ASM) was measured using two methods, the BIA method using a calibrated bioelectrical impedance analyzer (Inbody 720, Biospace Co., Ltd, Seoul, Korea) and the DXA method using the DXA scanner (Lunar Prodigy, GE Healthcare, Madison, WI, USA) as previously published (18,19). Both measurements provided the lean body mass of limbs and trunk, body fat mass, and bone mass for all subjects of the young reference group. ...
... The findings of this study showed excellent agreement between BIA and DXA methods in muscle mass measurement, though a small systematic bias existed. The reported systematic bias in this study is within the range of previously published data (0.1-2.1 kg) (18,36,37). Considering that the DXA used in estimating body composition is the reference method, the low ASMI threshold of the BIA using the ROC analysis represented the cutoff value of <6.53 and 5.40 kg/m 2 in men and women, respectively, to identify the ASMI of the participants measured by BIA. ...
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Background The optimal criteria for sarcopenia in the older Chinese population have not been defined. Consequently, this study aims to determine the optimal cutoffs of grip strength, appendicular skeletal muscle index (ASMI) using bioelectrical impedance analysis (BIA), and gait speed, comprising the best definition of sarcopenia for older Chinese populations.MethodsA total of 2,821 (1,398 men and 1,423 women) community-dwelling older people (≥60 years) and 409 (205 men and 204 women) young healthy adults (25–34 years) were recruited from three big cities in China. Besides gait speed and grip strength, we examined ASMI by BIA and dual-energy X-ray absorptiometry (DXA), comprising the three components of sarcopenia. DXA classification for low ASMI, 20th percentile among older adults in the study sample, was found to be best compared with the other existing classification, 1 SD and 2 SD below the mean for the young population, and was used as the gold standard to determine the optimal cutoffs of BIA using receiver operating characteristic curves (ROC). The cutoffs of handgrip strength and gait speed were determined following the same rule.ResultsUsing gender-specific 20th percentiles of DXA (6.53 kg/m2 for men and 5.40 kg/m2 for women), the cutoffs 7.05 kg/m2 for men and 5.85 kg/m2 for women were determined as optimal cutoffs of BIA by achieving the largest sensitivity (0.81, 95% CI: 0.63–0.93 for men and 0.90, 95% CI: 0.73–0.98 for women) and specificity greater than 0.80 (0.80, 95% CI: 0.72–0.87 for men and 0.81, 95% CI: 0.72–0.87 for women) in the ROC analysis. The 28.5 kg and 1.05 m/s for men and 18.6 kg and 1.01 m/s for women were determined as the cutoffs for handgrip strength and gait speed, respectively. Based on the derived cutoffs, 14.2% of men and 15.7% of women in the older Chinese study population were classified as sarcopenia.Conclusion Notably, 7.05 kg/m2, 28.5 kg, and 1.05 m/s for men and 5.85 kg/m2, 18.6 kg, and 1.01 m/s for women were selected as the optimal cutoffs for low ASMI by BIA, handgrip strength, and gait speed, respectively. These optimal cutoffs will enhance practicability for screening sarcopenia in primary care and clinical settings.
... However, until now, the measured values by MF-BIA were heterogeneous in accuracy compared with DEXA or MRI and showed differences in the diagnosis rate of sarcopenia in various studies [28][29][30][31][32][33][34][35][36][37][38]. Nine studies evaluated the correlation between MF-BIA and DEXA for assessing muscle mass [30,[32][33][34][36][37][38][39][40]. ...
... concordance correlation coefficient (CCC) = 0.4, k = 0.2-0.48 in LBM or FFM, ICC = 0.83-0.93, k = 0.397 in ALM, and ICC = 0.69-0.883 in trunk muscle mass) [28,31,36,38,39]. These prior studies showed a high correlation in assessing muscle mass between BIA and DEXA. ...
... They found that there was a systematic bias (DEXA minus MF-BIA) with an underestimation of whole-body lean mass of 3.17 kg and 2.73 kg (95% CI, 3.42 to 2.93 for males and 2.57 to 2.90 for females) and of appendicular lean mass of 1.48 kg and 1.59 kg (95% CI, 1.34 to 1.62 for male and 1.49 to 1.68 for female) [33]. Moreover, Ling et al. examined the accuracy of MF-BIA and they found that MF-BIA underestimated lean body mass by 1.8% compared to the reference method of DEXA [31]. The results of these previous studies suggest the need to improve BIA accuracy. ...
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Though bioelectrical impedance analysis (BIA) is a favorable tool for assessing body composition to estimate nutritional status and physical fitness, such as sarcopenia, there are accuracy issues. Hence, high-frequency (HF) BIA equipment uses an additional frequency of 2 and 3 MHz and has been developed as a commercial model. However, there are no studies validating the accuracy and safety of HF-BIA. Therefore, this study aims to assess the validity of HF-BIA in analyzing body composition relative to dual-energy X-ray absorptiometry (DEXA). Appendicular lean mass (ALM), fat-free mass (FFM), and percentage of body fat (PBF) were assessed by HF-BIA and DEXA in 109 individuals; 50.5% (n = 55) were males. The average age and body mass index (BMI) were 43.4 ± 14.7 years and 25.5 ± 6.7 in males and 44.9 ± 14.1 years and 24.0 ± 6.4 in females, respectively. The HF-BIA results showed a high correlation with the DEXA results for assessing ALM (standard coefficient beta (β) ≥ 0.95), FFM (β ≥ 0.98, coefficient of determinations (R2) ≥ 0.95), and PBF (β ≥ 0.94, R2 ≥ 0.89). Body composition measured by HF-BIA demonstrated good agreement with DEXA in Korean adults.
... These findings are consistent with current study results, which observed larger proportional bias when using MF-BIA in Hispanic females. In contrast, proportional bias was not observed between MF-BIA and DXA when evaluated in previous research by Ling et al. [21] . The discrepancies between the current study and previous findings of Ling et al. [21] could be multifactorial. ...
... In contrast, proportional bias was not observed between MF-BIA and DXA when evaluated in previous research by Ling et al. [21] . The discrepancies between the current study and previous findings of Ling et al. [21] could be multifactorial. First, the current study consisted of young Hispanic adults, whereas Ling et al. [21] used middle-aged non-Hispanic Caucasian adults. ...
... The discrepancies between the current study and previous findings of Ling et al. [21] could be multifactorial. First, the current study consisted of young Hispanic adults, whereas Ling et al. [21] used middle-aged non-Hispanic Caucasian adults. As previously mentioned, the hydration of FFM for Hispanics is lower than values observed in non-Hispanic Caucasians, which bioimpedance principles are based on. ...
Article
Body composition algorithms are typically validated using multi-ethnic populations without accounting for ethnicity. This might be problematic when using multi-frequency bioimpedance analysis (MF-BIA) for Hispanics. Group error (i.e., constant error [CE]), individual error (i.e., 95% limits of agreement [LOAs]), and proportional bias of MF-BIA were determined in Hispanic men and women (n = 84 and 97, respectively) when using dual energy X-ray absorptiometry (DXA) as a reference method. Due to the lack of an ethnic-specific impedance equation for Hispanics, it was hypothesized that MF-BIA would be biased when compared to DXA. For body fat percent (BF%), MF-BIA displayed similar CE±95% LOA for the sample (-3.17±5.45%), males (-3.2±5.5%), and females (-3.2±5.4%) compared to DXA. However, moderate proportional bias was present for females (r=0.48). The sample (r=0.22) and males (r=-0.04) had trivial-to-no proportional bias. Regarding fat mass (FM), MF-BIA exhibited CE±95% LOA values of -1.4±4.2 kg for the sample, -1.9±4.6 kg for males, and -0.9±3.6 kg for females. There was strong proportional bias for females (=0.68) and moderate bias for the sample (r=0.36). No proportional bias was observed for males (r=-0.02). For fat-free mass (FFM), males demonstrated the largest CE±95% LOA (1.6±4.6), compared to the sample (1.2±3.9 kg) and females (0.9±3.4 kg) when MF-BIA was compared to DXA. No proportional biases existed for the sample (r=-0.01) or males (r=-0.10). However, females exhibited a moderate, negative bias (r=-0.38). Due to the observed moderate-to-strong proportional biases within body composition estimates, the need for ethnic-specific algorithms is warranted, particularly for the Hispanic female population.
... Weight and body composition analyses were performed on a scale with multi-frequency (5, 50, and 250 kHz) bioelectrical impedance analysis using an eightpoint tactile electrode system (InBody 370; BIOSPACE Co., Ltd., Seoul, Korea). The direct segmental multi-frequency technique employs the assumption that the human body is composed of five interconnecting cylinders and takes direct impedance measurements from the various body compartments [15]. The spectrum of electrical frequencies predicts the phase angle [16], intracellular water (ICW), and extracellular water (ECW) compartments of the total body water (TBW) in the various body segments. ...
... Lean body mass is estimated as (ICW + ECW)/0.73 [15]. Fat mass is calculated as the difference between the total body weight and lean body mass. ...
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The aim of the present study was to evaluate the association between television viewing/physical activity (TVV/PA) interactions and cardiometabolic risk in an adult European population. A total of 2155 subjects (25–64 years) (45.2% males), a random population-based sample were evaluated in Brno, Czechia. TVV was classified as low (<2 h/day), moderate (2–4), and high (≥4). PA was classified as insufficient, moderate, and high. To assess the independent association of TVV/PA categories with cardiometabolic variables, multiple linear regression was used. After adjustments, significant associations were: High TVV/insufficient PA with body mass index (BMI) (β = 2.61, SE = 0.63), waist circumference (WC) (β = 7.52, SE = 1.58), body fat percent (%BF) (β = 6.24, SE = 1.02), glucose (β = 0.25, SE = 0.12), triglycerides (β = 0.18, SE = 0.05), and high density lipoprotein (HDL-c) (β = −0.10, SE = 0.04); high TVV/moderate PA with BMI (β = 1.98, SE = 0.45), WC (β = 5.43, SE = 1.12), %BF (β = 5.15, SE = 0.72), triglycerides (β = 0.08, SE = 0.04), total cholesterol (β = 0.21, SE = 0.10), low density protein (LDL-c) (β = 0.19, SE = 0.08), and HDL-c (β = −0.07, SE = 0.03); and moderate TVV/insufficient PA with WC (β = 2.68, SE = 1.25), %BF (β = 3.80, SE = 0.81), LDL-c (β = 0.18, SE = 0.09), and HDL-c (β = −0.07, SE = 0.03). Independent of PA levels, a higher TVV was associated with higher amounts of adipose tissue. Higher blood glucose and triglycerides were present in subjects with high TVV and insufficient PA, but not in those with high PA alone. These results affirm the independent cardiometabolic risk of sedentary routines even in subjects with high-levels of PA.
... Body composition was assessed with a direct segmental eightpoint multifrequency bioelectrical impedance analysis (BIA, InBody770, Biospace Inc., Seoul, Korea) at the initial postpartum evaluation. This analysis was previously shown to have acceptable agreement with dual-energy X-ray absorptiometry (DXA) and magnetic resonance imaging [19,20]. Total fat mass and visceral fat area (VFA) were measured by BIA. ...
... This may not fully reflect the actual skeletal muscle mass. However, it is a non-invasive and valid technique that provides accurate estimates of skeletal muscle mass that are closely correlated with measurements obtained using DXA and magnetic resonance imaging across ranges of age, volume status, and BMI [19,20]. Assess-Diabetes Metab J 2022 Forthcoming. ...
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Background: We evaluated whether postpartum muscle mass affects the risk of type 2 diabetes mellitus (T2DM) in Korean women with gestational diabetes mellitus (GDM). Methods: A total of 305 women with GDM (mean age, 34.9 years) was prospectively evaluated for incident prediabetes and T2DM from 2 months after delivery and annually thereafter. Appendicular skeletal muscle mass (ASM) was assessed with bioelectrical impedance analysis at the initial postpartum visit, and ASM, either divided by body mass index (BMI) or squared height, and the absolute ASM were used as muscle mass indices. The risk of incident prediabetes and T2DM was assessed according to tertiles of these indices using a logistic regression model. Results: After a mean follow-up duration of 3.3 years, the highest ASM/BMI tertile group had a 61% lower risk of incident prediabetes and T2DM compared to the lowest tertile group, and this remained significant after we adjusted for covariates (adjusted odds ratio, 0.37; 95% confidence interval [CI], 0.15 to 0.92; P=0.032). Equivalent findings were observed in normal weight women (BMI <23 kg/m2), but this association was not significant for overweight women (BMI ≥23 kg/m2). Absolute ASM or ASM/height2 was not associated with the risk of postpartum T2DM. Conclusion: A higher muscle mass, as defined by the ASM/BMI index, was associated with a lower risk of postpartum prediabetes and T2DM in Korean women with GDM.
... In addition to our primary comparisons between BIA-and DXA-assessed measures of body composition, we performed several pre-specified secondary and subgroup analyses. First, because electrode placement can impact BIA measurements 8,12 , we examined the correlation between percent regional body fat measures (i.e., trunk, gynoid, android, arms, and legs.) obtained from the DXA scan and BIA device mean percent total body fat. ...
... Previous studies in COPD populations have utilized different types of BIA devices (such as multifrequency, 8-point stand-on BIA, eight-lead 12-channel isolated switch BIA) to measure body composition differences. For example, a study performed by Ling et al. found that the Direct Segmental Multifrequency-BIA (DSM-BIA) overestimates percent fat mass relative to the DXA scan in middle-aged participants 12 . In contrast, two COPD studies found that a tetrapolar and an eight-contact electrode BIA device underestimated fat free mass (FFM) values when compared to the DXA scan in COPD patients 16,17 ; but that, similar to our findings, their BIA devices served as a valid alternative to measuring body composition differences. ...
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We examined the performance of a commercially-available handheld bioimpedance (BIA) device relative to dual X-ray absorptiometry (DXA) to assess body composition differences among Veterans with chronic obstructive pulmonary disease (COPD). Body composition was measured using DXA and BIA (Omron HBF-306C) at a single time point. Correlations between BIA- and DXA-assessed percent fat, fat mass, and fat-free mass were analyzed using Spearman (ρ) and Lin Concordance Correlation Coefficients (ρc). Mean differences in fat mass were visualized using Bland–Altman plots. Subgroup analyses by obesity status (BMI < 30 versus ≥ 30) were performed. Among 50 participants (96% male; mean age: 69.5 ± 6.0 years), BIA-assessed fat mass was strongly correlated (ρ = 0.94) and demonstrate excellent concordance (ρc = 0.95, [95%CI: 0.93–0.98]) with DXA, with a mean difference of 2.7 ± 3.2 kg between BIA and DXA. Although Spearman correlations between BIA- and DXA-assessed percent fat and fat-free mass were strong (ρ = 0.8 and 0.91, respectively), concordance values were only moderate (ρc = 0.67 and 0.74, respectively). Significantly stronger correlations were observed for obese relative to non-obese subjects for total percent fat (ρobese = 0.85 versus ρnon-obese = 0.5) and fat mass (ρobese = 0.96 versus ρnon-obese = 0.84). A handheld BIA device demonstrated high concordance with DXA for fat mass and moderate concordance for total percent fat and fat-free mass. ClinicalTrials.gov: NCT02099799.
... Measurements included body weight (BW), total and segmental (both legs, trunk, and both arms) skeletal muscle mass, fat mass and % body fat. The In-Body 770 is a valid tool for the assessment of total body and [35] segmental body composition [31]. Height was measured electronically to the nearest 0.1 cm, and body mass index (BMI) was calculated. ...
... Waist circumference (WC) was measured using a designated tape measure. ASMI was calculated by adding the sum skeletal masses of both arms and legs divided by height squared using the BIA technique [31]. Low muscle mass was defined according to the EWGSOP2 as ASMI < 7.0 kg/m 2 in men and < 5.5 kg/m 2 in women [16]. ...
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Background The accelerated loss of muscle strength and mass observed in older type 2 diabetes mellitus (T2DM) patients due to the combined effects of diabetes and obesity, greatly increases their risk for sarcopenia. Early detection and treatment of probable and confirmed sarcopenia is paramount to delay mobility disability. Using low handgrip strength cut-off points for the initial identification of sarcopenia according to the new European Working Group on Sarcopenia in Older People (EWGSOP2) guidelines may mask the presence of sarcopenia. Relative knee extension strength cut-off points using a simple hand-held dynamometer can assist clinicians in the diagnosis of probable and confirmed sarcopenia by possibly reducing false negative results. Methods A cohort of one hundred T2DM older patients (60% women) (mean age 74.5 years) mostly obese community dwelling older adults were evaluated for body composition by Bioelectrical impedance analysis (BIA), yielding appendicular skeletal mass index (ASMI) results. Patients underwent handgrip strength (HGS) and knee extension strength (KES) tests as well as functional ability tests. Prevalence of probable and confirmed sarcopenia using HGS and KES cut-off points were calculated. Pearson correlations were performed to evaluate the relationship between ASMI and limbs strength. A regression analysis was conducted to examine which variables best predict ASMI values. A multivariate analysis of covariance was performed to assess the effect of independent variables on KES and HGS. Results Using cutoff points for low KES identified 24 patients with probable sarcopenia and two with confirmed sarcopenia. Conversely, using the EWGSOP2 cut off points for low HGS, identified only one patient with probable sarcopenia and none of the patients with confirmed sarcopenia. Conclusion KES cut-off points using a simple hand-held dynamometer can assist in the identification of probable and confirmed sarcopenia using EWGSOP2 cut off points for low muscle mass in a population of older T2DM patients for further analysis and early treatment. This is notably true in patients possessing high body mass index (BMI) alongside normal ASMI and HGS, potentially reducing false positive sarcopenia screening results. Trial registration ClinicalTrials.gov PRS: NCT03560375 . Last registration date (last update): 06/06/2018. The trial was a-priori registered before actual recruitment of subjects.
... DSM-BIA has been validated for assessing segmental and whole body composition against dual energy X-ray absorptiometry. 49 DSM-BIA will not be performed in patients with (1) electronic internal medical devices or implants such as cardiac pacemakers; ...
... (2) plasters or bandages interfering with the placement of the electrodes; (3) amputation. Muscle mass will be expressed as SMM (kg), SMM index (SMI, kg/m 2 ) by dividing SMM (kg) by height squared (m 2 ), 49 relative SMM (%) by dividing SMM (kg) by body weight (kg)*100, ALM/height 2 (kg/m 2 ) by dividing ALM (kg) by height squared (m 2 ) 50 and fat-free mass (%). ...
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Introduction Sarcopenia is highly prevalent in geriatric rehabilitation patients. Resistance exercise training (RET) combined with protein supplementation is recommended to increase muscle mass and strength in older adults. However, sarcopenia awareness, feasibility to diagnose and treat sarcopenia, and efficacy of treatment in geriatric rehabilitation patients remain to be established. Methods and analysis Enhancing Muscle POWER in Geriatric Rehabilitation (EMPOWER-GR) encompasses four pillars: (1) an observational cohort study of 200 geriatric rehabilitation inpatients determining sarcopenia prevalence, functional and nutritional status at admission; (2) a survey among these 200 patients and 500 healthcare professionals and semistructured interviews in 30 patients and 15 carers determining sarcopenia awareness and barriers/enablers regarding diagnostics and treatment; (3) a feasibility, single-centre, randomised, controlled, open-label, two parallel-group trial in 80 geriatric rehabilitation patients with sarcopenia. The active group (n=40) receives three RET sessions per week and a leucine and vitamin D-enriched whey protein-based oral nutritional supplement two times per day in combination with usual care for 13 weeks. The control group (n=40) receives usual care. Primary outcomes are feasibility (adherence to the intervention, dropout rate, overall feasibility) and change from baseline in absolute muscle mass at discharge and week 13. Secondary outcomes are feasibility (participation rate) and change from baseline at discharge and week 13 in relative muscle mass, muscle strength, physical and functional performance, mobility, nutritional status, dietary intake, quality of life and length of stay; institutionalisation and hospitalisation at 6 months and mortality at 6 months and 2 years; (4) knowledge sharing on sarcopenia diagnosis and treatment. Ethics and dissemination Ethical exemption was received for the observational cohort study, ethics approval was received for the randomised controlled trial. Results will be disseminated through publications in scientific peer-reviewed journals, conferences and social media. Trial registration number NL9444.
... After about 30 seconds, the device provided information on the person's body composition, including body weight, ideal weight, BMI, waist-to-hip ratio (WHR), body fat percentage, muscle mass, and body water. The data extracted from the device software were used for additional analysis (ICC ≥ 0.88) (21). ...
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Background: Inadequate ergonomics can affect factors such as productivity and job involvement that play an important role in the sustainable development of organizations. To this end, the present study investigated the effect of workplace ergonomics and body composition on productivity and job involvement of employees in Kermanshah Oil Refinery.
... The lifestyles and dietary intakes of participants were not controlled although they were instructed by a nutritionist and were asked to maintain the same diet throughout the study. We used bioelectrical impedance to measure body composition variables and acknowledge that bioelectrical impedance is not a gold standard method for measuring these markers; however its reliability and validity has been reported previously (Jackson et al., 1988;Ling et al., 2011). The protocols used in our study were not equalized according to calorie expenditure, which might have influenced the results. ...
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Background Neuregulin 4 (Nrg4) is an adipokine that is sensitive to energy expenditure and with a potential role in metabolic homeostasis and obesity. This study examined the effects of 12 weeks of three different exercise training protocols on Nrg4 levels, cardiometabolic risk factors, and body composition parameters in men with obesity. Methods Sixty adult men with obesity (Mean ± SD; age: 27.60 ± 8.4 yrs.; height: 168.4 ± 2.6 cm; weight: 96.7 ± 7.2 kg) were randomly allocated into four equal ( n = 15) groups: High- Intensity Interval Training (HIIT), Circuit Resistance Training (CRT), Moderate Intensity Continuous Training (MICT) or a control group. The HIIT protocol involved six bouts of 3-min high-intensity exercise (90% VO 2 peak ) followed by 3-min low-intensity exercise (50% VO 2 peak ). The CRT group performed three circuits of resistance training, where each circuit included 11 exercises at 20% of one-repetition maximum (1RM) and 70% of VO 2 peak , and with a work-to-rest ratio of 2:1 (40-s exercise and 20-s rest) and 60-s recovery between circuits. The MICT group performed 36 min of exercise at 70% of VO 2 peak . All measurements were taken 72 h before and after the first and last training sessions. Results There were significant differences between the groups in fat-free mass (FFM), (effect size (ES): 0.78), fat mass (ES: 0.86), VO 2 peak (ES: 0.59), high-density lipoprotein cholesterol (HDL-C) (ES: 0.83), low-density lipoprotein (LDL-C) (ES: 0.79), total cholesterol (TC) (ES: 0.90), triglyceride (TG) (ES: 0.52) glucose (ES: 0.39), insulin (ES: 0.61), HOM-IR (ES: 0.91) and Nrg4 (ES: 0.98) ( p < 0.05). There were no significant changes in very-low-density lipoprotein cholesterol (VLDL-C) (ES: 0.13) levels, or body weights (ES: 0.51) ( p > 0.05). Levels of Nrg4 were negatively correlated with LDL-C, TC, TG, VLDL-C, glucose, insulin, HOMA-IR ( p < 0.05) and positively with HDL-C ( p < 0.05). Conclusion Our results suggest that HIIT and CRT protocols have greater effects than MICT protocol on Nrg4 levels, metabolic and cardiovascular risk factors, and body composition variables in men with obesity.
... An eight-electrode system connecting to the ankles and two fingertips of each patient's hand segments the human body into five parts, including the right arm, left arm, right leg, left leg, and trunk, and measures different body parts compartments. The instrument uses a current of 6 frequencies, including 1 kHz, 5 kHz, 50 kHz, 250 kHz, 500 kHz, and 1 MHz, the varied cell membrane conductivities from highfrequency to low-frequency current are therefore translated into extracellular water (ECW) and intracellular water (ICW) with different impedance (26). In the in-built software, other data including ECW/TBW of the whole body and separate body compartments, including right arm, left arm, trunk, right leg and left leg, and percentage of body fat (PBF), visceral fat area (VFA), skeletal muscle index (SKI) and phase angle (PhA) were calculated. ...
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Objective To investigate body fluid status in diabetic macular edema (DME) patients and the extent to which it is affected by renal function. Methods One hundred and thirty-two eyes from 132 patients with diabetes mellitus (DM) were prospectively collected in this cross-sectional, observational study. Thirty-five were DM patients without diabetic retinopathy (DR), 31 were DR patients without DME, and 66 were DME patients. The fluid status of each participant was quantified with extracellular water-to-total body water ratio (ECW/TBW) using a body composition monitor. Central subfield thickness (CST) and macular volume (MV) were obtained using optical coherence tomography (OCT). Urine albumin-to-creatinine ratio (UACR), estimated glomerular filtration rate (eGFR), and albumin was obtained using serum and urine laboratory data. Results ECW/TBW was significantly increased in DME patients (39.2 ± 0.9, %) compared to DM (38.1 ± 0.7, %, P = 0.003) and DR patients without DME (38.7 ± 0.9, %, P < 0.001). In multilinear regression, fluid overload was positively related to DME and UACR (DME vs. DM: β = 2.418, P < 0.001; DME vs. DR: β = 1.641, P = 0.001; UACR, per 10 ² , β = 1.017, P = 0.01). In the binary logistic regression for DME risk, the area under the receiver operating characteristic curve (AUROC) increased significantly by adding ECW/TBW along with UACR and age (AUC: 0.826 vs. 0.768). Conclusion DME patients had elevated body fluid volume independent of kidney functions. The assessment of extracellular fluid status may help in the management of DME.
... Body fat percent (BFP), body mass index (BMI), fat mass (FM), and muscle mass were evaluated by a multi-frequency bioelectrical impedance device (BIA; Jawon Medical X Contact-356, South Korea) as previously described . The test-retest reliability of the bioelectrical impedance method is high (R = 0.95 to 0.99; Ling et al., 2011). ...
Article
Purpose: We aimed to determine the effects of 12 weeks of soy milk consumption combined with resistance training (RT) on body composition, physical performance, and skeletal muscle regulatory markers in older men. Methods: In this randomized clinical trial study, 60 healthy elderly men (age = 65.63 ± 3.16 years) were randomly assigned to four groups: resistance training (RT; n = 15), soy milk consumption (SMC; n = 15), resistance training + soy milk (RSM; n = 15), and control (CON; n = 15) groups. The study was double-blind for the soy milk/placebo. Participants in RT and RSM groups performed resistance training (3 times/week) for 12 weeks. Participants in the SMC and RSM groups consumed 240 mL of soy milk daily. Body composition [body mass (BM), body fat percent (BFP), waist-hip ratio (WHR), and fat mass (FM)], physical performance [upper body strength (UBS), lower body strength (LBS), VO2max, upper anaerobic power, lower anaerobic power, and handgrip strength], and serum markers [follistatin, myostatin, myostatin-follistatin ratio (MFR), and growth and differentiation factor 11 (GDF11)] were evaluated before and after interventions. Results: All 3 interventions significantly (p < 0.05) increased serum follistatin concentrations (RT = 1.7%, SMC = 2.9%, RSM = 7.8%) and decreased serum myostatin (RT = −1.3% SMC = −5.4%, RSM = −0.5%) and GDF11 concentrations (RT = −1.4%, SMC = −1.4%, RSM = -9.0%), and MFR (RT = −2.6%, SMC = −3.2%, RSM = −12%). In addition, we observed significant reduction in all 3 intervention groups in BFP (RT = −3.6%, SMC = −1.4%, RSM = −6.0%), WHR (RT = −2.2%, SMC = −2.1%, RSM = −4.3%), and FM (RT = −9.6%, SMC = −3.8%, RSM = −11.0%). Moreover, results found significant increase only in RT and RSM groups for muscle mass (RT = 3.8% and RSM = 11.8%), UBS (RT = 10.9% and RSM = 21.8%), LBS (RT = 4.3% and RSM = 7.8%), upper anaerobic power (RT = 7.8% and RSM = 10.3%), and lower anaerobic power (RT = 4.6% and RSM = 8.9%). Handgrip strength were significantly increased in all 3 intervention groups (RT = 7.0%, SMC = 6.9%, RSM = 43.0%). VO 2max significantly increased only in RSM (1.7%) after 12 weeks of intervention. Additionally, significant differences were observed between the changes for all variables in the RSM group compared to RT, SMC, and CON groups (p < 0.05). Conclusions: There were synergistic effects of soy milk and RT for skeletal muscle regulatory markers, body composition, and physical performance. Results of the present study support the importance of soy milk in conjunction with RT for older men.
... Height was measured by a stadiometer and plotted in the Inbody 720 analyzer prior to the assessments. Inbody 720 has been shown to be valid for measuring body composition in general populations and among obese participants [53,54]. BMI, body fat percentage, and fat-free mass (kg) were the variables used in the current study. ...
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Healthy Life Centers (HLCs) have been established throughout Norway to support lifestyle changes and promote physical and mental health. We conducted a 12-month observational study among participants in an HLC that aimed to improve physical activity (PA) and dietary behaviors, and this study examined predictors of completion, and changes in psychological variables, lifestyle behaviors, and physical health indicators. The participants (N = 120, 71% female, mean age = 44 years) reported symptoms of psychological distress (77%) and were obese (77%). No baseline characteristics were found to be consistent predictors of completion (42%). Completers had significant improvements in autonomous motivation for PA (d = 0.89), perceived competence for PA (d = 1.64) and diet (d = 0.66), psychological distress (d = 0.71), fruit intake (d = 0.64), vegetable intake (d = 0.38), BMI among all participants (d = 0.21) and obese participants (d = 0.34), body fat percentage among all participants (d = 0.22) and obese participants (d = 0.33), and lower body strength (d = 0.91). Fat-free mass and all forms of PA remained unchanged from baseline to 12 months. Hence, there were indications of improvement among completers on psychological variables, lifestyle behaviors, and physical health indicators. The low rate of completion was a concern, and the unchanged levels of PA reflect an important area of focus for future interventions in the context of HLCs.
... Assessment of overweightness/obesity indicators was performed by multi-frequency bioimpedance analysis using the Tanita MC-180 (Bailida Co., Tokyo, Japan). This device is considered appropriate for evaluating overweightness/obesity indicators in the target population because its validity for assessing total and visceral adiposity in older women has been confirmed [26,27]. Overweightness/obesity indicators were measured using standard protocols with the subject in minimal clothes and without shoes on the instrument. ...
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Previous studies have found that the relationship between sedentary time (ST) and overweightness/obesity is unclear. The association between sedentary behavior and overweightness/obesity may depend on the type of sedentary behavior engaged in. Nowadays, in older Chinese adults, especially females, short video viewing (SVV) is the most popular leisure sedentary behavior. However, the association between SVV and overweightness/obesity remains to be determined. This study aimed to examine the associations between ST and SVV and overweightness/obesity in Chinese community-dwelling older women. A cross-sectional analysis of baseline data from the Physical Activity and Health in Older Women Study was carried out in this study. A total of 1105 older Chinese women aged 60–70 years were included. SVV was estimated using a self-reported questionnaire, and ST was objectively measured using a tri-axial accelerometer. Overweightness/obesity indicators, including body fat ratio (BFR), fat mass (FM), visceral fat mass (VFM), subcutaneous fat mass (SFM), trunk fat mass (TFM), and limb fat mass (LFM), were assessed using multi-frequency bioimpedance analysis. The covariates included socio-demographic data and a range of health-related factors. Multiple linear regression analyses were used to assess the association between ST and SVV and overweightness/obesity. ST was significantly positively associated with all indicators of overweightness/obesity; however, the associations disappeared after adjusting for moderate-to-vigorous-intensity physical activity (MVPA). A higher SVV time was associated with a higher body mass index (BMI) (β = 0.19, 95% confidence interval (CI): 0.05 to 0.32), BFR (β = 0.31, 95% CI: 0.07 to 0.56), FM (β = 0.33, 95% CI: 0.04 to 0.61), VFM (β = 0.09, 95% CI: 0.01 to 0.16), SFM (β = 0.24, 95% CI: 0.03 to 0.45), TFM (β = 0.21, 95% CI: 0.04 to 0.39), and LFM (β = 0.11, 95% CI: 0.00 to 0.23) in the fully adjusted models. Compared with non-food short videos, short food videos had a greater effect on overweightness/obesity. SVV was an independent risk factor for overweightness/obesity. A reduction in SVV (especially the food category) rather than ST might be an effective way to prevent overweightness/obesity when incorporated in future public health policy formulations.
... After a medical examination, anthropometric parameters were assessed (weight; height). Then, all subjects and patients underwent a segmental multifrequency bioelectronic impedance meter analysis to assess the body composition [27] with an impedance plethysmograph (Biacorpus RX4000 software, BodyComp 8.4). Body fat mass (FM) and fat-free mass (FFM) were calculated for each segment of the body, according to the manufacturer's database-derived disclosed equations, and total water with published equations using the classical cylindrical model and the Hanai mixture theory [28]. ...
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The screening of skeletal muscle diseases constitutes an unresolved challenge. Currently, exercise tests or plasmatic tests alone have shown limited performance in the screening of subjects with an increased risk of muscle oxidative metabolism impairment. Intensity-adjusted energy sub-strate levels of lactate (La), pyruvate (Pyr), β-hydroxybutyrate (BOH) and acetoacetate (AA) during a cardiopulmonary exercise test (CPET) could constitute alternative valid biomarkers to select "at-risk" patients, requiring the gold-standard diagnosis procedure through muscle biopsy. Thus, we aimed to test: 1) the validity of the V'O2-adjusted La, Pyr, BOH and AA during a CPET for the assessment of the muscle oxidative metabolism (exercise and mitochondrial respiration parameters); and 2) the discriminative value of the V'O2-adjusted energy and redox markers, as well as five other V'O2-adjusted TCA cycle-related metabolites, between healthy subjects, subjects with muscle complaints and muscle disease patients. Two hundred and thirty subjects with muscle complaints without diagnosis, nine patients with a diagnosed muscle disease and ten healthy subjects performed a CPET with blood assessments at rest, at the estimated 1st ventilatory threshold and at the maximal intensity. Twelve subjects with muscle complaints presenting a severe alteration of their profile underwent a muscle biopsy. The V'O2-adjusted plasma levels of La, Pyr, BOH and AA, and their respective ratios showed significant correlations with functional and muscle fiber mitochon-drial respiration parameters. Differences in exercise V'O2-adjusted La/Pyr, BOH, AA and BOH/AA were observed between healthy subjects, subjects with muscle complaints without diagnosis and muscle disease patients. The energy substrate and redox blood profile of complaining subjects with severe exercise intolerance matched the blood profile of muscle disease patients. Adding five tricar-boxylic acid cycle intermediates did not improve the discriminative value of the intensity-adjusted energy and redox markers. The V'O2-adjusted La, Pyr, BOH, AA and their respective ratios constitute valid muscle biomarkers that reveal similar blunted adaptations in muscle disease patients and in subjects with muscle complaints and severe exercise intolerance. A targeted metabolomic approach to improve the screening of "at-risk" patients is discussed. Citation: Grillet, P.-E.; Badiou, S.; Lambert, K.; Sutra, T.; Plawecki, M.; Raynaud de Mauverger, E.; Brun, J.-F.; Mercier, J.; Gouzi, F.; Cristol, J.P. Biomarkers of Redox Balance Adjusted to Exercise Intensity as a Useful Tool to Identify
... Since the reference group included Uruguayan children, adolescents, and adults non-exposed to CRFs, we avoided using bibliographical data from subjects who do not necessarily present characteristics similar to those of the Uruguayan population. Fourth, body composition data were corroborated using two validated BIA devices (InBody-120; OMRON-HBF514C), which showed a good concordance correlation (60)(61)(62). ...
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Bioelectrical impedance analysis (BIA)-derived indexes [e.g., fat (FMI) and fat-free mass indexes (FFMI), visceral fat level (VFL)] are used to characterize obesity as a cardiovascular risk factor (CRF). The BIA-derived index that better predicts arterial variability is still discussed. Aims To determine: (1) the association of classical [weight, height, body mass index (BMI), basal metabolic rate (BMR)] and BIA-derived indexes, with arterial properties deviations from expected values (arterial z-scores); (2) maximum arterial variations attributable to BIA-derived indexes; (3) whether the composition of total body, trunk and/or limbs is most closely associated with arterial variations. Methods Hemodynamic, structural, and functional parameters of different histological types of arteries were assessed ( n = 538, 7–85 years). Classical and BIA-derived indexes [fat mass and percentage, FMI, VFL, muscle mass percentage (PMM), FFMI, and percentage] were measured (mono- and multi-segmental devices). Arterial z-scores were obtained using age-related equations derived from individuals not-exposed to CRFs ( n = 1,688). Results First, regardless of the classical index considered, the associations with the arterial properties showed a specific hierarchy order: diameters and local stiffness > aortic and brachial blood pressure (BP) > regional stiffness. Second, all the associations of FMI and FFMI with z-scores were positive. Third, FFMI exceeded the association obtained with BMI and BMR, considering structural z-scores. In contrast, FMI did not exceed the association with z-scores achieved by BMI and BMR. Fourth, regardless of CRFs and classical indexes, arterial z-scores would be mainly explained by FFMI, VFL, and PMM. Fifth, regardless of the body-segment considered, the levels of association between FMI and z-scores did not exceed those found for classic and FFMI. Total fat mass and trunk indexes showed a greater strength of association with z-scores than the FMI of limbs. Sixth, compared to lower limb FFMI indexes, total and upper limbs FFMI showed higher levels of association with z-scores. Conclusions FFMI (but not FMI) exceeded the strength of association seen between BMI or BMR and structural z-scores. Regardless of the body segment analyzed, the associations between FMI and z-scores did not exceed those found with classic and FFMI. Arterial z-scores could be independently explained by FFMI, VFL, and PMM.
... All contributors were asked to remove their heavy clothes, shoes, and accessories. Then, body composition including body weight, body mass index (BMI), and skeletal muscle mass (SMM) were measured using an automated Bio-Impedance Analyzer BIA (Inbody 770, Inbody Co, Seoul, Korea) with a precision of 0.5 kg (28,30). Height was measured by an automatic BSM 370 (Biospace Co., Seoul, Korea) with a precision of 0.1 cm. ...
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Background and aims: Hypertension may lead to disability and death by increasing the risk of cardiovascular disease, kidney failure, and dementia. This study aimed to determine the association between obesity, sarcopenia and sarcopenic obesity, and hypertension in adults resident in Ravansar, a city in the west of Iran. Methods: This cross-sectional study was conducted on 4,021 subjects from the baseline data of the Ravansar Non-Communicable Disease (RaNCD) cohort study, in the west region of Iran, from October 2014 up to February 2017. Body composition was categorized into obese, sarcopenia, sarcopenic obese, and normal based on measurements of muscle strength, skeletal muscle mass, and waist circumference. Univariate and multiple logistic regression models were used to examine the relationships, using the STATA 15 software. Results: The mean age of the participant was 47.9 years (SD: 8.4), the body mass index (BMI) was 26.84 kg/m2 (SD: 4.44), and the prevalence of hypertension was 15.12%. The prevalence of obesity, sarcopenia, and sarcopenic obesity were 24.37, 22.01, and 6.91%, respectively. Body composition groups had significant differences in age, total calorie intake, BMI, skeletal muscle mass, and muscle strength (P-value ≤ 0.001). In crude model, the obese (OR = 2.64; 95% CI: 2.11-3.30), sarcopenic (OR = 2.45; 95% CI: 1.94-3.08), and sarcopenic obese (OR = 3.83; 95% CI: 2.81-5.22) groups had a higher odds of hypertension. However, in adjusted models, only the obese group had a higher likelihood of hypertension (OR = 2.18; 95% CI: 1.70-2.80). Conclusion: This study showed that obesity was associated with hypertension, whereas sarcopenia and sarcopenic obesity had no significant relationship with hypertension.
... The anthropometric characteristics of the athletes were obtained using the bioimpedanciometer (Inbody 230, Inbody), which has been previously validated by a dual-energy X-ray system. 12 ...
Purpose: The critical power (CP) concept has been extended from cycling to the running field with the development of wearable monitoring tools. Particularly, the Stryd running power meter and its 9/3-minute CP test is very popular in the running community. Locating this mechanical threshold according to the physiological landmarks would help to define each boundary and intensity domain in the running field. Thus, this study aimed to determine the CP location concerning anaerobic threshold, respiratory compensation point (RCP), and maximum oxygen uptake (VO2max). Method: A group of 15 high-caliber athletes performed the 9/3-minute Stryd CP test and a graded exercise test in 2 different testing sessions. Results: Anaerobic threshold, RCP, and CP were located at 73% (5.41%), 86.82% (3.85%), and 88.71% (5.84%) of VO2max, respectively, with a VO2max of 66.3 (7.20) mL/kg/min. No significant differences were obtained between CP and RCP in any of its units (ie, in watts per kilogram and milliliters per kilogram per minute; P ≥ .184). Conclusions: CP and RCP represent the same boundary in high-caliber athletes. These results suggest that coaches and athletes can determine the metabolic perturbance threshold that CP and RCP represent in an easy and accessible way.
... 8) However, as the existing BIA method measures wholebody impedance by considering the human body as a single cylinder, it cannot reflect the body shape, regional variations, and right-left side differences; furthermore, it cannot measure extracellular and intracellular fluid separately using only a single frequency, and the estimation formula for calculating body composition from impedance requires correction by adding statistical variables based on age and gender. 9) In this study, we investigated the quantitative evaluation of lower limb lymphedema using a BIA device 10,11) with improved development of BIA technology 12,13) that shows segmental water contents using direct and multi-frequency measurements. ...
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Background: There is a need for a simple method for the quantitative evaluation of lymphedema swelling. In this study, we performed a direct segmental multi-frequency impedance analysis in patients with leg lymphedema. Methods: The subjects were 36 patients (6 men and 30 women) with 46 lymphedema legs. The average age was 61 years. All patients had International Society of Lymphology stage II lymphedema. Swelling ratio and ultrasound subcutaneous tissue echo-free space (FS) were examined. InBody 770 was used to measure the extracellular water (ECW), intracellular water (ICW), and total body water (TBW) volumes. Changes before and after complex decongestive treatment (CDT) were examined. Results: In 26 unilateral cases, the ECW, ICW, and TBW volumes of the affected legs were higher than those of the contralateral unaffected legs, and the ECW/TBW ratio was significantly higher in the affected legs (0.41) than in the contralateral unaffected legs (0.391). There was a significant correlation between the leg swelling ratio and the ECW/TBW ratio between the affected and contralateral unaffected legs (correlation coefficient=0.882). Ultrasound findings of the 46 affected legs were classified into no FS (group 0), minimal or only horizontal FS (group 1), and cobblestone-like FS (group 2). The ECW/TBW ratio of the affected legs in each group was 0.393 (14 legs), 0.407 (10 legs), and 0.426 (22 legs) respectively, demonstrating significant differences among the 3 groups. After CDT, the amount of water decreased in the affected legs and increased in the trunks and both upper limbs. The ECW/TBW ratio decreased significantly, from 0.432 to 0.414 in the affected legs, from 0.401 to 0.392 in the unaffected legs, and from 0.413 to 0.402 in the trunks. The ECW/TBW ratio had not changed and remained below 0.4 in the upper limbs. Conclusion: The segmental water contents measured by direct segmental multi-frequency impedance analysis correlates well with the degree of lymphedema swelling, and subcutaneous echo findings and can demonstrate water distribution change before and after CDT, which is considered to be a useful quantitative evaluation method for lymphedema. (This is secondary publication from Jpn J Phlebol 2020; 31(1): 1-7.).
... Appendicular muscle mass, body fat percentage, fat mass, bone mineral composition, skeletal muscle mass and fat free mass were collected. In Body S10 is a validated method for estimating skeletal muscle mass compared with dual-energy X-ray absorptiometry, the gold standard measure [28]. BIA measurements were taken with participants in a supine position either in a reclined armchair or on the participant's bed with arms placed away from the body and legs separated. ...
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The aim of this study was to investigate the prevalence of sarcopenia and associated risk factors among older adults living in three residential aged care (RAC) facilities within Auckland, New Zealand. A total of 91 older adults (63% women, mean age ± SD; 86.0 ± 8.3 years) were recruited. Using the European Working Group on Sarcopenia in Older People criteria, sarcopenia was diagnosed from the assessment of: appendicular skeletal muscle mass/height2, using an InBody S10 body composition analyser and a SECA portable stadiometer or ulna length to estimate standing height; grip strength using a JAMAR handheld dynamometer; and physical performance with a 2.4-m gait speed test. Malnutrition risk was assessed using the Mini Nutrition Assessment-Short Form (MNA-SF). Most (83%) of residents were malnourished or at risk of malnutrition, and 41% were sarcopenic. Multivariate regression analysis showed lower body mass index (Odds Ratio (OR) = 1.4, 95% CI: 1.1, 1.7, p = 0.003) and lower MNA-SF score (OR = 1.6, 95% CI: 1.0, 2.4, p = 0.047) were predictive of sarcopenia after controlling for age, level of care, depression, and number of medications. Findings highlight the need for regular malnutrition screening in RAC to prevent the development of sarcopenia, where low weight or unintentional weight loss should prompt sarcopenia screening and assessment.
... The maximum score out of six attempts was used for analysis. SMI (kg/m 2 ) was measured using direct segmental multi-frequency bioelectrical impedance analysis (DSM-BIA, InBody S10, Biospace Co., Ltd, Seoul) [38].Contraindications for DSM-BIA measurement included pacemaker or any electronic internal medical device, plasters or bandages that could not be removed from the positioning place of the electrodes, amputated arm and/or leg or contact isolation. ...
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Purpose Albumin and C-reactive protein (CRP) are non-specific markers of inflammation, which could affect muscle tissue during acute hospitalization. We investigated the association between albumin and CRP during acute hospitalization with functional and body composition parameters in patients admitted to geriatric rehabilitation. Methods The REStORing Health of Acutely Unwell AdulTs (RESORT) cohort includes geriatric rehabilitation patients assessed for change in activities of daily living (ADL, using the Katz index) during acute hospitalization, and subsequently for Katz ADL, gait speed (GS), handgrip strength (HGS) and skeletal muscle mass index (SMI) at geriatric rehabilitation admission. Albumin and CRP average (median), variation (interquartile range), and maximum or minimum were collected from serum samples, and were examined for their association with functional and body composition parameters using multivariable linear regression analysis adjusted for age, sex and length of acute hospital stay. Results 1769 Inpatients were included for analyses (mean age 82.6 years ± 8.1, 56% female). Median length of acute hospitalization was 7 [IQR 4, 13] days and median number of albumin and CRP measurements was 5 [IQR 3, 12] times. ADL declined in 89% of patients (median − 3 points, IQR − 4, − 2). Lower average albumin, higher albumin variation and lower minimum albumin were associated with larger declines in ADL and with lower ADL, GS, HGS and SMI at geriatric rehabilitation admission. Higher average and maximum CRP were associated with lower GS. Conclusion Inflammation, especially lower albumin concentrations, during acute hospitalization is associated with lower physical function at geriatric rehabilitation admission.
... Anthropometrics are objectively assessed using a calibrated height and weight measuring system, from which measures of height (cm) and weight (kg) can be obtained and body mass index (BMI) can be calculated (weight (kg)/[height (m)] 2 ). Dual-energy X-ray absorptiometry (DXA) [13][14][15] and Bioelectrical Impedance Analysis (BIA) [13,16,17] are included as tools for objective assessment of body composition from which measures of fat mass, lean soft-tissue mass (comprising muscle, inner organs and body water), and bone mineral content can be obtained (e.g., appendicular lean mass (ALM) and skeletal muscle index (SMI)). ...
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Assessing multiple domains of health in older adults requires multidimensional and large datasets. Consensus on definitions, measurement protocols and outcome measures is a prerequisite. The Physical Activity and Nutritional INfluences In Ageing (PANINI) Toolkit aims to provide a standardized toolkit of best-practice measures for assessing health domains of older adults with an emphasis on nutrition and physical activity. The toolkit was drafted by consensus of multidisciplinary and pan-European experts on ageing to standardize research initiatives in diverse populations within the PANINI consortium. Domains within the PANINI Toolkit include socio-demographics, general health, nutrition, physical activity and physical performance and psychological and cognitive health. Implementation across various countries, settings and ageing populations has proven the feasibility of its use in research. This multidimensional and standardized approach supports interoperability and re-use of data, which is needed to optimize the coordination of research efforts, increase generalizability of findings and ultimately address the challenges of ageing.
... Bioimpedance Multi-frequency InBodyS10 (Ottoboni, Rio de Janeiro, RJ, Brazil) was used to assess phase angle. The InBodyS10 showed excellent agreements with DEXA regarding to whole body lean mass, fat mass and percentage body fat (16). The applied current was 100 µA (1 kHz) and 500 µA and frequency was 50 kHz. ...
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Objectives The present study was designed to estimate phase angle percentile curves for a broad age range of healthy individuals.Methods This is a cross-sectional study of healthy Brazilian individuals aged five to 80. InBodyS10 was used to assess phase angle. Reference curves were stratified by sex and estimated using Generalized additive models for location, scale, and shape as a continuous function of age. The phase angle determinants analyzed were physical activity, age, BMI, and SES variables.ResultsData were analyzed from 2,146 individuals, 1,189 (55.2%) of whom were female. In both sexes, the phase angles showed a similar pattern (an increasing trend from childhood to the teenage phase, followed by stabilization during adult ages and a decrease in old adults). In female, the relationship between phase angle and age were associated with BMI and family income. In the male, the relationship between phase angle and age were associated with skin color and family income.Conclusions To the best of our knowledge, it is the first attempt to apply the GAMLSS technique to estimate phase angle percentiles in a healthy population covering most of the life cycle. We also showed that there are different phase angle determinants according to sex.
... This may be due to the appropriate training period and the involvement of large muscle groups in the training protocol that require higher cellular energy compared to small muscle groups (47). The limitations of our study include the small sample size and utilization of bioelectrical impedance to measure body composition, which is not as accurate as dual-energy x-ray absorptiometry (the gold standard technique for body composition measurement); however, previous studies have shown that it is a valid and reliable method (48,49). ...
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Background and objectives: Previous investigations have shown that physical activity can improve insulin sensitivity and body composition by reducing the concentration of inflammatory biomarkers. The study aimed at evaluating effects of eight weeks of resistance training and high-intensity interval training on adropin, blood glucose markers, and body composition in overweight females. Methods: sixteen overweight females (mean age: 30 ± 4.3 years and body mass index= 29 ± 2.6 kg/m 2) were randomly assigned to a resistance training group (n=8) and a high-intensity interval training group (n=8). Participants in both groups trained three times a week for eight weeks. Body composition and serum level of blood markers were determined at baseline and after the last training session. Results: Body mass, body fat percentage, and waist-hip ratio decreased significantly in both groups (p<0.05). VO 2max significantly increased in both groups, while the changes in the resistance training group were greater than in the high-intensity interval training group (p<0.05). Insulin and HOMA-IR concentrations decreased significantly in the resistance training group (p<0.05). Conclusion: Eight weeks of both training procedures could significantly decrease body composition markers. However, the training duration was not sufficient to alter fating blood sugar or adropin concentrations. affect body fat percentage compared to HIIT (9). In one study, eight weeks of ET significantly increased serum adropin concentrations in obese adults (23). Fujie et al. (2015) also reported that eight weeks of ET at 60-70% of maximum heart rate increased adropin concentrations in healthy middle-aged and elderly individuals (24). Furthermore, Alizadeh et al. (2018) demonstrated a significant increase in adropin concentrations following ET in overweight females (25). Given the lack of studies on the effects of resistance training (RT) and HIIT on serum concentrations of adropin in obese or overweight individuals, we aimed to compare effects of RT and HIIT on body composition, insulin, and adropin concentrations in overweight females. MATERIALS AND METHODS Twenty-four overweight and obese females (mean age: 30 ± 4.3 years, mean height: 164.8 ± 4.4 cm) participated in the present study. Inclusion criteria included age of between 25 and 35 years and body mass index (BMI) of 25-35. Exclusion criteria were having cardiovascular disease, diabetes, hypertension, sleep disorders, and history of regular exercise in the last six months. Written consent was obtained from all subjects before participation in the study. The study protocol was approved by the Institutional Human Subject Committee of Ferdowsi University of Mashhad and carried out in accordance with the Declaration of Helsinki. Before baseline measurements, the participants were familiarized with the experiments and procedures. Then, they were randomly assigned into a RT group (n=8) and a HIIT group (n=8). The allocation was stratified by BMI of <25.0 or ≥25.0 kg/m 2 , and the sequence was randomized by a computer. Measurements were made at baseline and after eight weeks of training at a specific time. The subjects were instructed not to alter their regular lifestyle and dietary habits during the study. Maximal strength testing was carried out 24 hours after the body composition measurement. For this purpose, the subjects first warmed up for 10 minutes and then performed two attempts to lift heaviest weight, and the number of repetitions was recorded.
... The anthropometric characteristics of the subjects (body mass [kg], percentage of lean mass [%] and percentage of fat mass [%]) were obtained using the bioimpedanciometer Inbody 230 (Inbody, Seoul, Korea), which has been previously validated by a dual-energy X-ray system (Ling et al., 2011). Subjects were encouraged to follow the American Society of Exercise Physiologists recommendations before the test (Heyward, 2001). ...
Article
This study aimed to determine the effect of the intra-session exercise sequence of a concurrent training programme on the components of health-related physical fitness. Twenty-four healthy young adults were allocated into two different groups differing only in the exercise order to conduct an 8-week intra-session concurrent training programme consisting of three sessions of 60–90 minutes (180–270 min/week), with all-out running sprint intervals, back squat, and bench press endurance and resistance exercises (i.e., ET+RT and RT+ET). The 8-week intra-session concurrent training programme overall improved all the components of physical fitness regardless of the exercise sequence. However, ET + RT and RT + ET groups reported moderate and small improvements for squat jump (ET + RT: 3.82 cm [1.11 to 6.53 cm]; RT + ET: 0.31 cm [−1.72 to 2.33 cm]), countermovement jump (ET + RT: 3.76 cm [1.43 to 6.08 cm]; RT + ET: 2.07 cm [−0.03 to 4.17 cm]) and maximum oxygen uptake (ET + RT: 4.75 ml/kg/min [1.14 to 8.35 ml/kg/min]; RT + ET: 1.66 ml/kg/min [−0.89 to 4.21 ml/kg/min]), respectively. Therefore, greater lower-body power and cardiorespiratory fitness gains might be induced following the ET + RT sequence.
... 33 In contrast, Ling et al. found that BIA, as compared to DXA as the gold standard, slightly underpredicted at normal and overweight BMI's but overpredicted at obese BMI's in a healthy middle-age adult population. 34 In hemodialysis patients, who have a frequently changing hydration status, Furstenberg et al., measured an average LBM of 46.215 using BIA and 45.691 using DXA. 35 In an outpatient Thai hemodialysis population, Jayanama et al. found a LBM of 43.77 using DXA, 42.6 using the portable InBody S10, and 45.08 using a stationary BIA device. ...
Article
Background: Changes in body composition, especially loss of lean mass, commonly occur in the orthopedic trauma population due to physical inactivity and inadequate nutrition. The purpose of this study was to assess inter-rater and intra-rater reliability of a portable bioelectrical impedance analysis (BIA) device to measure body composition in an orthopedic trauma population after operative fracture fixation. BIA uses a weak electric current to measure impedance (resistance) in the body and uses this to calculate the components of body composition using extensively studied formulas. Methods: Twenty subjects were enrolled, up to 72 hours after operative fixation of musculoskeletal injuries and underwent body composition measurements by two independent raters. One measurement was obtained by each rater at the time of enrollment and again between 1-4 hours after the initial measurement. Reliability was assessed using intraclass correlation coefficients (ICC) and minimum detectable change (MDC) values were calculated from these results. Results: Inter-rater reliability was excellent with ICC values for body fat mass (BFM), lean body mass (LBM), skeletal muscle mass (SMM), dry lean mass (DLM), and percent body fat (PBF) of 0.993, 0.984, 0.984, 0.979, and 0.986 respectively. Intra-rater reliability was also high for BFM, LBM, SMM, DLM, and PBF, at 0.994, 0.989, 0.990, 0.983, 0.987 (rater 1) and 0.994, 0.988, 0.989, 0.985, 0.989 (rater 2). MDC values were calculated to be 4.05 kg for BFM, 4.10 kg for LBM, 2.45 kg for SMM, 1.21 kg for DLM, and 4.83% for PBF. Conclusion: Portable BIA devices are a versatile and attractive option that can reliably be used to assess body composition and changes in lean body mass in the orthopedic trauma population for both research and clinical endeavors. Level of Evidence: III.
... We performed an additional analysis to assess the association between NAFLD and the prevalence of VMS according to the fat mass percentage measured using a multi-frequency bioimpedance analyzer with eight-point tactile electrodes (InBody 720, Biospace Co., Seoul, Korea). This technique has been validated for body composition assessment and correlates well with results obtained using dual-energy X-ray absorptiometry or abdominal computed tomography [28,29]. We defined obesity using a body fat percentage cut-off of ≥35% for women [30]. ...
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The role of nonalcoholic fatty liver disease (NAFLD) in vasomotor symptom (VMS) risk in premenopausal women is unknown. We examined the prevalence of early-onset VMSs according to NAFLD status in lean and overweight premenopausal women. This cross-sectional study included 4242 premenopausal Korean women (mean age 45.4 years). VMSs (hot flashes and night sweats) were assessed using the Korean version of the Menopause-Specific Quality of Life questionnaire. Hepatic steatosis was determined using liver ultrasound; lean was defined as a body mass index of <23 kg/m2. Participants were categorized into four groups: NAFLD-free lean (reference), NAFLD-free overweight, lean NAFLD, and overweight NAFLD. Compared with the reference, the multivariable-adjusted prevalence ratios (PRs) (95% confidence intervals (CIs)) for VMSs in NAFLD-free overweight, lean NAFLD, and overweight NAFLD were 1.22 (1.06–1.41), 1.38 (1.06–1.79), and 1.49 (1.28–1.73), respectively. For moderate-to-severe VMSs, the multivariable-adjusted PRs (95% CIs) comparing NAFLD-free overweight, lean NAFLD, and overweight NAFLD to the reference were 1.38 (1.10–1.74), 1.73 (1.16–2.57), and 1.74 (1.37–2.21), respectively. NAFLD, even lean NAFLD, was significantly associated with an increased risk of prevalent early-onset VMSs and their severe forms among premenopausal women. Further studies are needed to determine the longitudinal association between NAFLD and VMS risk.
... Ahora bien, al comparar los datos obtenidos por bioimpedancia en concordancia con otros métodos de referencia, se encuentra que esta báscula fue validada con el método DXA por Ling, et al. 31 , en cuyo estudio compararon los resultados de la masa magra en población normal y con sobrepeso, encontrando una correlación del 99%. Por su parte, Miller et al. 32 compararon los resultados del porcentaje graso de los dos métodos (Inbody y DXA) y hallaron una relación significativa (r = 0.94; p < 0.0001). ...
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Introducción El ángulo de fase se utiliza actualmente como indicador del estado nutricional de los adultos y marcador pronóstico de presencia y progresión de enfermedades crónicas, como las cardiovasculares. Objetivo Determinar la asociación entre el ángulo de fase y los indicadores de riesgo cardiovascular en estudiantes universitarios. Método: Estudio correlacional de corte transversal, en el que se evalúo a 30 estudiantes universitarios (edad 22.1 ± 2 años, peso 65.6 ± 10,3 kg) a través de IPAQ (versión corta), glucometría basal, composición corporal mediante bioimpedancia eléctrica con el instrumento Inbody® de referencia 770, fuerza prensil, batería de Bosco (Optogait®) y consumo de oxígeno indirecto (test de Leger). Resultados Se encontró una media de ángulo de fase de 6.4 ± 0.66, y se halló correlación moderada entre masa magra en tronco (0.68; p = 0.05), tasa metabólica basal (0.64; p = 0.009), nivel de fitness (0.71; p = 0.003), Counter Movement Jump (0.56; p = 0.028) y ángulo de fase. Las mujeres presentan correlación entre relación de cintura y cadera (r = 0.74; p = 0.034). Conclusiones El ángulo demostró ser un indicador predictor de riesgo cardiovascular en población adulta joven; además, permitió una visión más exacta de la predisposición y la potencialidad para padecer enfermedad cardiovascular.
... DSM-BIA directly measures the trunk impedance without using the empirical estimation, which ensures the high repeatability and accuracy of the results [7]. Recently, DSM-BIA has shown superior results in the estimation of body composition [8] and fluid volume management of hemodialysis patients [9], but the results in DWA of continuous ambulatory peritoneal dialysis (CAPD) patients are not very clear. Therefore, we conducted thisstudy to investigate the accuracy of DSM-BIA in DWA of continuous ambulatory peritoneal dialysis (CAPD) patients and to explore the related factors affecting fluid status in patients with CAPD. ...
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Objectives Dry weight assessment (DWA) is an important part of dialysis and fluid management in patients receiving renal replacement therapy. With the development of bioimpedance analysis (BIA), the development of the direct segmental multi-frequency BIA (DSM–BIA) has provided a more convenient measure for DWA of dialysis patients, but its accuracy remains unclear. This study was designed to evaluate the application of DSM–BIA in DWA of continuous ambulatory peritoneal dialysis (CAPD) patients. Design This is a cross-sectional study. Using the conventional BIA as a reference, we examined the accuracy of the DSM–BIA technique for assessing dry weight in CAPD patients and analyzed the potential factors influencing their fluid volume status. Setting and participants A total of 31 patients with end-stage renal disease receiving CAPD and 310 healthy volunteers were recruited for this study. Methods The intraclass correlation coefficients (ICC) and Bland–Altman plots were used to assess the consistency between DSM–BIA and the conventional BIA for DWA. Univariate and multivariate linear regression analyses were used to explore the influencing factors associated with the edema index. Results DSM–BIA and the conventional BIA technology were consistent in DWA in CAPD patients (ICC female 0.972, ICC male 0.882, ICC total 0.960). Similarly, Bland–Altman plots showed good agreements between the two methods in DWA for both genders. Univariate and multivariate linear regression analysis showed both eGFR level (P = 0.04) and serum NT-pro BNP concentration (P = 0.007) were positively correlated with the ratio of extracellular water to total body water (ECW/TCW). Conclusions DSM–BIA in DWA has good accuracy in clinical applications and has potential application value for fluid volume management in CAPD patients.
... Moreover, we used bioelectrical impedance, a cheaper and less invasive method compared to DXA, because numerous studies have investigated the validity of BIA for measuring body composition, comparing its results with DXA, and these studies reported that BIA showed good overall agreement with DXA in healthy adults. All comparisons between measurements provided by BIA and DXA showed strong significant correlations between both methods, acceptable limits of agreement for body fat percentage and absence of significant biases between BIA and DXA 56,57,58,59,60,61 . Our study was conducted in a multicenter study population with a large sample size and geographical diversity, allowing us to include subjects with different cultural and racial characteristics. ...
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Body fat distribution seems to have different effects in cardiovascular diseases (CVD). We aimed to estimate the associations between lower limbs and trunk fat ratio and the 10-year CVD risk, and isolated risk factors in men and women. A total of 10,917 participants from ELSA-Brasil were eligible for this cross-sectional study. Associations between lower limb/trunk fat ratio with the percentage of 10-year CVD risk - according to the Framingham Risk Score - and its risk factors (systolic blood pressure, total cholesterol and HDL-cholesterol, diabetes, and use of antihypertensive medication) were performed using generalized linear models, linear and logistic regressions. All analyses were stratified by gender and adjustments were made by age, self-reported skin color, educational attainment, alcohol consumption, leisure physical activity, hypolipidemic drug use and, for women, menopausal status. In this study, 55.91% were women, with a mean age of 52.68 (SD = 6.57) years. A higher lower limb/trunk fat ratio was related to lower 10-year CVD risk, as well as a reduction in systolic blood pressure, total cholesterol, and antihypertensive drug use, also an increasing HDL-cholesterol in both genders, but this relationship was stronger in women. Besides, a protective relationship to diabetes was observed in women. Higher fat accumulation in the lower body, when compared to the trunk, seems to have a lower risk of CVD and associated risk factors - even in the presence of fat in the abdominal region - with women presenting lower risks than men.
... SMFBIA was validated against isotope dilution for TBW measurement [10,11], and against DXA [12,13] and a 4compartment model [10] for FFM. The SMFBIA method is quick, easy to administer, non-invasive, and less expensive than many other body composition methods. ...
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This study aimed to evaluate the changes in impedance and estimates of body composition variables obtained from segmental multi-frequency bioelectrical impedance analysis (SMFBIA) following acute hydration change. All participants (N = 11 active adults) had SMFBIA measurements at baseline (euhydration), post-dehydration, and post-hyperhydration in an experimental repeated-measures design. Dehydration and hyperhydration trials were randomized with the opposite treatment given 24 h later. Dehydration was achieved via a heat chamber of 40 °C and 60% relative humidity. Hyperhydration was achieved by drinking lightly-salted water (30 mmol·L-1 NaCl; 1.76 g NaCl·L-1) within 30 min. Post-measurements were taken 30 min after each treatment. Despite changes in mass post-dehydration (Δ = -2.0%, p < 0.001) and post-hyperhydration (Δ = 1.2%, p < 0.001), SMFBIA estimates of total body water (TBW) did not change significantly across trials (p = 0.507), leading to significant differences (p < 0.001) in SMFBIA-estimates of body fat percentage across trials. Dehydration resulted in a significant (p < 0.001) 8% decrease in limb impedances at both 20 kHz and 100 kHz. Hyperhydration increased limb impedances only slightly (1.5%, p > 0.05). Impedance changes in the trunk followed an opposite pattern of the limbs. SMFBIA failed to track acute changes in TBW. Divergent impedance changes suggest the trunk is influenced by fluid volume, but the limbs are influenced by ion concentration.
... The first type has been spearheaded by the Genetic Investigation of ANthropometric Traits (GIANT) consortium and others, leading to the discovery of over 300 loci associated with waist-to-hip ratio adjusted for BMI (WHRadjBMI) in an analysis of nearly 700,000 individuals 11,12 . Another recent GWAS aimed to examine fat distribution using estimates of body composition based on stepping on a scale equipped with impedance technology, known to be reasonably accurate for total fat volume but less so for fat distribution [13][14][15] . Despite the considerable value of these studies, a central limitation is an unclear relationship between each anthropometric trait and each fat depot of biological interest-for example, an increase in WHRadjBMI could be capturing increased visceral adipose tissue (VAT; around the abdominal organs), increased abdominal subcutaneous adipose tissue (ASAT; abdominal fat under the skin), decreased gluteofemoral adipose tissue (GFAT; hip and thigh fat), or some combination of these perturbations 16,17 . ...
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For any given level of overall adiposity, individuals vary considerably in fat distribution. The inherited basis of fat distribution in the general population is not fully understood. Here, we study up to 38,965 UK Biobank participants with MRI-derived visceral (VAT), abdominal subcutaneous (ASAT), and gluteofemoral (GFAT) adipose tissue volumes. Because these fat depot volumes are highly correlated with BMI, we additionally study six local adiposity traits: VAT adjusted for BMI and height (VATadj), ASATadj, GFATadj, VAT/ASAT, VAT/GFAT, and ASAT/GFAT. We identify 250 independent common variants (39 newly-identified) associated with at least one trait, with many associations more pronounced in female participants. Rare variant association studies extend prior evidence for PDE3B as an important modulator of fat distribution. Local adiposity traits (1) highlight depot-specific genetic architecture and (2) enable construction of depot-specific polygenic scores that have divergent associations with type 2 diabetes and coronary artery disease. These results – using MRI-derived, BMI-independent measures of local adiposity – confirm fat distribution as a highly heritable trait with important implications for cardiometabolic health outcomes. The inherited basis of body fat distribution is not fully understood. Here, the authors use genetic data and MRI-derived measures of local adiposity to highlight fat depot-specific genetic architecture with implications for cardiometabolic health.
... Sin embargo, a partir de los años 80 empezó a surgir un nuevo método con los primeros aparatos de bioimpedancia eléctrica que suponían una forma simple, no invasiva y rápida de estimar el peso y cantidad de los diferentes tejidos del cuerpo humano. Por estas características, por su constante mejora y sofisticación, se posicionó de manera que hoy en día representa, junto con la antropometría, uno de los métodos de referencia empleados en la estimación de los compartimentos de la composición corporal; entre ellos, la grasa corporal (Ling et al., 2011;Moreno et al., 2001). ...
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Objetivo: Comparar la composición corporal por antropometría clásica e impedancia bioeléctrica en estudiantado universitario de una universidad peruana. Método: Estudio correlacional, transversal, conformado por 152 estudiantes (77 varones y 75 mujeres)matriculados en el ciclo 2018-II con edad promedio de 20.45 ± 3.63 años. Se calculó para el método de antropometría el índice de masa corporal, mediciones antropométricas y se utilizó la ecuación de Yuhasz (1974) para determinar el porcentaje de grasa corporal, y para el de bioimpedancia eléctrica se utilizó el analizador tetrapolar multifrecuencia de medición segmental directaInbody 120. Para establecer la correlación se utilizó el coeficiente de Pearson y para la concordancia se utilizó el método gráficode Bland Altman e índice de estabilidad. Los datos fueron analizados con el programa estadístico IBM SPSS Statistics, versión27.0. Para todos los análisis se utilizó un nivel de significancia (p<0.05). Resultados: Existe una fuerte correlación estadísticamentesignificativa (p<0.01y r=0.95) entre los métodos de antropometría y bioimpedancia eléctrica para la determinación del porcentaje de grasa corporal; además, una buena concordancia según el método gráfico de Bland Altman, reforzada con el índice de estabilidad para complemento de la interpretación (IE= 95 %). Conclusiones: Ambos métodos son intercambiables entre sí, por lo que pueden ser usados indistintamente en este tipo de población para determinar el porcentaje de grasa corporal expresado en porcentaje.
... The BMI calculation was performed using measures obtained from a direct segmental multi-frequency bioelectrical impedance analysis (DSM-BIA) with an InBody 720 body composition analyzer. The DSM-BIA technique provides an accurate assessment of segmental and body composition [27,28]. ...
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Introduction: The rise in armed conflicts has contributed to an increase in the number of asylum seekers. Prolonged asylum processes may negatively affect asylum seekers' health and lead to inactivity. Studies show that physical activity interventions are associated with improvements in health outcomes. However, there are a limited number of studies investigating the associations of physical activity on asylum seekers' health. Methods: Participants (263 males and 204 females), mostly from Syria, were assessed before and after a 10-week intervention for VO2 max, body mass index (BMI), skeletal muscle mass (SMM), body fat, and visceral fat. Linear mixed models were used to test differences within groups, and a linear regression model analysis was performed to test whether physiological variables predicted adherence. Results: Participants' VO2 max increased: males by 2.96 mL/min/kg and females 2.57 mL/min/kg. Increased SMM percentages were seen in both genders: females by 0.38% and males 0.23%. Visceral fat area decreased: males by 0.73 cm2 and females 5.44 cm2. Conclusions: Participants showed significant increases in VO2 max and SMM and decreased visceral fat. This study provides an insight into asylum seekers' health and serves as a starting point to new interventions in which physical activity is used as a tool to promote and improve vulnerable populations' health.
... Ahora bien, al comparar los datos obtenidos por bioimpedancia con otros métodos Gold Standard, se encuentra que esta báscula fue validada con el método DXA (Ling et al, 2011), estudio en el que se compararon los resultados de la masa magra en población normal y con sobrepeso, encontrándose una correlación del 99%. Por otra parte, Miller et al. (2016) compararon los resultados del porcentaje graso de los dos métodos (Inbody, DXA), encontrando una relación significativa (r =.94, p<0.0001). ...
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Actualmente, la bioimpedancia eléctrica se ha convertido en un elemento capaz de establecer de forma más precisa la composición corporal; de igual manera, ha trascendido como herramienta diagnóstica importante para identificar de forma temprana la presencia de factores de riesgo cardiovascular. Objetivo: identificar los principales predictores de riesgo cardiovascular en población joven físicamente activa, empleando bioimpedancia. Método: estudio correlacional de corte transversal. Se evaluaron 30 estudiantes universitarios (edad 22,1 años ±2, peso 65,6 Kg±10,3), empleando: IPAQ (versión corta), glucometría basal, composición corporal mediante bioimpedancia eléctrica (Inbody® 770), fuerza prensil, batería de Bosco (Optogait®), consumo de oxígeno (test de Leger). Resultados: en mujeres, se evidencia una correlación muy alta entre la masa magra en tronco y masa magra en brazo izquierdo (r=0,97 p= 0,00) y brazo derecho (r=0,98 p=0,00); respecto al género masculino, se encontraron correlaciones altas y significativas entre el porcentaje de masa magra en tronco y masa magra en brazo derecho e izquierdo (r=0,99 p= 0,00); igualmente, entre porcentaje de masa magra en tronco y tasa metabólica basal (r=0,97 p= 0,00). Conclusiones: se identifican relaciones significativas entre: porcentaje de masa magra en tronco como variable independiente e indicadores de riesgo cardiovascular (masa magra de miembros superiores y tasa metabólica basal), siendo buenos predictores de riesgo cardiometabólico en jóvenes físicamente activos.
Article
Background Aims International guidelines recommend physical activity for subjects with nonalcoholic fatty liver disease (NAFLD). This study investigated the association of physical activity with risk of liver fibrosis, sarcopenia, and cardiovascular disease (CVD) in NAFLD. Methods In this multicenter, retrospective study, 11,690 NAFLD subjects who underwent a health screening program and were assessed for physical activity (metabolic equivalent task [MET]-min/week) between 2014 and 2020 were recruited. Liver fibrosis was assessed using the fibrosis-4 index, NAFLD fibrosis score, and FibroScan-AST score. Sarcopenia using multi-frequency bioelectric impedance analysis and CVD risk using atherosclerotic CVD (ASCVD) risk score and coronary artery calcium (CAC) score were calculated. Results The prevalence of fibrosis, sarcopenia, high probability of ASCVD, and high CAC score significantly decreased with increasing quartiles of physical activity (all P for trend<0.001). In a fully-adjusted model, physical activity above 600 MET-min/week (≥3rd quartile) was independently associated with a reduced risk of fibrosis (adjusted odds ratio [aOR]=0.59; 95% CI=0.40–0.86), sarcopenia (aOR=0.72; 95% CI=0.58–0.88), high probability of ASCVD (aOR=0.58; 95% CI=0.46–0.73), and high CAC score (aOR=0.32; 95% CI=0.13–0.83; all P<0.05). Additionally, increasing amounts of physical activity was significantly associated with a risk reduction between fibrosis, sarcopenia, and high probability of ASCVD (all P for trend<0.001). In subjects with sarcopenic obesity or lean NAFLD, physical activity was also independently associated with a reduced risk of fibrosis and high probability of ASCVD (all P<0.05). Conclusions Physical activity showed a protective effect against fibrosis, sarcopenia, and CVD in NAFLD.
Chapter
From a theoretical standpoint, skeletal muscle is a primary driver of the relationship between body composition, bone health, and clinical outcomes, as it is involved in mobility, strength, and balance. However, while muscles play a vital role in human health at all stages of life, it is the health factor that is rarely talked about. Throughout life, the tissue masses of bone and muscle are tightly correlated. During organogenesis, muscle and bone develop in close association from common mesodermal precursors to determine adult muscle and bone mass. In addition, changes in muscle and bone mass brought about by exercise or disuse are also closely coupled. With age, loss of muscle mass is associated with loss of bone mass. Despite these obvious examples suggesting coupling of bone and muscle mass, the precise mechanisms responsible for synchronizing bone and skeletal mass remain unclear. This chapter discusses the evolution of muscle health as a key factor of the broad musculoskeletal health, and its important role in health and healthy aging. It combines the basic, yet up to date, information about muscle health, the muscle bone interaction, together with discussions on the muscle health in aging and disease and approaches to management of muscle loss.
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Background: There is a need to promote initiatives toward reaching more active and healthier lifestyles. Gamification has emerged among teachers as a powerful teaching strategy that favors students' motivation and behavioral change by applying game elements in nongame contexts. Purpose: To examine the effects of a 14-week gamification-based teaching program, including the use of a game-based mobile app on body composition in college students. Materials and Methods: One hundred twelve college students (21.22 ± 2.55 years) were assigned to a gamification-based group or a control group. College students from the intervention group participated in a gamification program under the narrative of "STAR WARS" and had a mobile app with a countdown timer. They had to meet physical activity recommendations to gain lifetime (i.e., sum time to the countdown). A portable eight-polar bioelectrical impedance analysis was used to obtain body composition outcomes; height (cm) was measured with a stadiometer; and waist circumference (cm) was measured using a metric tape. Body mass index (BMI), muscle mass index, fat mass index, and body fat percentage were computed. Results: Participants from the gamification program reported a significantly lower BMI, waist circumference, fat mass index and body fat percentage after the intervention, in comparison with the control group, indicated by an effect size ranging from -0.23 to -0.11 (all P ≤ 0.043). Conclusion: Gamification and the use of interactive mobile app are powerful teaching strategies in higher education to motivate students toward healthier lifestyles that lead to body composition benefits.
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The effect of sarcopenic visceral obesity on the risk of nonalcoholic fatty liver disease (NAFLD) is uncertain. We investigated (a) whether the skeletal muscle mass to visceral fat area ratio (SV ratio), as a measure of sarcopenic visceral obesity, is a risk factor for NAFLD; and (b) whether the SV ratio adds to conventional adiposity measures to improve prediction of incident NAFLD. Adults without NAFLD (n = 151,017) were followed up for a median of 3.7 years. Hepatic steatosis was measured using ultrasonography, and liver fibrosis scores were estimated using the Fibrosis-4 index (FIB-4) and the NAFLD Fibrosis Score (NFS). Cox proportional hazards models were used to determine sex-specific adjusted hazard ratios (aHRs) (95% confidence intervals [CIs]). The incremental predictive performance was assessed using the area under the receiver operating characteristic curve, net reclassification improvement, and integrated discrimination improvement. Multivariable aHRs (95% CIs) for incident NAFLD comparing the lowest versus the highest quintile of SV ratio were 3.77 (3.56-3.99) for men and 11.69 (10.46-13.06) for women (p-interaction by sex < 0.001). For incident NAFLD with intermediate/high FIB-4, aHRs were 2.83 (2.19-3.64) for men and 7.96 (3.85-16.44) for women (similar results were obtained for NFS). Associations remained significant even after adjustment for body mass index, waist circumference, and time-varying covariates. These associations were also more pronounced in nonobese than obese participants (p-interaction < 0.001). The addition of SV ratio to conventional adiposity measures modestly improved risk prediction for incident NAFLD. SV ratio was inversely associated with risk of developing NAFLD, with effect modification by sex and obesity. Conclusion: Low SV ratio is a complementary index to conventional adiposity measures in the evaluation of NAFLD risk.
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Objective: Despite known benefit of vitamin D in reducing sarcopenia risk in older adults, its effect against muscle loss in young population is unknown. We aimed to examine the association of serum 25-hydroxy vitamin D [25(OH)D] level and its changes over time with the risk of incident low muscle mass (LMM) in young and middle-aged adults. Design: A cohort study Methods: The study included Korean adults (median age, 36.9 years) without LMM at baseline followed up for a median of 3.9 years (maximum, 7.3 years). LMM was defined as the appendicular skeletal muscle (ASM) mass by body weight (ASM/weight) of one standard deviation below the sex-specific mean for young reference group. Cox-proportional hazard models were used to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Results: Among 192,908 individuals without LMM at baseline, 19,526 developed LMM. After adjusting for potential confounders, the multivariable-adjusted HRs (95% CIs) for incident LMM comparing 25(OH)D levels of 25–<50, 50–<75, and ≥75 nmol/L to 25(OH)D <25 nmol/L were 0.93 (0.90-0.97), 0.85 (0.81-0.89), and 0.77 (0.71-0.83), respectively. The inverse association of 25(OH)D with incident LMM was consistently observed in young (aged <40 years) and older individuals (aged ≥40 years). Individuals with increased 25(OH)D levels (<50 to ≥50 nmol/L) or persistently adequate 25(OH)D levels (≥50 nmol/L) between baseline and follow-up visit had lower risk of incident LMM than those with persistently low 25(OH)D levels. Conclusions: Maintaining sufficient serum 25(OH)D could prevent unfavourable changes in muscle mass in both young and middle-aged Korean adults.
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People with chronic obstructive pulmonary disease (COPD) tend to have abnormally low levels of fat-free mass (FFM), which includes skeletal muscle mass as a central component. The purpose of this systematic review was to synthesise available evidence on the association between FFM and exercise test outcomes in COPD. MEDLINE, Cochrane Library, EMBASE, Web of Science, and Scopus were searched. Studies that evaluated exercise-related outcomes in relation to measures of FFM in COPD were included. Eighty-three studies, containing 18,770 (39% female) COPD participants, were included. Considerable heterogeneity was identified in the ways that FFM and exercise test outcomes were assessed; however, higher levels of FFM were generally associated with greater peak exercise capacity. This association was stronger for some exercise test outcomes (e.g. peak rate of oxygen consumption during incremental cycle exercise testing) than others (e.g. six-minute walking distance). This review identified heterogeneity in the methods used for measuring FFM and exercise capacity. There was, in general, a positive association between FFM and exercise capacity in COPD. There was also an identified lack of studies investigating associations between FFM and temporal physiological and perceptual responses to exercise. This review highlights the significance of FFM as a determinant of exercise capacity in COPD.
Article
Objectives/background The prevalence of obstructive sleep apnea (OSA) in people over 70 years can reach up to 95%. Aerobic or combined exercise programs have been shown to impact positively on OSA severity. Resistance training changes leg fluid retention. We hypothesized that through this mechanism it may have an impact on the OSA severity in older adults. Patients/methods We evaluated changes in the respiratory event index (REI) of older adults with moderate-severe obstructive sleep apnea in a randomized, masked, controlled, parallel group trial. Participants between the age of 65 and 80 years with REI between 20 and 50 events/hour were assigned randomly to 12 weeks of resistance training or healthy life-style recommendations. Change in REI was the primary outcome. Muscle thickness, maximum strength, and physical function were secondary outcomes and body mass index (BMI) and body water content were assessed as mediators. Results Twenty-three subjects were included, 57% men, aged 71 ± 5 years, randomized to training (n = =12) and control intervention (n = =11). The baseline REI in the training and control groups were 30 ± 7/h and 29 ± 9/h; at follow-up, the delta REI were −3.6/hour (95% confidence interval −0.7 to −5.4) and 6.7/hour (5.2–8.6), respectively, with significant time × ×group interaction that remained significant after adjusting the generalized estimating equations model for delta BMI and delta body water content. Conclusions Twelve weeks of resistance training in older adults significantly changed the respiratory event index and was well tolerated. Changes in body water content were slight but cannot be dismissed as contributing to REI reduction.
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Step length is a critical hallmark of health status. However, few studies have investigated the modifiable factors that may affect step length. An exploratory, cross-sectional study was performed to evaluate the surface electromyography (sEMG) and body impedance analysis (BIA) parameters, combined with individual demographic data, to predict the individual step length using the GAITRite® system. Healthy participants aged 40–80 years were prospectively recruited, and three models were built to predict individual step length. The first model was the best-fit model (R2 = 0.244, p < 0.001); the root mean square (RMS) values at maximal knee flexion and height were included as significant variables. The second model used all candidate variables, except sEMG variables, and revealed that age, height, and body fat mass (BFM) were significant variables for predicting the average step length (R2 = 0.198, p < 0.001). The third model, which was used to predict step length without sEMG and BIA, showed that only age and height remained significant (R2 = 0.158, p < 0.001). This study revealed that the RMS value at maximal strength knee flexion, height, age, and BFM are important predictors for individual step length, and possibly suggesting that strengthening knee flexor function and reducing BFM may help improve step length.
Article
To investigate what are the effects of pre‐surgical aerobic dance‐based exercise programme (PSADBE) and physical activity counselling (PAC) programme on lower extremity functions after surgery in people with morbid obesity awaiting bariatric surgery (PMOABS). This study was a single‐blind, randomized controlled study. Groups were divided into Group I (PSADBE and PAC) and Group II (PAC). Both groups received PAC, Group I completed the PSADBE programme accompanied by music for 60 min/2 days/8 weeks. Thirty‐four PMOABS were included in the study. The 6‐Minute Walking Test, as primary outcomes, and The Stair Climbing Up‐Down Test for evaluating functional capacity, Biodex Isokinetic Test and Exercise System® for evaluating muscle strength were used. Besides, muscle endurance, physical activity (PA) level, fatigue and quality of life (QoL) were also assessed. All measurements were repeated three times; pre‐treatment, post‐treatment and the fifth‐month post‐surgery. After 8 weeks, significant changes were found in functional capacity, muscle strength and endurance, PA level, fatigue and QoL in both groups (p < .05). Comparing the groups, the changes in functional capacity, muscle strength and endurance, PA and fatigue scores after treatment and the fifth‐month post‐surgery were statistically superior in Group I (p < .05). Adding an 8‐week PSADBE programme to PAC is an effective treatment option for improving postoperative functional capacity, muscle strength and endurance, PA level and fatigue in PMOABS.
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Background Metabolic syndrome (MetS) is defined as a cluster of risk factors for predicting type 2 diabetes mellitus and cardiovascular disease. Objectives This cross-sectional study aimed to develop a cut-off value for fat versus lean mass ratio (FLMR) in predicting MetS and to investigate the association between this indicator with MetS and its components. Methods Subjects comprised 238 Malay adolescents (79% female) aged 18–19 years old. Anthropometric assessment comprised weight, height and waist circumference (WC). Body composition was measured using bioelectrical impedance analysis techniques while blood pressure was measured using a blood pressure monitor. Fasting blood glucose, total cholesterol , triglycerides, high-density lipoprotein cholesterol (HDL-c), and low-density lipoprotein cholesterol were determined from an overnight fasting blood sample. MetS was determined based on International Diabetes Federation (2007) definition for adolescents aged 16-year-old and above. Results The prevalence of MetS was 2.1%. Receiver Operating Characteristics curve analysis revealed that the optimal cut-off value for FLMR was 0.441 with an Area Under the Curve of 0.874 (95% CI: 0.825, 0.913); with sensitivity of 80.0% and specificity of 71.0%. FLMR cut-off of 0.441 was associated with high WC ( p < .001), low HDL-c ( p < .001) and MetS ( p < .05). Binary Logistic Regression analysis revealed that adolescents with high WC, low HDL-c and MetS had higher odds of developing increased FLMR than the cut-off value with an odds ratio (OR) of 43.4 (95% CI: 9.7,193.9), 4.7 (95% CI: 2.3,9.8) and 13.3 (95% CI: 1.5,121.2), respectively. Conclusion FLMR possesses fair discriminatory ability in identifying MetS among adolescents and significant association exists between FLMR and MetS and some of its components.
Article
Aim: This study aimed to compare bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DEXA) in measuring skeletal muscle mass (MM), and its prognostic implications in old patients with heart failure. Methods: We prospectively evaluated MM measured by both BIA and DEXA in 226 hospitalized elderly (≥65 years) patients with heart failure. The cut-off values proposed by the Asian Working Group in Sarcopenia were used to define low MM. The prognostic endpoint was all-cause death. Results: The median age of the cohort was 82 years (interquartile range: 75-87), and 51.8% of patients were men. According to the BIA and DEXA, 177 (78.3%) and 120 (53.1%) patients were diagnosed with low MM, respectively, and the two assessment tools showed poor agreement (Cohen's kappa coefficient: 0.294). During the follow-up, 32 patients (14.2%) died; only low MM defined by DEXA (hazard ratio 2.45, 95% confidence interval 1.05-5.72, P = 0.039), but not BIA (hazard ratio 1.03, 95% confidence interval 0.35-3.06, P = 0.955), was associated with poor prognosis after adjusting for pre-existing risk factors. Moreover, low MM defined by DEXA (net reclassification improvement: 0.58, P < 0.001), but not BIA (net reclassification improvement: -0.005, P = 0.975), provides incremental prognostic predictability when considered with pre-existing risk factors and brain natriuretic peptide level at discharge. Conclusions: In elderly hospitalized patients with heart failure, low MM defined by DEXA and BIA show significant discordance. The MM defined by DEXA, but not BIA, provides additional prognostic value to pre-existing prognostic models. Geriatr Gerontol Int ••; ••: ••-•• Geriatr Gerontol Int 2022; ••: ••-••.
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Background and objective: Variations in the risk factors for sarcopenia can lead to differences in the likelihood of developing sarcopenia among older adults; however, few studies have explored the interactions among the risk factors. This study examined the interactions among risk factors and identified a discriminative pathway for groups at risk of sarcopenia in community-dwelling older adults. Methods: A cross-sectional study was conducted between July and August 2019 to recruit 200 older adults from an outpatient department of a hospital providing care for older people. Data on various risk factors, namely demographics (age, gender, education, comorbidities, and body mass index [BMI]), dietary habits (weekly consumption of milk, coffee, and meat), lifestyle behaviours (vitamin D supplementation, smoking, drinking, and physical activity), and depression symptoms were collected. Sarcopenia was defined according to the Asian Working Group for Sarcopenia criteria. A classification and regression tree (CART) model was used to examine interactions among these factors and identify groups at risk of sarcopenia. Findings: The prevalence of sarcopenia was 38.5%. The CART model identified two end groups at differential risks of sarcopenia, with a minimum of one and a maximum of three risk factors. In the first group, low BMI (<18.5 kg/m2 ) was a predominant risk factor for sarcopenia among older people. In the second group, older adults with a normal BMI, aged ≥68 years, and without a regular walking habit had a higher probability of developing sarcopenia than did their counterparts. Conclusions: The interactive effects among older age, BMI, and walking may cause different probabilities of developing sarcopenia in the older population. Implications for practice: Older adults with a low or normal BMI but without a regular walking habit could be a predominant risk group for sarcopenia. The appropriate maintenance of body weight and regular walking activity is suggested to prevent sarcopenia in community-dwelling older adults.
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Aims/introduction: poor glycemic control and insulin treatment are reported to be associated with sarcopenia in type 2 diabetes, type 1 diabetes may be a stronger risk for sarcopenia. We therefore studied the effect of the type of diabetes, glycemic control, and insulin therapy on the prevalence and characteristics of sarcopenia. Materials and methods: A total of 812 Japanese patients with diabetes (type 1: n=57; type 2: n=755) were enrolled in this study. Sarcopenia was defined as low handgrip strength or slow gait speed and low appendicular skeletal muscle mass. Results: Among participants aged ≥65 years, the sarcopenia prevalence rate was higher among patients with type 1 diabetes (20.0%) than among those with type 2 diabetes (8.1%). The prevalence rate of low handgrip strength was higher in type 1 diabetes (50.0%) than in type 2 diabetes (28.7%). In logistic regression analysis, type 1 diabetes was significantly associated with the prevalence of low handgrip strength. In logistic regression analysis, medication with insulin was significantly associated with the prevalence of sarcopenia; this association was not retained after adjusting for HbA1c. Conclusions: The prevalence of sarcopenia in older adult patients was higher in those with type 1 diabetes than in those with type 2 diabetes. Among the components of sarcopenia, the difference was most prominent in the frequency of low handgrip strength. Poor glycemic control rather than type of diabetes or insulin treatment was revealed to be a primary risk factor for sarcopenia in diabetes mellitus.
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Abstract Background Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease characterized by joint inflammation, abnormal body composition, and an increased risk for sarcopenia. Muscle wasting in turn increases the risk of infection, morbidity, and premature mortality, but little is known of the relation between nutrient intake and sarcopenia in RA. Methods A prospective cohort study with follow‐up for 1 year examined body composition and diet in female outpatients with RA. We performed logistic regression analysis to assess which factors might have contributed to this loss of muscle mass. Multivariate logistic regression analysis with a forward–backward stepwise selection was also analysed. SKG/Jcl mice, which develop RA spontaneously, were fed normal chow or a high‐fat diet (HFD) and evaluated for inflammation and muscle mass. Results A total 53 female patients were included. The median age was 57.0 years, with an interquartile range (IQR) of 49.5 to 62.0 years, and the median disease duration was 4.0 years, with an IQR of 2.0 to 9.0 years. Fourteen patients (26.4%) had skeletal muscle mass index below the cut‐off for sarcopenia (≤5.7 kg/m2) as defined by the Asia Working Group for Sarcopenia. Multiple logistic regression analysis revealed that the intake of saturated fatty acids was associated with a >5% decrease in skeletal muscle index of RA patients over 1 year [odds ratio 95% confidence interval 1.431 (1.082–1.894), P = 0.012]. In 9 weeks old SKG/Jcl mice, HFD feeding precipitated the onset of RA and exacerbated rheumatoid synovitis in association with the induction of T helper 17 cell differentiation. The serum concentrations of inflammatory cytokines including IL‐6 and TNF‐α were significantly higher in HFD‐fed RA mice than in normal chow (NC)‐fed RA mice or in HFD‐fed control mice (IL‐6; 3.8 vs. 32.2 pg/mL, P
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This study used multi-frequency bioimpedance spectroscopy (BIS) of the arm and whole body to estimate muscle mass (MM) and subcutaneous adipose tissue (SAT) in 31 hemodialysis (HD) patients comparing these results with magnetic resonance imaging (MRI) and body potassium ((40)K) as gold standards. Total body and arm MM (MM(MRI)) and SAT (SAT(MRI)) were measured by MRI. All measurements were made before dialysis treatment. Regression models with the arm (aBIS) and whole body (wBIS) resistances were established. Correlations between gold standards and the BIS model were high for the arm SAT (r(2) = 0.93, standard error of estimate (SEE) = 3.6 kg), and whole body SAT (r(2) = 0.92, SEE = 3.5 kg), and for arm MM (r(2) = 0.84, SEE = 2.28 kg) and whole body MM (r(2) = 0.86, SEE = 2.28 kg). Total body MM and SAT can be accurately predicted by arm BIS models with advantages of convenience and portability, and it should be useful to assess nutritional status in HD patients.
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Body composition (BC) assessment is indispensable to evaluate nutritional status and thus health, both at the population and individual level, and to assess the efficacy of primary and secondary preventive nutritional strategies. Changes in BC, including the regional distribution of body fat, largely occur during pubertal transition, with marked differences between genders. They may, however, also occur in the elderly, who experience significant changes in the ratio between body fat and muscle with aging. The development and implementation of more sophisticated techniques (e.g. BC assessment at the molecular and atomic levels) could provide a major contribution to determining BC at different levels. This review discusses the application of dual-energy X-ray absorptiometry (DXA) on BC determination, given that DXA has the potential to provide overall and regional assessment of BC in terms of fat, lean mass and bone. DXA is widely used in many clinical settings primarily diagnosis osteoporosis. This article describes the use of whole-body DXA in assessing BC in patients with chronic diseases (e.g. metabolic syndrome) as well as in different sport activities to evaluate the effects of exercise.
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The prevalence of abdominal obesity exceeds that of general obesity. We sought to determine the prevalence of abdominal subcutaneous and visceral obesity and to characterize the different patterns of fat distribution in a community-based sample. Participants from the Framingham Heart Study (n = 3,348, 48% women, mean age 52 years) underwent multidetector computed tomography; subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT) volumes were assessed. Sex-specific high SAT and VAT definitions were based on 90th percentile cut points from a healthy referent sample. Metabolic risk factors were examined in subgroups with elevated SAT and VAT. The prevalence of high SAT was 30% (women) and 31% (men) and that for high VAT was 44% (women) and 42% (men). Overall, 27.8% of the sample was discordant for high SAT and high VAT: 19.9% had SAT less than but VAT equal to or greater than the 90th percentile, and 7.9% had SAT greater than but VAT less than the 90th percentile. The prevalence of metabolic syndrome was higher among women and men with SAT less than the 90th percentile and high VAT than in those with high SAT but VAT less than the 90th percentile, despite lower BMI and waist circumference. Findings were similar for hypertension, elevated triglycerides, and low HDL cholesterol. Nearly one-third of our sample has abdominal subcutaneous obesity, and >40% have visceral obesity. Clinical measures of BMI and waist circumference may misclassify individuals in terms of VAT and metabolic risk.
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We compared body composition estimates using an eight-electrode, segmental, multiple-frequency bioelectrical impedance analysis (segmental MF-BIA) and dual x-ray absorptiometry (DXA) in a group of healthy adults with a range of body mass indexes (BMIs). Percentage of body fat (%BF), fat-free mass, and fat mass assessed by DXA and segmental MF-BIA in 132 healthy adults were classified by normal (N; 18.5-24.9 kg/m(2)), overweight (OW; 25-29.9 kg/m(2)), and obese (OB; 30-39.9 kg/m(2)) BMI. Compared with DXA, segmental MF-BIA overestimated %BF in the OB BMI group (3.4%; P < 0.0001). MF-BIA overestimated %BF among men (0.75%; P < 0.006) and women (0.87%; P < 0.006) and underestimated it in the N BMI group (-1.56%; P < 0.0001); %BF was not different between methods in the OW BMI group. Error in %BF determined by segmental MF-BIA and DXA increased as %BF increased (r = 0.42, P < 0.0001). Waist circumference was the only significant predictor of systematic error in %BF between MF-BIA and DXA (r = 0.60, P < 0.0001). Eight-electrode, segmental MF-BIA is a valid method to estimate %BF in adults with BMI classified as N and OW, but not as OB. Estimation of trunk resistance with current segmental MF-BIA devices may explain the underestimation of %BF in the adults with OB BMI. Further examination of the effect of waist circumference and body fat distribution on the accuracy of BIA measurements is warranted.
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To develop a simplified but accurate method for determining the masses of various abdominal adipose tissue compartments, we studied the predictive value of masses of intraperitoneal, retroperitoneal, and subcutaneous abdominal adipose tissue determined on single axial abdominal magnetic resonance imaging (MRI) slices taken at various intervertebral levels from the 12th thoracic to 1st sacral vertebra (identified on a sagittal section) for the respective total masses of each compartment calculated from contiguous 10-mm thick MRI slices covering the entire abdomen in 49 men (26 without diabetes and 23 with non-insulin-dependent diabetes mellitus). The MRI slice at the intervertebral level between the lumbar (L) 2 and 3 vertebrae showed the highest and most consistent predictive value for all three compartments (R2 = 0.85 for all). Furthermore, compared with other intervertebral levels, the L2-L3 level had a higher amount of intraperitoneal and retroperitoneal adipose tissue mass. We conclude that determining the masses of various abdominal adipose tissue compartments at the L2-L3 intervertebral level by MRI is an acceptably reliable and accurate method for studying abdominal adiposity in men.
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We validated whole body composition estimates from dual-energy X-ray absorptiometry (DEXA) against estimates from a four-component model to determine whether accuracy is affected by gender, race, athletic status, or musculoskeletal development in young adults. Measurements of body density by hydrostatic weighing, body water by deuterium dilution, and bone mineral by whole body DEXA were obtained in 172 young men (n = 91) and women (n = 81). Estimates of body fat (%Fat) from DEXA (%FatDEXA) were highly correlated with estimates of body fat from the four-component model [body density, total body water, and total body mineral (%Fatd,w,m); r = 0.94, standard error of the estimante (SEE) = 2.8% body mass (BM)] with no significant difference between methods [mean of the difference +/- SD of the difference = -0.4 +/- 2.9 (SD) % BM, P = 0.10] in women and men. On the basis of the comparison with %Fatd,w,m, estimates of %FatDEXA were slightly more accurate than those from body density (r = 0.91, SEE = 3.4%; mean of the difference +/- SD of the difference = -1.2 +/- 3.4% BM). Differences between %FatDEXA and %Fatd,w,m were weakly related to body thickness, as reflected by BMI (r = -0.34), and to the percentage of water in the fat-free mass (r = -0.51), but were not affected by race, athletic status, or musculoskeletal development. We conclude that body composition estimates from DEXA are accurate compared with those from a four-component model in young adults who vary in gender, race, athletic status, body size, musculoskeletal development, and body fatness.
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To evaluate bioelectrical impedance analysis (BIA) in estimating the nutritional status and outcome of patients with chronic obstructive pulmonary disease (COPD) and acute respiratory failure (ARF) in comparison with measurements of anthropometric parameters and plasma levels of visceral proteins. Retrospective study. A ten-bed intensive care unit (ICU) in a university teaching hospital. 51 COPD patients with ARF in whom BIA data, anthropometric parameters, and measurements of visceral proteins were available. BIA results in patients requiring mechanical ventilation (MV) vs. those who did not showed lower active cell mass (ACM; 37.5 +/- 6.5% vs. 42.4 +/- 7.2% body weight, P = 0.01) and a higher extra-/intracellular water volume ratio (ECW/ICW; 1.25 +/- 0.2 vs. 1.04 +/- 0.2, P = 0.0001), suggesting a more severe alteration in the nutritional status among those on MV. Anthropometric data showed the opposite results, since body weight, body mass index (BMI), triceps skinfold thickness (TSF), and fat mass were significantly higher in the invasively ventilated patients, whereas middle-arm muscle circumference (MAMC) did not differ between the two groups. The marked inflation of the extracellular compartment (ECW, ECW/ICW) that was well shown by BIA in the invasively ventilated patients presumably lead to inaccurate anthropometric results (overestimation of TSF and fat mass, and erroneous measure of MAMC). A higher death rate (38% vs. 0%, P = 0.01) was observed in the patients with ACM depletion (ACM < or = 40.6% body weight, n = 26) than in those without ACM depletion (n = 25). Low albumin level (< 30 g/l) was associated with increased mortality (33% vs. 7%, P = 0.04), but the differences in the other biological and anthropometric parameters (prealbumin and transferrin levels, body weight, BMI, TSF, MAMC, fat mass, and fat-free mass) were not associated with mortality. This study suggests that the decrease in BIA-derived ACM is a good indication of malnutrition and of poor outcome in COPD patients with ARF.
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Recent studies support the possibility of estimating abdominal fat using a region of interest (ROI) selected by conventional whole body dual-energy X-ray absorptiometry (DXA). This is an important observation as DXA ROI estimates have some advantages over waist circumference or computed tomography/magnetic resonance imaging (MRI) as a means of assessing visceral adipose tissue (VAT) and adipose tissue distribution. The aim of this study was to evaluate the usefulness of DXA abdominal ROI estimates in assessing VAT among non-obese men. Observational, cross-sectional study comparing correlations between MRI-measured total VAT and surrogate measures including DXA ROIs. A stepwise multiple regression model was applied to derive a predictive equation with total VAT mass. Ninety non-obese healthy men between the ages of 18 and 44 y with BMI<30 kg/m(2). Abdominal adipose tissue and total VAT were measured by whole body MRI; VAT area by single-slice MRI at the L4-5 level; specific DXA ROIs for abdominal regional fat defined as ROI A (L2-4), B (L2-upper iliac), C (lower costal-upper iliac), and D (ROI C excluding spine); and simple anthropometric measures. Correlations between total VAT and ROIs A (r=0.85) and B (r=0.84) were not significantly different from that of VAT area at L4-5 (r=0.87), but significantly higher (P <0.01) than that of waist circumference (r=0.77). The highest correlations with total abdominal adipose tissue were for DXA ROIs and conventional DXA trunk fat (r=0.95-0.97). A stepwise multiple regression analysis revealed that 86% of the variance in total VAT was predicted by VAT area at L4-5, ROI A, and waist-hip ratio. DXA ROIs (L2-4, L2-upper iliac) were associated with total VAT as well as MRI-derived VAT area at L4-5 in non-obese men. DXA ROI fat distribution estimates may be useful in the early detection of men with abdominal/visceral obesity.
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To establish the accuracy of an eight-polar tactile-electrode impedance method in the assessment of total body water (TBW). Transversal study. University department. Fifty healthy subjects (25 men and 25 women) with a mean (s.d.) age of 40 (12) y. TBW measured by deuterium oxide dilution; resistance (R) of arms, trunk and legs measured at frequencies of 5, 50, 250 and 500 kHz with an eight-polar tactile-electrode impedance-meter (InBody 3.0, Biospace, Seoul, Korea). An algorithm for the prediction of TBW from the whole-body resistance index at 500 kHz (height (2)/R(500) where R is the sum of the segmental resistances of arms, trunk and legs) was developed in a randomly chosen subsample of 35 subjects. This algorithm had an adjusted coefficient of determination (r2(adj)) of 0.81 (P<0.0001) and a root mean square error (RMSE) of 3.6 l (9%). Cross-validation of the predictive algorithm in the remaining 15 subjects gave an r2(adj) of 0.87 (P<0.0001) and an RMSE of 3.0 l (8%). The precision of eight-polar BIA, determined by measuring R three times a day for five consecutive days in a fasting subject, was < or =2.8% for all segments and frequencies. Eight-polar BIA is a precise method that offers accurate estimates of TBW in healthy subjects. This promising method should undergo further studies of precision and its accuracy in assessing extracellular water and appendicular body composition should be determined. Modena and Reggio Emilia University.
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To calibrate eight-polar bioelectrical impedance analysis (BIA) against dual-energy X-ray absorptiometry (DXA) for the assessment of total and appendicular body composition in healthy adults. A cross-sectional study was carried out. Sixty-eight females and 42 males aged 21-82 years participated in the study. Whole-body fat-free mass (FFM) and appendicular lean tissue mass (LTM) were measured by DXA; resistance (R) of arms, trunk and legs was measured by eight-polar BIA at frequencies of 5, 50, 250 and 500 kHz; whole-body resistance was calculated as the sum R of arms, trunk and legs. The resistance index (RI), i.e. the height(2)/resistance ratio, was the best predictor of FFM and appendicular LTM. As compared with weight (Wt), RI at 500 kHz explained 35% more variance of FFM (vs 0.57), 45% more variance of LTM(arm) (vs 0.48) and 36% more variance of LTM(leg) (vs 0.50) (p < 0.0001 for all). The contribution of age to the unexplained variance of FFM and appendicular LTM was nil or negligible and the RI x sex interactions were either not significant or not important on practical grounds. The percent root mean square error of the estimate was 6% for FFM and 8% for LTM(arm) and LTM(leg). Eight-polar BIA offers accurate estimates of total and appendicular body composition. The attractive hypothesis that eight-polar BIA is influenced minimally by age and sex should be tested on larger samples including younger individuals.
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We conducted a sib pair study in very old subjects for the purpose of mapping longevity loci. In the present analysis, we explore whether our recruitment strategy has resulted in a population enriched for a heritable component for exceptional longevity. Our study includes families with at least two long-living siblings (men aged 89 years or above; women aged 91 years or above). Data were collected on date of birth and, if applicable, date of death of parents, brothers and sisters, offspring, and spouses of the long-living participants. Standardised mortality ratios (SMRs) compared with the general Dutch population, were calculated. The SMR for all siblings of the long-living participants was 0.66 (95% CI 0.60-0.73). A similar survival benefit was also observed in the parents (SMR=0.76, 95% CI 0.66-0.87) and in the offspring of the long-living subjects (SMR=0.65, 95% CI 0.51-0.80). The SMR of the spouses of the long-living subjects was 0.95 (95% CI 0.82-1.12). The familial clustering of extended survival is unlikely to be caused by ascertainment bias, because in all analyses the long-living participants were excluded. Moreover, it is also unlikely to be caused by environmental factors, because the spouses of the long-living participants had a mortality risk comparable with the general Dutch population, whereas they share the same environment. We conclude that our sample is genetically enriched for extreme survival.
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Similar to lipodystrophy syndromes, aging results in increased visceral adiposity with loss of subcutaneous adipose tissue in the extremities. The hypothesis of this study is that the distribution of limb fat to trunk fat (LF/TF) ratio in elderly persons has a stronger correlation than trunk fat alone to insulin resistance and adiponectin levels. Thirty-eight elderly participants were divided into an insulin-resistant (IR) group and an insulin-sensitive (IS) group. Limb fat and trunk fat were measured by dual-energy x-ray absorptiometry. Insulin resistance was measured by a hyperinsulinemic-euglycemic clamp. There was no significant difference between the IS and IR groups with respect to body mass index, body fat index, absolute amount of trunk fat, or percent body fat. However, the difference in LF/TF ratio between the IS (1.02 +/- 0.05) and the IR groups (0.77 +/- 0.05) was highly significantly different (p <.001). Insulin resistance had a stronger correlation to the LF/TF ratio (r = 0.61, p <.001) than to absolute trunk fat (r = -0.32, p =.051). Adiponectin levels had a strong association with the LF/TF ratio (r = 0.63, p <.001), but did not correlate to absolute trunk fat (r = -0.24, p =.18). The distribution of body fat (LF/TF ratio) in elderly persons is a stronger determinant of insulin resistance and adiponectin levels than is trunk fat alone. The LF/TF ratio can be a useful tool to assess insulin sensitivity in the elderly population.
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New, vertical, 8-electrode bioimpedance spectroscopy (BIS) analyzers provide detailed body-composition and nutritional information within 2 min. This is the first report on BIS's accuracy in predicting relative fatness [percentage body fat (%BF)] in a heterogeneous sample according to a multicomponent model criterion. We compared %BF measurements from 2 BIS devices with those from a multicomponent model in a sample of Hispanic, black, and white adults. Equal numbers of apparently healthy men and women (n = 75 of each) from each racial-ethnic group, diverse in body mass index and age, volunteered. Reference %BF (%BF(4C)) was computed by using a 4-component (4C) model with total bone mineral content obtained from dual-energy X-ray absorptiometry, body density from underwater weighing with measured residual lung volume, and total body water from traditional BIS. Estimations from InBody 720 (%BF(720)) and InBody 320 (%BF(320)) BIS analyzers were validated against %BF(4C). The %BF(720) (r = 0.85, SEE = 5.19%BF) and %BF(320) (r = 0.84, SEE = 5.17%BF) correlations were significant (P < 0.05) in the men; main effects were nonsignificant. Correlations for %BF(720) (r = 0.88, SEE = 4.85%BF) and %BF(320) (r = 0.89, SEE = 4.82%BF) also were significant in the women (P < 0.05); there was a main effect for method but not race-ethnicity. There were no sex-specific overestimations or underestimations at the extremes of the distributions. BIS estimates of %BF(4C) were well correlated in men and women. There were no significant methodologic differences in the men. The %BF(4C) was significantly underestimated by %BF(720) and %BF(320) in the women.
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To compare the risk of mortality of nonagenarian siblings with that of sporadic nonagenarians (not selected on having a nonagenarian sibling) and to compare the prevalence of morbidity in their offspring with that of the offsprings' partners. Longitudinal (mortality risk) and cross-sectional (disease prevalence). Nationwide sample. The Leiden Longevity Study consists of 991 nonagenarian siblings derived from 420 Caucasian families, 1,365 of their offspring, and 621 of the offsprings' partners. In the Leiden 85-plus Study, 599 subjects aged 85 were included, of whom 275 attained the age of 90 (sporadic nonagenarians). All nonagenarian siblings and sporadic nonagenarians were followed for mortality (with a mean+/-standard deviation follow-up time of 2.7+/-1.4 years and 3.0+/-1.5 years, respectively). Information on medical history and medication use was collected for offspring and their partners. Nonagenarian siblings had a 41% lower risk of mortality (P<.001) than sporadic nonagenarians. The offspring of nonagenarian siblings had a lower prevalence of myocardial infarction (2.4% vs 4.1%, P=.03), hypertension (23.0% vs 27.5%, P=.01), diabetes mellitus (4.4% vs 7.6%, P=.004), and use of cardiovascular medication (23.0% vs 28.9%, P=.003) than their partners. The lower mortality rate of nonagenarian siblings and lower prevalence of morbidity in their middle-aged offspring reinforce the notion that resilience against disease and death have similar underlying biology that is determined by genetic or familial factors.
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Background: Evaluation and monitoring of nutritional status is a fundamental concept in providing nutritional care to patients with end-stage renal failure. There have been, however, few practically available indices assessing whole body protein stores of patients. Methods:We enrolled 448 end-stage renal disease patients, 394 on maintenance hemodialysis (HD) and 54 on continuous ambulatory peritoneal dialysis (PD) in this study. 83 Age- and sex-matched subjects (controls) whose creatinine clearance was more than 70 ml/min and urinary protein excretion was less than 1.0 g/day were also recruited for comparison. To assess whole body somatic protein stores, we devised the body protein index (BPI). The volume of body protein mass was measured by multifrequency bioelectrical impedance analysis and then BPI was calculated as body protein mass (kg) divided by height in meters (m2). Based on BPI, we defined the nutritional status of the patients as normal if the value was within -10% of the mean value of control subjects, -10 to -14% as mild malnutrition, -15 to -19% as moderate malnutrition, and
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To validate the bioelectrical impedance spectroscopy (BIS) model against dual-energy X-ray absorptiometry (DXA), to develop and compare BIS estimates of skeletal muscle mass (SMM) to other prediction equations, and to report BIS reference values of body composition in a population-based sample of 75-year-old Swedes. Body composition was measured by BIS in 574 subjects, and by DXA and BIS in a subset of 98 subjects. Data from the latter group was used to develop BIS prediction equations for total body skeletal muscle mass (TBSMM). Average fat free mass (FFM) measured by DXA and BIS was comparable. FFM(BIS) for women and men was 40.6 kg and 55.8 kg, respectively. Average fat free mass index (FFMI) and body fat index (BFI) for women were 15.6 and 11.0. Average FFMI and BFI for men were 18.3 and 8.6. Existing bioelectrical impedance analysis equations to predict SMM were not valid in this cohort. A TBSMM prediction equation developed from this sample had an R(2)(pred) of 0.91, indicating that the equation would explain 91% of the variability in future observations. BIS correctly estimated average FFM in healthy elderly Swedes. For prediction of TBSMM, a population specific equation was required.
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Previous studies using indirect calorimetry in Crohn's disease have suggested that with weight loss there is a proportionally greater decrease in body fat along with a spring of lean mass. This study analyzed body composition (compared with that of controls) by direct methods in a group of 30 patients with active Crohn's disease and further evaluated the effects of nutrition support on body composition. Total body protein was assessed by neutron activation, fat was assessed by dual energy x-ray absorptiometry, water was assessed by bioelectric impedance analysis, and potassium was assessed by gamma-ray technique. These measurements were repeated in patients with Crohn's disease after 3 weeks of enteral nutrition by feeding tube that provided 35 nonprotein kcal/kg of ideal body weight. Compared with age- and sex-matched controls, patients had lost (on average) 11.3 kg (16%) of body weight (p < .0005), including 5.1 kg (30%) of fat (p < .0005), 2.2 kg (19%) of protein (p < .025), 3.7 kg (10%) of water (p = NS), and 24.9 g (21%) of total body potassium (p < .01). After enteral feeding, body weight increased by 1.9 +/- 0.3 kg (p < .0005). Weight gain was accompanied by an increase in body protein (0.3 +/- 0.1 kg), fat (0.3 +/- 0.1 kg), and water (1.1 +/- 0.4 kg) (all p < .025), and by a nonsignificant increase in total body potassium. The weight gain of approximately 2 kg consisted of 65% water, 18% fat, and 18% protein, thus comprising a normal proportion of body composition. Reduced body weight in patients with Crohn's disease compared with that in controls was due to less fat tissue. With modest nutritional repletion, proportionate gains in all body compartments are possible.
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Dual-energy X-ray absorptiometry (DEXA) is rapidly becoming the method of choice for body composition measurements. We tested inter-machine variability because large differences in body composition measurements between different DEXA machines have recently been reported. Comparison of total body scans using 2 DEXA machines from the same manufacturer (DPX-L; Lunar Co, Madison, WI) on 10 volunteers (5M/5F). We observed statistically significant differences between the 2 machines for all mean values of body composition variables as a result of a systematic underestimation of bone mineral and overestimation of fat tissue by one machine vs the other. However, the magnitude of the observed differences was small (namely bone mineral +68 +/- 57 g; percent body fat -1.7 +/- 1%, Mean +/- s.d.). Differences do exist in the performances of 2 DEXA machines from the same manufacturer. Although the differences reported in the present study are small, emphasis should be given in pre-testing machines when multiple apparatuses are used in a study. Also, because the observed error was systematic, randomized designs are necessary when more than one DEXA machine is used in longitudinal/intervention study. Better yet, manufacturers of DEXA machine should standardize their equipment to ensure the best consistency between machines.
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To determine, using segmental bioelectrical impedance analysis (BIA), the characteristics of fluid shift of each body segment in continuous ambulatory peritoneal dialysis (CAPD) patients during and after peritoneal dialysis (PD) solution exchange. Observational study with repeated measurements of bioelectrical impedance, which is inversely related to tissue fluid content. Thirteen clinically stable CAPD patients. Bioelectrical impedance was measured at frequencies of 5, 50, 250, and 500 kHz in each body segment four times: (1) before and (2) after drainage of dialysate, and (3) at 1 hour and (4) at 2 hours after exchange of new 1.5% dextrose PD solution. Impedance of both arms was significantly increased at 1 hour post exchange at all frequencies. In the trunk, impedance at all frequencies increased significantly after drainage, decreased significantly at 1 hour post exchange, and then increased again for the next hour without significance. Impedance of both legs showed a decreasing tendency at all frequencies during and after exchange. Net calculated water volume changes between the time before drainage and 2 hours post exchange were -0.5 L in the trunk, -0.25 L in both arms, +0.47 L in both legs, -0.28 L in total. The change in body weight between the time before drainage and 2 hours post exchange was -0.21 kg, on average, and significantly correlated with total net calculated water volume change (p = 0.009). Each body segment of the CAPD patient has its own characteristic pattern of fluid shift in response to PD solution exchange or dwell. Segmental BIA may be a useful tool for understanding the physiological changes in fluid shift in CAPD patients.
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Malnutrition is a known risk factor for survival in renal failure patients. Of concern, a significant degree of malnutrition may develop in the predialysis period due to dietary restrictions and uremia. To further define this issue, we evaluated 25 predialysis patients using serum chemistries, body mass index (BMI), fat free mass (FFM), body cell mass (BCM), and protein appearance rate (PAR) as surrogates of nutritional status and compared their results to those obtained in established hemodialysis patients and recipients of living donor renal allografts during a nine-month observation period. Pre- dialysis patients had significantly (p<0.0001) higher body weight (28%), body mass index (26%), body cell mass (17%) and fat free mass (15%) than hemodialysis and transplant patients. Intracellular water content was similar in all groups. As many patients do not start dialysis until clearance values fall below 10 ml/min, it is possible that greater tissue mass losses occur in the weeks preceding initiation of dialytic therapy. Why renal transplant recipients fail to increase tissue mass may relate to the catabolic effects of immunosuppression. We conclude that the early stages of pre-end stage renal disease are associated with relatively good preservation of body cell mass.
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The accuracy of total body fat mass and leg fat mass measurements by fan-beam dual-energy X-ray absorptiometry (DEXA) was assessed in 60 healthy elderly subjects (aged 70-79 yr). Total fat and leg fat mass at four leg regions (total leg, thigh, midthigh, and calf) were measured with the QDR 4500A (Hologic, Waltham, MA). The four-compartment model and multislice computed tomography scans were selected as criterion methods for total fat and leg fat mass, respectively. Total fat mass from DEXA was positively associated with fat mass from the four-compartment model with a standard error of the estimate ranging from 1.4 to 1.6 kg. DEXA fan-beam tended to overestimate fat mass for total leg and total thigh fat mass, whereas only marginal differences in fat mass measurements at the midthigh and calf were demonstrated (</=0.08 kg, P < 0.0005). Although there were significant differences between DEXA fan beam and the criterion methods, these differences were of small magnitude, suggesting that DEXA is an accurate method for measurement of fat mass for the elderly.
Article
Skinfold thickness (SFT) and bioelectrical impedance (BIA) are readily available and commonly used techniques in patient monitoring for body composition analysis (BCA) in clinical practise. Another one, dual-energy X-ray absorptiometry (DEXA) method became popular in body composition analysis (BCA) in recent years. Its results have been reported to be quite accurate and precise, in comparison with in vivo or in vitro multiple component reference methods. The aim of the present study was to assess the degree of agreement between SFT and DEXA, and BIA and DEXA methods, in obese and nonobese patients. Body fat mass (FM) was measured in 16 nonobese (mean body mass index; BMI = 22.2 +/- 2.2 kg/m(2)) and in 21 obese (BMI = 34.5 +/- 6.1 kg/m(2)) women with DEXA, SFT, and BIA in the same morning. Mean (+/- SD) FM (kg) was 16.3 +/- 5.5, 15.0 +/- 5.1, 14.7 +/- 4.9 in nonobese subjects and 38.8 +/- 10.1, 36.3 +/- 10.0, 37.1 +/- 12.0 in obese patients, by DEXA, SFT and BIA, respectively. Comparison of the DEXA-BIA and DEXA-STF methods showed high correlation in regression line analysis in nonobese subjects as, r(2) = 0.93 and 0.89, respectively. Regression coefficients were 0.84 and 0.75 in obese patients. However, reanalysis of the data by the Bland and Altman method revealed an obvious lack of agreement between the DEXA-BIA and DEXA-SFT methods in obese patients. In addition, FM was underestimated by BIA and SFT as compared to DEXA in both of the study groups. Besides, better precision was obtained by DEXA method among the others. The SFT or BIA method would be preferred to monitor BCA in non-obese subjects in clinical routine. However, DEXA should be considered as the method of choice in obese patient monitoring, since reproducibility gains special importance, other than the accuracy in the context.
Article
Human body composition, particularly the content of fat tissue and its distribution, has been extensively measured in healthy, diseased, obese and elderly subjects. A variety of non-invasive methods have been applied for these studies. Bioelectrical impedance analysis (BIA) is a commonly used method, based on the conduction of electrical current in the body and the differences in the ability to conduct electricity between the fat and water components of the body. Recently, dual-energy x-ray absorptiometry (DEXA) has been introduced for bone mass, bone mineral density and body composition studies. Unlike other methods, DEXA measures three components of the body: bone mineral content, fat tissue mass, and lean tissue mass, and additionally regional fat distribution. The objective of this study was to compare body composition as assessed by DEXA and BIA methods in a sample of 100 patients. Body composition was studied in 100 consecutive subjects, 59 women and 41 men. The lean body mass (LBM), fat body mass (FBM), and percent body fat (%BF) were measured by the DEXA and BIA techniques. There were highly statistically significant linear relationships between LBM, FBM and %BF assessed by DEXA and BIA in both sexes (p<0.001 for all measurements). No influence of age or BMI on the relationship between DEXA and BIA results was observed. Differences were observed between DEXA and BIA measurements of both fat and fat-free tissue. The results suggest that DEXA may underestimate the LBM and overestimate body fat compared with BIA, probably due to different assumptions about the constants. We conclude that both methods are suitable for body composition studies.