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Body composition, energy expenditure and physical activity

Accuracy of segmental multi-frequency bioelectrical impedance analysis for assessing whole-body and appendicular fat mass and lean soft tissue mass in frail women aged 75 years and older

Abstract

BACKGROUND/OBJECTIVE:

We aimed to examine the accuracy of segmental multi-frequency bioelectrical impedance analysis (SMF-BIA) for the assessment of whole-body and appendicular fat mass (FM) and lean soft tissue mass (LM) in frail older women, using dual-energy X-ray absorptiometry (DXA) as a reference method.

SUBJECTS/METHODS:

All 129 community-dwelling Japanese frail older women with a mean age of 80.9 years (range, 75–89 years) from the Frailty Intervention Trial were recruited. The agreements between SMF-BIA and DXA for whole-body and appendicular body composition were assessed using simple linear regression and Bland–Altman analysis.

RESULTS:

High coefficients of determination (R2) for whole-body FM (R2=0.94, s.e. of estimate (SEE)=1.2 kg), whole-body LM (R2=0.85, SEE=1.4 kg), and appendicular FM (R2=0.82, SEE=1.1 kg) were observed between SMF-BIA and DXA. The R2 coefficient for appendicular LM was moderate (R2=0.76, SEE=0.8 kg). Bland–Altman plots demonstrated that there was systematic (constant) bias (that is, DXA minus SMF-BIA) with overestimation of whole-body FM (bias=−1.2 kg, 95% confidence interval (CI)=−1.5 to −0.1) and underestimation of whole-body LM (bias=2.1 kg, 95% CI=1.8–2.3) by SMF-BIA. Similar, the appendicular measurements also demonstrated systematic bias with overestimation of appendicular FM (bias=−0.3 kg, 95% CI=−0.5 to −0.1) and underestimation of whole-body LM (bias=1.5 kg, 95% CI=1.4–1.7) by SMF-BIA. In addition, the individual level accuracy demonstrated a non-proportional bias for whole-body LM (r=0.08, P=0.338) and appendicular FM (r=0.07, P=0.413).

CONCLUSIONS:

SMF-BIA had acceptable accuracy for the estimation of whole-body and appendicular FM and LM in frail older women, although SMF-BIA underestimated LM and overestimated FM relative to DXA.

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Acknowledgements

We are deeply grateful to the study participants and to the staff of the Tokyo Metropolitan Institute of Gerontology for their cooperation.

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Correspondence to M Kim.

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Author contributions: Both authors designed the study together. MK developed the study concept and design, analysed and interpreted the data, and prepared the manuscript. HK recruited subjects, assisted with statistical analysis and reviewed the manuscript for accuracy.

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Kim, M., Kim, H. Accuracy of segmental multi-frequency bioelectrical impedance analysis for assessing whole-body and appendicular fat mass and lean soft tissue mass in frail women aged 75 years and older. Eur J Clin Nutr 67, 395–400 (2013). https://doi.org/10.1038/ejcn.2013.9

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