Abstract
We aimed to compare the level of agreement between leg-to-leg bioelectrical impedance analysis (LBIA) and dual-energy X-ray absorptiometry (DXA) for assessing changes in body composition following exercise intervention among individuals with Type 2 diabetes mellitus (T2DM). Forty-four adults with T2DM, age 53.2 ± 9.1 years; BMI 30.8 ± 5.9 kg/m2 participated in a 6-month exercise program with pre and post intervention assessments of body composition. Fat free mass (FFM), % body fat (%FM) and fat mass (FM) were measured by LBIA (TBF-300A) and DXA. LBIA assessments of changes in %FM and FM post intervention showed good relative agreements with DXA variables (P < 0.001). However, Bland-Altman plot(s) indicated that there were systematic errors in the assessment of the changes in body composition using LBIA compared to DXA such that, the greater the changes in participant body composition, the greater the disparity in body composition data obtained via LBIA versus DXA data (FFM, P = 0.013; %FM, P < 0.001; FM, P < 0.001). In conclusion, assessment of pre and post intervention body composition implies that LBIA is a good tool for assessment qualitative change in body composition (gain or loss) among people with T2DM but is not sufficiently sensitive to track quantitative changes in an individual's body composition.
Highlights
Exercise has long been recognized as a cornerstone of diabetes management and for the prevention of incident diabetes [1]
There were strong correlations between Fat free mass (FFM), %fat mass (FM), and FM assessed by leg bioelectrical impedance analysis (LBIA) and that of dual-energy X-ray absorptiometry (DXA) (FFM: r = 0.942, P < 0.001; %FM, r = 0.833, P < 0.001; FM: r = 0.929, P < 0.001 (Figure 1)
The Bland-Altman plots showed that there were no systematic errors in assessment of FFM (P = 0.907), %FM (P = 0.100), and FM (P = 0.06) using LBIA compared with DXA (Figure 2)
Summary
Exercise has long been recognized as a cornerstone of diabetes management and for the prevention of incident diabetes [1]. Understanding body composition and how it changes is essential to the prescription and evaluation of exercise rehabilitation programs for patients with T2DM. Dual-energy X-ray absorptiometry (DXA) is an advanced technique for estimating body fat, lean soft tissue mass, bone mineral content, and bone mineral density [2]. The utility of DXA is limited due to the cost of the equipment, expertise required to acquire and analyze scans (trained operators), lack of portability, availability of funding, and their ∼123 kg weight limit. These criteria combine to limit the availability of DXA in most settings with the exception of some tertiary rehabilitation centers
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