Comparison of Anthropometry, Bioelectrical Impedance, and Dual-energy X-ray Absorptiometry for Body Composition in Cirrhosis

Abstract

This study was planned to evaluate triceps skinfold thickness (TSFT), mid-arm muscle circumference (MAMC) and bioelectrical impedance analysis (BIA) for assessing body composition using dual-energy X-ray absorptiometry (DEXA) (reference)and to predict fat mass (FM) and fat-free mass (FFM) in patients with cirrhosis. FM and FFM were assessed by using DEXA and BIA. Skin-fold calliper was used for measuring TSFT, and MAMC was calculated. Bland-Altman plot was used to determine agreement and linear regression analysis for obtaining equations to predict FM and FFM. Patients with cirrhosis (n=302, 241 male, age 43.7±12.0 years) were included. Bland-Altman plot showed very good agreement between BIA and DEXA for the estimation of FM and FFM. Majority of patients were within the limit of agreement: FM (98%) and FFM (96.4%). BIA shows a positive correlation with DEXA:FM (r=0.73, P≤0.001) and FFM (r=0.86, P≤0.001). DEXA (FM and FFM) shows a positive correlation with TSFT (r=0.69, P≤0.01)and MAMC (r=0.61, P≤0.01). The mean difference between the observed and predicted value of FM and FFM by BIA in the developmental set was 0.01 and 0.05, respectively; whereas in the validation set, it was -0.13 and 0.86, respectively. The mean difference between the observed and predicted value of TSFT and MAMC in the developmental set was 0.43 and 0.07; whereas, in the validation set, it was 0.16 and 0.48, respectively. Anthropometry (TSFT and MAMC) and BIA are simple and easy to useand can be a substitute of DEXA for FM and FFM assessment in routine clinical settings in patients with cirrhosis.