Abstract
Background and aimsBody composition assessment is often used in clinical practice for nutritional evaluation and monitoring. The standard method, dual-energy X-ray absorptiometry (DXA), is hardly feasible in routine clinical practice contrary to Bioelectrical Impedance Analysis (BIA) method. We thus aimed to compare body composition assessment by DXA and BIA according to the body mass index (BMI) in a large cohort.MethodsRetrospectively, we analysed DXA and BIA measures in patients followed in a Nutrition Unit from 2010 to 2016. Body composition was assessed under standardized conditions in the morning, after a fasting period of 12 h, by DXA (Lunar Prodigy Advance) and BIA (Bodystat QuadScan 4000, Manufacturer’s equation). Bland-Altman test was performed for each class of BMI (kg/m2) and fat mass and fat free mass values were compared using Kruskal-Wallis test. Pearson correlations were also performed and the concordance coefficient of Lin was calculated.ResultsWhatever the BMI, BIA and DXA methods reported higher concordance for values of FM than FFM. Body composition values were very closed for patients with BMI between 16 and 18,5 (difference < 1kg). For BMI > 18,5 and BMI < 40, BIA overestimated fat free mass from 3,38 to 8,28 kg, and underestimated fat mass from 2,51 to 5,67 kg compared with DXA method. For BMI ≥ 40, differences vary with BMI. For BMI < 16, BIA underestimated fat free mass by 2,25 kg, and overestimated fat mass by 2,57 kg. However, limits of agreement were very large either for FM and FFM values, irrespective of BMI.ConclusionThe small bias, particularly in patients with BMI between 16 and 18, suggests that BIA and DXA methods are interchangeable at a population level. However, concordance between BIA and DXA methods at the individual level is lacking, irrespective of BMI.
Highlights
It is widely accepted that body composition can independently influence health [1,2,3,4]
We aimed to compare body composition assessment by dual-energy X-ray absorptiometry (DXA) and Bioelectrical Impedance Analysis (BIA) according to the body mass index (BMI) in a large cohort
Body composition values were very closed for patients with BMI between 16 and 18,5
Summary
It is widely accepted that body composition can independently influence health [1,2,3,4]. Dual-energy X-ray absorptiometry (DXA) provides a rapid and non-invasive assessment of FM (fat mass), FFM (fat free mass) and bone mineral density, and is considered to be the reference method in clinical research [6]. Bioelectrical Impedance Analysis (BIA) method is commonly used for body composition assessment in clinical practice and research studies. Multiple frequencies-BIA (MF-BIA) has been developed and allows prediction of (i) intracellular and extracellular water independently, and (ii) especially the phase angle which is known to decrease with age and height, and increase with greater FFM in men and women [9]. Body composition assessment is often used in clinical practice for nutritional evaluation and monitoring. The standard method, dual-energy X-ray absorptiometry (DXA), is hardly feasible in routine clinical practice contrary to Bioelectrical Impedance Analysis (BIA) method. We aimed to compare body composition assessment by DXA and BIA according to the body mass index (BMI) in a large cohort
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