Abstract
BackgroundThere is a loss of lean body mass (LBM) with increasing age. A low LBM has been associated with increased adverse effects from prescribed medications such as chemotherapy. Accurate assessment of LBM may allow for more accurate drug prescribing. The aims of this study were to develop new prediction equations (PEs) for LBM with anthropometric and biochemical variables from a development cohort and then validate the best performing PEs in validation cohorts.MethodsPEs were developed in a cohort of 188 healthy subjects and then validated in a convenience cohort of 52 healthy subjects. The best performing anthropometric PE was then compared to published anthropometric PEs in an older (age ≥ 50 years) cohort of 2287 people. Best subset regression analysis was used to derive PEs. Correlation, Bland-Altman and Sheiner & Beal methods were used to validate and compare the PEs against dual X-ray absorptiometry (DXA)-derived LBM.ResultsThe PE which included biochemistry variables performed only marginally better than the anthropometric PE. The anthropometric PE on average over-estimated LBM by 0.74 kg in the combined cohort. Across gender (male vs. female), body mass index (< 22, 22- < 27, 27- < 30 and ≥30 kg/m2) and age groups (50–64, 65–79 and ≥80 years), the maximum mean over-estimation of the anthropometric PE was 1.36 kg.ConclusionsA new anthropometric PE has been developed that offers an alternative for clinicians when access to DXA is limited. Further research is required to determine the clinical utility and if it will improve the safety of medication use.
Highlights
There is a loss of lean body mass (LBM) with increasing age
No significant differences between the two cohorts were noted for hsCRP or LBM
Based on adjusted R2 and potential clinical utility, the following prediction equations (PEs) were selected for further validation in the VC: Table 1 compares LBMPE1-4 to LBMDXA in the VC
Summary
There is a loss of lean body mass (LBM) with increasing age. A low LBM has been associated with increased adverse effects from prescribed medications such as chemotherapy. Accurate assessment of LBM may allow for more accurate drug prescribing. There is a decline in lean body mass (LBM) and very often an increase in adiposity [1]. A major impediment to the routine clinical use of LBM is the reliance on relatively inaccessible or expensive methods of body composition measurements. Computed tomography (CT), magnetic resonance imaging and dual absorptiometry x-ray (DXA) are used to assess LBM but these methods may be difficult to access in clinical practice (e.g. frail or rural patients) [10]. The bioelectrical impedance analysis (BIA) method is portable, it still requires the purchase of special equipment and it’s accuracy is dependent on many other factors such as state of hydration, food intake and exercise [11]
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