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Comparison of Skinfold Thicknesses and Bioimpedance Spectroscopy to Dual-Energy X-Ray Absorptiometry for the Body Fat Measurement in Patients With Chronic Kidney Disease.

ABSTRACT: The aim of the study was to compare the amount of body fat measured by skinfold thickness (SFT) and bioimpedance spectroscopy (BIS) with dual-energy x-ray absorptiometry (DXA) as a reference method.Forty-eight patients undergoing hemodialysis treatment thrice-weekly for at least 3 months (HD group) with a mean age of 59.8 ± 15.5 years, 61 patients with chronic kidney disease (CKD) with an estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m2 and a mean age of 60.1 ± 17.7 years (predialysis group, PreD), and 33 individuals without kidney disease with an eGFR >60 mL/min/1.73 m2 and a mean age of 58.7 ± 17.0 years (control group) were included.Mean percentages of body fat measured by SFT did not significantly differ from those measured by DXA in the HD group ( P = .249) and the PreD group ( P = .355). In the control group, mean percentage of fat mass measured by SFT was significantly higher than measured by DXA ( P = .004). Mean difference was 1.99% ± 3.65%. The measurements of body fat performed by BIS were significantly higher than those performed by DXA in all studied groups ( P < .001). Age was statistically significant and the strongest factor that influenced the variability of measurements obtained by BIS and DXA in all studied groups ( R2 = 0.302, 0.153, and 0.250, respectively, for HD, PreD, and control groups).SFT as a method of fat mass assessment in daily routine practice seems to be more reliable then BIS in patients treated with hemodialysis and in patients with stage IV/V CKD. However, methods based on bioimpedance techniques can potentially offer more data such as overhydration or an amount of lean tissue mass, but further investigations are needed to establish method the most suitable for patients with CKD.

SUBMITTER: Rymarz A

PROVIDER: S-EPMC5542130 | biostudies-other | 2017 Aug

REPOSITORIES: biostudies-other

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Project description:Background/objectivesIndividuals with HIV are susceptible to visceral fat accumulation, which confers an increased risk of cardiometabolic disease. Advanced software to ascertain visceral fat content from dual-energy X-ray absorptiometry (DXA) has not been validated among this population. We sought to compare DXA with computed tomography (CT) in the measurement of visceral fat cross-sectional area (VAT) in HIV and non-HIV using Bland-Altman analyses.Subjects/methodsData were combined from five previously conducted studies of individuals with HIV (n = 313) and controls without HIV (n = 144) in which paired DXA and CT scans were available. In cross-sectional analyses, DXA-VAT was compared with CT-VAT among participants with and without HIV. In longitudinal analyses, changes in VAT over time were compared between DXA and CT among participants with and without HIV receiving no intervention over 12 months and among individuals with HIV receiving tesamorelin-a medication known to reduce VAT-over 6 months.ResultsIn HIV, DXA underestimated VAT compared with CT among individuals with increased visceral adiposity. The measurement bias was -9 ± 47 cm2 overall, but became progressively larger with greater VAT (P < 0.0001), e.g., -61 ± 58 cm2 among those with VAT ≥ 200 cm2. Sex-stratified analyses revealed that the relationship between VAT and measurement bias was especially pronounced in men (P < 0.0001). Longitudinally, DXA underestimated changes in VAT, particularly among those at the extremes of VAT gain or loss (P < 0.0001). In contrast to the cross-sectional findings, the tendency for DXA to underestimate longitudinal changes in VAT was evident in both men and women. Analogous findings were seen among controls in cross-sectional and longitudinal analyses.ConclusionsDXA underestimated VAT relative to CT in men with and without HIV, who had increased visceral adiposity. DXA also underestimated changes in VAT over time in men and women, irrespective of HIV status. DXA-VAT should be used with caution among both HIV and non-HIV-infected populations.

Project description:BackgroundThis study aimed to adjust and cross-validate skeletal muscle mass measurements between bioimpedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA) for the screening of sarcopenia in the community and to estimate the prevalence of sarcopenia in Hong Kong.MethodsScreening of sarcopenia was provided to community-dwelling older adults. Appendicular skeletal muscle mass (ASM) was evaluated by BIA (InBody 120 or 720) and/or DXA. Handgrip strength and/or gait speed were assessed. Diagnosis of sarcopenia was based on the 2019 revised Asian Working Group for Sarcopenia cut-offs. Agreement analysis was performed to cross-validate ASM measurements by BIA and DXA. Multiple regression was used to explore contribution of measured parameters in predicting DXA ASM from BIA.ResultsA total of 1587 participants (age = 72 ± 12 years) were recruited; 1065 participants were screened by BIA (InBody 120) with 18 followed up by DXA, while the remaining 522 participants were assessed by the BIA (InBody 720) and DXA. The appendicular skeletal muscle mass index (ASMI) evaluated by BIA showed a mean difference of 2.89 ± 0.38 kg/m2 (InBody 120) and 2.97 ± 0.45 kg/m2 (InBody 720) against DXA gold standard. A significant overestimation of muscle mass was measured by BIA compared with DXA (P < 0.005). BIA data were adjusted using prediction equation and mean difference reduced to -0.02 ± 0.31 kg/m2 in cross-validation. Prevalence of sarcopenia in older adults ≥65 ranged from 39.4% (based on ASMI by DXA) to 40.8% (based on predicted DXA ASMI from BIA). Low ASMI by DXA was found in 68.5% of the older adults screened. The percentage of older adults exhibited low handgrip strength ranged from 31.3% to 56%, while 49% showed low gait speed.ConclusionsBioimpedance analysis was found to overestimate skeletal muscle mass compared with DXA. With adjustment equations, BIA can be used as a quick and reliable tool for screening sarcopenia in community and clinical settings with limited access to better options.

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Comparison of Skinfold Thicknesses and Bioimpedance Spectroscopy to Dual-Energy X-Ray Absorptiometry for the Body Fat Measurement in Patients With Chronic Kidney Disease.

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