Bioelectrical impedance analysis and dual x-ray absorptiometry agreement for skeletal muscle mass index evaluation in sarcopenia diagnosis

Abstract

Background: All definitions for diagnosing sarcopenia include the estimation of muscle mass. This can be made using bioelectrical impedance analysis (BIA) or dual x-ray absorptiometry (DXA). BIA is a portable and inexpensive method suitable for clinical settings, while DXA is cumbersome, more expensive and less available. Objectives: To evaluate the interchangeability of both techniques for skeletal muscle mass index (SMI) estimation, and assess whether the two methods are comparable for the diagnosis of sarcopenia. Approach: Prospective, cross-sectional study. Setting: Faculty for Health Sciences, Universidad de Caldas, Colombia. Participants: Seventy-two subjects aged 65–80 years were recruited. Measurements: BIA and DXA for SMI estimation and sarcopenia diagnoses using the definition of the European Working Group on Sarcopenia in Older People (EWGSOP). Of the 72 patients, 28 were diagnosed with sarcopenia by BIA and corroborated by DXA were included in the study. To establish the agreement between techniques, the intraclass correlation coefficient and the concordance correlation coefficient were calculated. A Bland–Altman plot evaluated the agreement. To evaluate agreement on the diagnosis of sarcopenia, a Cohen’s kappa test was performed. Main results: Agreement between SMI by BIA and DXA was good according to the intraclass correlation coefficient (ICC 0.7 95% CI 0.5 to 0.8) but poor when the concordance correlation coefficient was used (CCC 0.4 was calculated 95% CI 0.3 to 0.5). The Bland–Altman analysis showed a clinically unacceptable discrepancy between the methods; the confidence intervals were too wide; the difference between methods tends to get larger as the average increases and the scatter around the bias line get larger as the average gets higher. Cohen’s kappa test was 0.2 (SEE: 0.1). Significance: The agreement between BIA and DXA was weak. We concluded that, in this studied population, the methods were not interchangeable. Results may improve if a specific formula in a greater sample size is used.

A Comparative Study of High-Frequency Bioelectrical Impedance Analysis and Dual-Energy X-ray Absorptiometry for Estimating Body Composition

“…However, until now, the measured values by MF-BIA were heterogeneous in accuracy compared with DEXA or MRI and showed differences in the diagnosis rate of sarcopenia in various studies [ 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 ]. Nine studies evaluated the correlation between MF-BIA and DEXA for assessing muscle mass [ 30 , 32 , 33 , 34 , 36 , 37 , 38 , 39 , 40 ].…”

Definition of an adapted cut-off for determining low lean tissue mass in older women with obesity: a comparison to current cut-offs

“…It is difficult to precisely answer this as many factors influence low LTM onset, progression and diagnosis 35 . Moreover, it was demonstrated that the prevalence varies with age 12 , methods of evaluation (DXA or bioelectrical impedance) 36 , and the cut-offs used 14 . A meta-analysis of 19 studies demonstrated an overall low LTM prevalence of 17% of older Brazilians aged ≥ 60 years 37 .…”

Prognostic significance of sarcopenia as determined by bioelectrical impedance analysis in patients with advanced pancreatic cancer receiving gemcitabine plus nab‑paclitaxel: A retrospective study

“…Because it is defined by a decrease in skeletal muscle mass, the skeletal muscle index (SMI) is useful for the evaluation of sarcopenia ( 13 ). The methods of measuring the SMI include measuring the cross-sectional area of the muscle by examining images, such as computed tomography (CT) and magnetic resonance imaging (MRI); bioelectrical impedance analysis (BIA); and dual-energy X-ray absorptiometry (DEXA) ( 14 , 15 ).…”