Clinical detection of sarcopenic obesity by bioelectrical impedance analysis

Abstract

To assess whether bioelectrical impedance analysis (BIA) provides clinically useful information on body composition beyond that obtained from measuring height and weight, we clinically classified 306 obese patients (233 females and 73 males) into tertiles of increasing fat-free mass estimated by BIA. Because fat-free mass by BIA is an estimate of lean body mass, the lowest tertile was clinically defined as sarcopenic obesity (reduced lean body mass), as contrasted with proportionate or muscular obesity in the next two tertiles. Fat mass in patients in each of the above tertiles based on BIA was then compared with fat mass estimated by using the equations of Garrow and Webster with body mass index (weight/height2). BIA-estimated fat mass was 4.3 kg greater in the sarcopenic group (n = 102) than predicted from body mass index. Fat mass predicted by BIA in the proportionate (n = 102) and muscular (n = 102) groups differed by less than the SEE of fat mass predicted by BMI. In premenopausal women at increased risk of breast cancer BIA showed a high prevalence of sarcopenic obesity (28/30) in these women at normal body mass indexes. Thus, BIA may be clinically useful for demonstrating sarcopenic obesity, but additional studies are needed to determine the metabolic and clinical significance of sarcopenic obesity.

Identification of sarcopenic obesity in postmenopausal women: a cutoff proposal

“…Initial studies proposed the clinical detection of sarcopenic obesity by bioelectrical impedance analysis (27) but later reports emphasized the importance of using more sophisticated measurements such as DXA through clinical examination (22). Although Newman et al (4) had considered FM and height in their approach, they did not use the term sarcopenic obesity in their report.…”

Anthropometric body fat composition reference values in Spanish adolescents. The AVENA Study

“…The major shortcoming of the body mass indices is that the actual composition of the body is not taken into account: the excess body mass may be made up of fat mass or fat-free mass, both of which will be judged as excess mass. On the other hand, a deficit of the body mass may be due to a fat-free mass deficit or mobilization of fat mass, or both combined (Heber et al, 1996). In terms of body composition, it has been observed that, in each sex, annual increases in BMI were driven primarily by increases in fat free mass/ stature 2 until late adolescence, with increases in total body fat/stature 2 contributing to a larger proportion of the BMI increases in girls than in boys (Maynard et al, 2001).…”

Underestimation of percentage fat mass measured by bioelectrical impedance analysis compared to dual energy X-ray absorptiometry method in obese children

“…The correlation coef®cient between BMI values and body mass percentage by DXA method was only 0.605, compared to BIA, which was 0.889. Even though the calculation of body fat mass percentage was done from the BMI (by the formula by Garrow and Webster; Heber et al, 1996), the correlation coef®cient was only slightly improved to 0.625.…”