External cross-validation of bioelectrical impedance analysis for the assessment of body composition in Korean adults

Abstract

Bioelectrical impedance analysis (BIA) models must be validated against a reference method in a representative population sample before they can be accepted as accurate and applicable. The purpose of this study was to compare the eight-electrode BIA method with DEXA as a reference method in the assessment of body composition in Korean adults and to investigate the predictive accuracy and applicability of the eight-electrode BIA model. A total of 174 apparently healthy adults participated. The study was designed as a cross-sectional study. FM, %fat, and FFM were estimated by an eight-electrode BIA model and were measured by DEXA. Correlations between BIA_%fat and DEXA_%fat were 0.956 for men and 0.960 for women with a total error of 2.1%fat in men and 2.3%fat in women. The mean difference between BIA_%fat and DEXA_%fat was small but significant (P < 0.05), which resulted in an overestimation of 1.2 ± 2.2%fat (95% CI: -3.2-6.2%fat) in men and an underestimation of -2.0 ± 2.4%fat (95% CI: -2.3-7.1%fat) in women. In the Bland-Altman analysis, the %fat of 86.3% of men was accurately estimated and the %fat of 66.0% of women was accurately estimated to within 3.5%fat. The BIA had good agreement for prediction of %fat in Korean adults. However, the eight-electrode BIA had small, but systemic, errors of %fat in the predictive accuracy for individual estimation. The total errors led to an overestimation of %fat in lean men and an underestimation of %fat in obese women.

Fat Mass by Bioelectrical Impedance Analysis is not Associated With Increased Risk of Barrett Esophagus

“…However, their cost and accessibility limit their use in large-scale epidemiological research. Recent advancements in BIA technology along with validation data against DEXA in diverse populations including adolescents, 21 Hispanic diabetics, 22 general population adults, 23, 24 and morbidly obese bariatric surgery candidates 25 support the use of BIA in epidemiological research.…”

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“…Waist circumference was measured at the mid‐point of the lowest rib and iliac crest. Body composition was performed using multifrequency BIA (Inbody 4.0; Biospace Co., Gangnamgu, Seoul, South Korea) according to previously reported methods …”

“…Body composition was performed using multifrequency BIA (Inbody 4.0; Biospace Co., Gangnamgu, Seoul, South Korea) according to previously reported methods. 15 Venous blood samples were collected after an overnight fast of at least 12 h. Fasting plasma concentrations of glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) were measured using a Hitachi 7600 automated analyzer (Hitachi Co., Tokyo, Japan). Glycated hemoglobin (HbA1c) level was measured using a Tosoh HLC-723 HbG7 analyzer (Tosoh Bioscience Ltd., Redditch, UK).…”

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“…The errors of measurement are small and systemic. For example, Kim et al [33] compared the body fat % measurements by direct dual-energy X-ray absorptiometry (DEXA) method and the eight electrode bioelectrical impedance (BIA) method in 174 healthy Korean adults. The mean difference between BIA % fat and DEXA % fat was small but significant (p < 0.05), which resulted in an overestimation of 1.2% ± 2.2% fat in men and an underestimation of 2.0% ± 2.4% fat in women.…”