Academic Department of Education, Federal Institute for Education, Sciences, and Technology Southeast of Minas Gerais, Rio Pomba, Minas Gerais, Brazil.
Departments of Physical Education, Federal University of Viçosa, Viçosa, Minas Gerais, Brazil.
Adv Nutr. 2018 Sep 1;9(5):617-624. doi: 10.1093/advances/nmy043.
The Body Adiposity Index (BAI) is a practical anthropometric method used to measure body fat (BF) percentage (BF%). Recently developed, the validity and precision of BAI has been studied with adult samples of men and women, populations from different countries and ethnicities, varying amounts of BF, and sensitivity to detecting change over time. However, it is still necessary to determine its potential use in clinical practice and epidemiologic studies. Thus, our objective was to verify, through a systematic review, the validity of the BAI in predicting BF% in adults. Two independent researchers performed a search using PubMed, Web of Science, Science Direct, and Scopus databases. In order to be included, the studies had to use dual-energy X-ray absorptiometry (DXA) as a reference method. We excluded studies with samples from individuals with diseases or syndromes that alter the regional distribution of BF%. We included 19 studies with samples on individuals from different continents, varied ethnicities, both sexes, and a wide age range (18-83 y). The concordance of the BAI with DXA assessed by Lin's concordance correlation coefficient showed results classified as poor (pc < 0.90). Bland-Altman plots showed that the BAI produced large individual errors when predicting BF% in all studies using this analysis. The studies were consistent in affirming that the BAI showed limited capacity to estimate BF% in adults. The BAI shows wide individual errors, in agreement with the reference method, and a lack of sensitivity in detecting change in BF% over time. The method presents a systematic error of BF% overestimation in individuals with ≤20% of BF, and underestimation in individuals with >30% of BF, regardless of sex, age, and ethnicity. The results of this systematic review show enough evidence that the BAI does not present satisfying results, and its use is not recommended for BF% determination in adults.
身体脂肪指数（BAI）是一种实用的人体测量方法，用于测量体脂百分比（BF%）。最近开发的 BAI 的有效性和精度已经在男性和女性成年人样本、来自不同国家和种族的人群、不同 BF%的人群以及检测随时间变化的敏感性方面进行了研究。然而，仍然需要确定其在临床实践和流行病学研究中的潜在用途。因此，我们的目的是通过系统评价来验证 BAI 在预测成年人 BF%方面的有效性。两名独立研究人员使用 PubMed、Web of Science、Science Direct 和 Scopus 数据库进行了搜索。为了被包括在内，研究必须使用双能 X 射线吸收法（DXA）作为参考方法。我们排除了来自患有改变 BF 区域性分布的疾病或综合征的个体的样本研究。我们纳入了 19 项研究，样本来自不同大洲、不同种族、男女和广泛年龄范围（18-83 岁）的个体。通过林氏一致性相关系数评估 BAI 与 DXA 的一致性，结果被归类为较差（pc < 0.90）。Bland-Altman 图显示，在所有使用这种分析方法的研究中，BAI 在预测 BF%时产生了较大的个体误差。这些研究一致肯定 BAI 显示出在成年人中估计 BF%的能力有限。BAI 显示出广泛的个体误差，与参考方法一致，并且在检测 BF%随时间变化方面缺乏敏感性。该方法在 BF%≤20%的个体中表现出 BF%高估的系统误差，在 BF%>30%的个体中表现出 BF%低估的系统误差，无论性别、年龄和种族如何。这项系统评价的结果表明，有足够的证据表明 BAI 结果不理想，不建议在成年人中使用 BAI 来确定 BF%。
