用于测量2134例肥胖患者身体成分的生物电阻抗方程的准确性。

Accuracy of bioimpedance equations for measuring body composition in a cohort of 2134 patients with obesity.

作者信息

Coëffier Moise, El Machkouri Mohamed, L'Huillier Clément, Folope Vanessa, Lelandais Hélène, Grigioni Sébastien, Déchelotte Pierre, Achamrah Najate

机构信息

Nutrition Department, CHU Rouen, Rouen, France; Université de Rouen Normandie, INSERM UMR 1073, Nutrition, Inflammation and Microbiota-gut-brain Axis, IRIB, Rouen, France; Clinical Investigation Centre CIC 1404, INSERM and CHU Rouen, Rouen, France.

Université de Rouen Normandie, CNRS UMR 6085, Laboratory of Mathematics Raphael Salem, Rouen, France.

出版信息

Clin Nutr. 2022 Sep;41(9):2013-2024. doi: 10.1016/j.clnu.2022.07.032. Epub 2022 Jul 30.

DOI:10.1016/j.clnu.2022.07.032

PMID:35970132

Abstract

INTRODUCTION

Measuring body composition is an important issue to phenotype patients with obesity and to follow the nutritional care efficiency. Bioelectrical Impedance Analysis (BIA) is a simple and rapid technique. However, validity of BIA in patients with obesity remains controversial. Thus, we aimed to evaluate the validity of several BIA equations to assess body composition in a large cohort of patients with obesity by using dual X ray absorptiometry (DXA) as reference.

METHODS

Seven BIA equations have been retrospectively applied on electrical data measured by BIA in patients with obesity with BMI equal or higher than 30 kg/m and results were compared to DXA-derived fat mass (FM) and fat-free mass (FFM). BIA and DXA were done the same day after an overnight fasting. Results were compared with Bland-Altman method and Pearson correlation. We also calculated the accuracy defined as the percentage of patients with DXA-BIA difference within ± 10% of DXA measures for FFM and FM.

RESULTS

Data from 2134 patients with class I and II obesity (ob1/2, n = 1452, 47.4 ± 14.2 y; 35.0 ± 2.7 kg.m) and class III obesity (ob3, n = 682, 48.2 ± 13.9 y; 44.1 ± 3.5 kg.m) were analyzed. The best results to evaluate FFM both in ob1/2 and ob3 groups were obtained with Roubenoff's equation: Bland Altman bias at -1.96 and -0.82 kg, Pearson correlation r at 0.93 and 0.87, accuracy at 75.7% and 83.3%, respectively. However, limits of agreements at 95% were high: [-9.42; 5.49 kg] and [-8.16; 6.52 kg]. For FM evaluation, Roubenoff's equation also showed best results for ob1/2 group (bias at -1.17 kg; correlation r at 0.89 and accuracy at 79.1%) but not for ob3 group. In this latter group, Deurenberg's equation exhibited the best results (bias at 2.09 kg; correlation r at 0.81 and accuracy at 76.8%). However, limits of agreements remained high.

CONCLUSION

In patients with obesity, Roubenoff BIA equation should be recommended to assess fat free mass, even if limits of agreements remain high.

摘要

引言

测量身体成分对于肥胖患者的表型分析以及跟踪营养护理效果而言是一个重要问题。生物电阻抗分析（BIA）是一种简单快速的技术。然而，BIA在肥胖患者中的有效性仍存在争议。因此，我们旨在通过使用双能X线吸收法（DXA）作为参考，评估多个BIA方程在一大群肥胖患者中评估身体成分的有效性。

方法

对体重指数（BMI）等于或高于30kg/m²的肥胖患者通过BIA测量的电数据回顾性应用了七个BIA方程，并将结果与DXA得出的脂肪量（FM）和去脂体重（FFM）进行比较。BIA和DXA在禁食过夜后的同一天进行。结果采用Bland-Altman法和Pearson相关性进行比较。我们还计算了准确性，定义为FFM和FM的DXA-BIA差异在DXA测量值±10%范围内的患者百分比。

结果

分析了2134例I级和II级肥胖患者（ob1/2，n = 1452，47.4±14.2岁；35.0±2.7kg·m²）和III级肥胖患者（ob3，n = 682，48.2±13.9岁；44.1±3.5kg·m²）的数据。在ob1/2组和ob3组中，使用Roubenoff方程评估FFM得到的结果最佳：Bland-Altman偏差分别为-1.96kg和-0.82kg，Pearson相关性r分别为0.93和0.87，准确性分别为75.7%和83.3%。然而，95%的一致性界限较高：[-9.42；5.49kg]和[-8.16；6.52kg]。对于FM评估，Roubenoff方程在ob1/2组中也显示出最佳结果（偏差为-1.17kg；相关性r为0.89，准确性为79.1%），但在ob3组中并非如此。在ob3组中，Deurenberg方程表现出最佳结果（偏差为2.09kg；相关性r为0.81，准确性为76.8%）。然而，一致性界限仍然较高。