Benjaminsen Camilla Raaby, Jørgensen Rasmus Møller, Vestergaard Esben Thyssen, Bruun Jens Meldgaard
Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus N, Denmark.
Steno Diabetes Center Aarhus, Aarhus University Hospital, Aarhus N, Denmark; Department of Pediatrics, Aarhus University Hospital, Aarhus N, Denmark; Department of Clinical Medicine, Faculty of Health, Aarhus University, Aarhus N, Denmark; Danish National Center for Obesity, Aarhus N, Denmark.
Nutr Res. 2025 Jan;133:1-12. doi: 10.1016/j.nutres.2024.11.003. Epub 2024 Nov 14.
Accurate and efficient body composition assessment is essential for diagnosing and monitoring childhood obesity in clinical and research settings. This study evaluated the agreement between bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA) in assessing body composition and its changes during a long-term lifestyle intervention in children and adolescents with obesity. We hypothesized that BIA is comparable to DXA in tracking longitudinal changes in body composition in this population. The study included 92 children and adolescents 5 to 17 years of age (mean 10.5 ± 2.9 years) classified as obese at the time of measurement (body mass index-standard deviation score ≥ 2 SD). From January 1, 2014, to December 31, 2017, they participated in a lifestyle intervention at Randers Regional Hospital. Body composition was assessed using BIA and DXA at baseline and follow-up (mean 20.5 ± 9.3 months). Bland-Altman plots, correlation- and concordance analyses were used to evaluate the agreement between methods. Bland-Altman plots demonstrated wide limits of agreement without significant bias for longitudinal changes in fat mass (FM), FM%, fat-free mass (FFM), and FFM% (0.39 kg (CI -0.14, 0.93), -0.39% (CI -1.06, 0.26), -0.21 kg (CI -0.73, 0.31), and 0.39% (CI -0.27, 1.05), respectively). Correlations between methods for changes in FM, FM%, FFM, and FFM% were 0.93, 0.83, 0.88, and 0.83, respectively. In cross-sectional assessments, BIA underestimated FM and FM% and overestimated FFM and FFM% compared to DXA. Conclusively, BIA effectively monitors longitudinal changes in body composition at a group level in a pediatric population with obesity. However, caution is needed for individual assessments.
在临床和研究环境中，准确而高效的身体成分评估对于诊断和监测儿童肥胖至关重要。本研究评估了生物电阻抗分析（BIA）和双能X线吸收法（DXA）在评估肥胖儿童和青少年长期生活方式干预期间身体成分及其变化方面的一致性。我们假设在该人群中，BIA在追踪身体成分的纵向变化方面与DXA相当。该研究纳入了92名5至17岁（平均10.5±2.9岁）的儿童和青少年，他们在测量时被归类为肥胖（体重指数标准差评分≥2 SD）。从2014年1月1日至2017年12月31日，他们在兰讷斯地区医院参加了一项生活方式干预。在基线和随访时（平均20.5±9.3个月）使用BIA和DXA评估身体成分。采用Bland-Altman图、相关性和一致性分析来评估方法之间的一致性。Bland-Altman图显示，对于脂肪量（FM）、FM%、去脂体重（FFM）和FFM%的纵向变化，一致性界限较宽，但无显著偏差（分别为0.39 kg（CI -0.14，0.93）、-0.39%（CI -1.06，0.26）、-0.21 kg（CI -0.73，0.31）和0.39%（CI -0.27，1.05））。FM、FM%、FFM和FFM%变化的方法之间的相关性分别为0.93、0.83、0.88和0.83。在横断面评估中，与DXA相比，BIA低估了FM和FM%，高估了FFM和FFM%。总之，BIA能有效地在群体水平上监测肥胖儿科人群身体成分的纵向变化。然而，个体评估时需要谨慎。
