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Relative Accuracy of Bioelectrical Impedance Analysis for Assessing Body Composition in Children With Severe Obesity
Soofia Khan1, Stavra A Xanthakos1,2, Lindsey Hornung3
1Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center.
Insights
A multifrequency octopolar bioelectrical impedance analysis (BIA) device accurately measures body composition in obese children compared to DXA. This handheld device offers precise, point-of-care assessment for pediatric obesity management.
Area of Science:
- Pediatric Endocrinology
- Body Composition Analysis
- Medical Device Accuracy
Background:
- Accurate body composition assessment is crucial for managing pediatric obesity.
- The reliability of different bioelectrical impedance analysis (BIA) devices in this population remains unclear.
Purpose of the Study:
- To compare the accuracy of two BIA devices against dual-energy X-ray absorptiometry (DXA).
- To evaluate BIA device performance in obese and severely obese children.
Main Methods:
- A cross-sectional study included 78 obese children.
- Body composition was measured using a handheld single-frequency BIA, a stationary multifrequency BIA, and DXA.
- Intermethod agreement was analyzed using intraclass correlations and Bland-Altman analyses.
Main Results:
- The multifrequency octopolar BIA showed high agreement with DXA for body fat percentage (ICC=0.87) and appendicular lean mass.
- The single-frequency tetrapolar BIA demonstrated poor agreement for body fat percentage (ICC=0.39) and underestimated values.
- Differences between multifrequency BIA and DXA were small, with limits of agreement around ±5%.
Conclusions:
- Bioelectrical impedance analysis devices differ significantly in accuracy for assessing body composition in obese children.
- The multifrequency octopolar BIA device provides accurate estimates of body fat percentage and lean mass relative to DXA.
- This multifrequency BIA device is suitable for point-of-care use in pediatric obesity assessment.
Objectives:
The accuracy of different bioelectrical impedance analysis (BIA) devices for assessing body composition in children with obesity is unclear. We determined the relative accuracy of 2 BIA devices compared to dual x-ray absorptiometry (DXA) in obese and severely obese children.
Methods:
We measured body composition in a cross-sectional study of 78 obese children by a handheld single frequency tetrapolar BIA device (Omron), a stationary multifrequency octopolar BIA device (InBody 370) and DXA. Intermethod agreement was assessed by intraclass correlations, paired t tests, and Bland-Altman analyses.
Results:
Participants (37% female, age 14.8 ± 2.7 years) had mean (±standard deviation) body mass index of 36.7 ± 7.5 kg/m, body fat percentage of 46.4% ± 5.2%, and appendicular lean mass of 22.5 ± 6.0 kg by DXA. Intraclass correlations with DXA for body fat percentage were 0.39 and 0.87 for single frequency tetrapolar and multifrequency octopolar BIA devices, respectively. The single frequency tetrapolar BIA underestimated body fat percentage by 5.5% ± 2.9% (P < 0.0001). Differences between the multifrequency octopolar BIA and DXA for body fat percentage (-1.1% ± 2.8%) and appendicular lean mass (-0.3 ± 1.4 kg) were small, and 95% limits of agreement were approximately ±5%.
Conclusions:
BIA machines vary in relative accuracy in measuring body composition in children who are obese and severely obese. The multifrequency octopolar BIA device accurately estimated body fat percentage and appendicular lean mass relative to DXA and has the advantage of point of care performance.
