Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Communication
  • Published:

Body composition in patients with an ileostomy and inflammatory bowel disease: validation of bio-electric impedance spectroscopy (BIS)

Abstract

Objective: To validate bio-electric impedance spectroscopy (BIS) by comparison with other methods for determination of body water compartments in stable subjects with an ileostomy and no or minor small bowel resection for inflammatory bowel disease (IBD).

Subjects: Twenty-one subjects were included, age range 36–65 y (female/male=12/9), Crohn's disease (CD), n=14, ulcerative colitis (UC), n=6 and indeterminate colitis (IDC), n=1.

Methods: Fluid compartments were assessed by the use of three independent methods: BIS, dual-energy X-ray absorptiometry (DXA) and dilution techniques (DIL); tritiated water (total body water, TBW); and bromide (extracellular water, ECW), respectively. Intra-cellular water (ICW) was calculated as TBW−ECW. For comparison TBW was also predicted according to an empirical formula. Differences were analysed using Bland–Altman plots.

Results: The mean TBW values obtained from the impedance measurement differed in the order of −2.21 (DIL) to 1.41 (DXA) in women and −2.01 (DIL) to 2.61 (DXA) in men, from the measured and derived values of total body water. Prediction of TBW gave values that were close to BIS, with a mean difference of −0.31 in male subjects and +0.51 in female subjects.

Assessment of ECW revealed that the mean difference between dilution and impedance was less in women than in men (P<0.01).

Conclusion: The differences between all methods to assess fluid compartments are pronounced. To further investigate the use of the method in clinical practice for dynamic monitoring of rehydration in ileostomates with acute diarrhoea, repeated measurements together with comparison with weight fluid-balance charts are suggested.

Sponsorship: The study was supported by grants from the Swedish Medical Research Council (17X-03117), Göteborgs Läkarsällskap and IB and A Lundbergs forskningsstiftelse.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  • Bland J, Altman D . 1986 Statistical methods for assessing agreement between two methods of clinical measurement Lancet 8: 307–310

    Article  Google Scholar 

  • Bruce Å, Andersson M, Arvidsson B, Isaksson B . 1980 Body composition. Prediction of normal body potassium, body water and body fat in adults on the basis of body height, body weight and age Scand. J. Clin. Lab. Invest. 40: 461–473

    Article  CAS  Google Scholar 

  • Christie P, Knight G, Hill G . 1990 Metabolism of body water and electrolytes after surgery for ulcerative colitis: conventional ileostomy vs. J-pouch Br. J. Surg. 77: 149–151

    Article  CAS  Google Scholar 

  • Chumlea C, Guo S . 1997 Bioelectric impedance: a history, research issues, and recent consensus In Emerging Technologies for Nutrition Research ed. S Carlson-Newberry & R Costello pp 169–192 Washington, DC: National Academy Press

    Google Scholar 

  • Cooper J, Laughland A, Gunning E, Burkinshaw L, Williams N . 1986 Body composition in ileostomy patients with and without ileal resection Gut 27: 680–685

    Article  CAS  Google Scholar 

  • Cox-Reijven P, Soethers P . 2000 Validation of bio-impedance spectroscopy: effects of degree of obesity and ways of calculating volumes from measured resistance values Int. J. Obes. Relat. Metab. Disord. 24: 271–280

    Article  CAS  Google Scholar 

  • De Lorenzo A, Andreoli A, Matthie J, Withers P . 1997 Predicting body cell mass with bioimpedance by using theoretical methods: a technological review J. Appl. Physiol. 82: 1542–1558

    Article  CAS  Google Scholar 

  • Deurenberg P . 1996 Limitations of the bioelectrical impedance method for the assessment of body fat in severe obesity Am. J. Clin. Nutr. 64: 449S–452S

    Article  CAS  Google Scholar 

  • Deurenberg P, Tagliabue A, Shouten F . 1995 Multi-frequency impedance for the prediction of extracellular water and total body water Br. J. Nutr. 73: 349–358

    Article  CAS  Google Scholar 

  • Dewit O, Ward L, Middleton SJ, Watson C, Friend PJ, Elia M . 1997 Multiple frequency bioimpedance: a bed-side technique for assessment of fluid shift patterns in a patient with severe dehydration Clin. Nutr. 16: 189–192

    Article  CAS  Google Scholar 

  • Ellis K, Wong W . 1998 Human hydrometry: comparison of multifrequency bioelectrical impedance with 2H2O and bromine dilution J. Appl. Physiol. 85: 1056–1062

    Article  CAS  Google Scholar 

  • Ellis K, Shypailo R, Wong W . 1999 Measurement of body water by multifrequency bioelectrical impedance spectroscopy in a multiethnic pediatric population Am. J. Clin. Nutr. 70: 847–853

    Article  CAS  Google Scholar 

  • Gallagher D, Visser M, Wang Z, Harris T, Pierson R, Heymsfield S . 1996 Metabolically active component of fat-free body mass: influences of age, adiposity, and gender Metabolism 45: 992–997

    Article  CAS  Google Scholar 

  • Geerling B, van Marken Lichtenbelt W, Stockbrugger R, Brummer R-JM . 1999 Gender specific alterations of body composition in patients with inflammatory bowel disease compared with controls Eur. J. Clin. Nutr. 53: 479–485

    Article  CAS  Google Scholar 

  • Gudivaka R, Schoeller D, Kushner R, Bolt M . 1999 Single- and multi-frequency models for bioeletrical impedance analysis of body water compartments J. Appl. Physiol. 87: 1087–1096

    Article  CAS  Google Scholar 

  • Heymsfield S, Wang Z, Visser M, Gallagher D, Pierson R Jr . 1996 Techniques used in the measurement of body composition: an overview with emphasis on bioelectrical impedance analysis Am. J. Clin. Nutr. 64: 478–484

    Article  Google Scholar 

  • Hill G, Goligher J, Smith A, Mair W . 1975 Long term changes in total body water, total exchangeable sodium and total body potassium before and after ileostomy Br. J. Surg. 62: 524–527

    Article  CAS  Google Scholar 

  • Jebb S, Elia M . 1993 Techniques for the measurement of body composition: a practical guide Int. J. Obes. Relat. Metab. Disord. 17: 611–621

    CAS  PubMed  Google Scholar 

  • Miller M, Cosgriff J, Forbes G . 1989 Bromide space determination using anion-exchange chromatography for measurement of bromide Am. J. Clin. Nutr. 50: 168–171

    Article  CAS  Google Scholar 

  • Nilsson L, Andersson H, Bosaeus I, Myrvold H . 1982 Total body water and total body potassium in patients with continent ileostomies Gut 23: 589–593

    Article  CAS  Google Scholar 

  • Pace I, Rathburn E . 1945 Studies on body composition. III The body water and chemically combined nitrogen content in relation to fat content J. Biol. Chem. 158: 685–691

    CAS  Google Scholar 

  • Royall D, Greenberg G, Allard J, Baker J, Harrison J, Jeejeebhoy K . 1994 Critical assessment of body-composition measurements in malnourished subjects with Crohn's disease: the role of bioelectric impedance analysis Am. J. Clin. Nutr. 59: 325–330

    Article  CAS  Google Scholar 

  • Schoeller D . 1992 Isotope dilution methods In Obesity ed. B Björntorp & B Brodoff pp 80–88 New York: Lippingcott

    Google Scholar 

  • Van Loan MD, Mayclin PL . 1992 Use of multi-frequency bioelectrical impedance analysis for the estimation of extracellular fluid Eur. J. Clin. Nutr. 46: 117–124

    CAS  PubMed  Google Scholar 

  • Van Marken Lichtenbelt WD, Westerterp KR, Wouters L, Luijendijk SC . 1994 Validation of bioelectrical-impedance measurements as a method to estimate body-water compartments Am. J. Clin. Nutr. 60: 159–166

    Article  CAS  Google Scholar 

  • Wang Z, Deurenberg P, Wang W, Pietrobelli A, Baumgartner RN, Heymsfield S . 1999a Hydration of fat-free body mass: new physiological modeling approach Am. J. Physiol. 276: (Endocrinol. Metab 39) E995–E1003

    Article  CAS  Google Scholar 

  • Wang Z, Deurenberg P, Wang W, Pietrobelli A, Baumgartner RN, Heymsfield S . 1999b Hydration of fat-free body mass: review and critique of a classic body-composition constant 1–3 Am. J. Clin. Nutr. 69: 833–841

    Article  CAS  Google Scholar 

Download references

Acknowledgements

This investigation was supported by grants from the Swedish Medical Research Council (17X-03117), Göteborgs Läkarsällskap, and IB och A Lundbergs Forskningsstiftelse. Mr NG Carlsson, who is gratefully acknowledged, performed the bromide analyses.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to E Carlsson.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Carlsson, E., Bosaeus, I. & Nordgren, S. Body composition in patients with an ileostomy and inflammatory bowel disease: validation of bio-electric impedance spectroscopy (BIS). Eur J Clin Nutr 56, 680–686 (2002). https://doi.org/10.1038/sj.ejcn.1601378

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.ejcn.1601378

Keywords

This article is cited by

Search

Quick links