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Body composition, energy expenditure and physical activity

Comparison of bioimpedance spectroscopy and dual energy X-ray absorptiometry for assessing body composition changes in obese children during weight loss

European Journal of Clinical Nutrition volume 75, pages 73–84 (2021)Cite this article

Subjects

Abstract

Background

Obesity and age influence the reliability of dual energy X-ray absorptiometry scanning (DEXA) and bioimpedance spectroscopy (BIS). Both are used in clinical settings, but have not been compared for measurements in obese children. We compared DEXA and BIS for evaluating body composition and inherent changes in obese children before and after a 10-month weight loss programme.

Methods

DEXA and BIS were used to evaluate 130 patients at baseline and 75 at follow-up. We tested agreement between the two techniques using Bland–Altman plots and proportional bias using Passing–Bablok regressions.

Results

The Bland–Altman plots showed wide agreement limits before and after weight loss and when monitoring longitudinal changes. At baseline, the Passing–Bablok regressions revealed a proportional bias for all body compartments. After significant weight loss no proportional bias was found for fat mass and percentage, although BIS systematically underestimated fat mass by 2.9 kg. Longitudinally, no proportional bias was found in the measured changes of absolute fat, fat-free mass and fat-free percentage between both methods, although BIS systematically underestimated fat and fat-free mass by 2.6 and 0.7 kg, respectively.

Conclusion

While BIS and DEXA are not interchangeable at baseline, the agreement between the two improved after significant weight loss. Proportional changes in fat mass, fat-free mass and fat-free percentage were similar for both techniques. BIS is a viable alternative to DEXA for future paediatric obesity studies measuring treatment effect at group levels, but is not superior to DEXA and cannot be used for monitoring individual changes due to wide limits of agreement.

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Fig. 1: Bland–Altman plots comparing the BCM- and DEXA-derived measurements of the four body compartments before and after treatment.
Fig. 2: Passing–Bablok regressions comparing the BCM- and DEXA-derived measurements of the four body compartments before and after treatment.
Fig. 3

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Acknowledgements

We would like to thank all patients and their parents for participating in our study. Furthermore, we would like to thank our colleagues from ‘Het Zeepreventorium’ and Eddy Basslé specifically for providing us with a venue in which to conduct our measurements.

Funding

This publication was made possible with financial support from the ‘Fonds voor Wetenschappelijk Onderzoek’ (FWO), FWO-TBM project number 150179.

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Author notes

  1. These authors contributed equally: Eline Vermeiren, Marijke Ysebaert

Authors and Affiliations

  1. Laboratory of Experimental Medicine and Paediatrics, University of Antwerp, Universiteitsplein 1, Wilrijk, Belgium

    Eline Vermeiren, Marijke Ysebaert, Kim Van Hoorenbeeck, Luc Bruyndonckx, Kristof Van Dessel, Benedicte De Winter, Stijn Verhulst & Annelies Van Eyck

  2. Department of Paediatrics, University Hospital of Antwerp, Wilrijkstraat 10, Edegem, Belgium

    Kim Van Hoorenbeeck, Stijn Verhulst & Annelies Van Eyck

  3. Department of Endocrinology, University Hospital of Antwerp, Wilrijkstraat 10, Edegem, Belgium

    Kristof Van Dessel

  4. Het Zeepreventorium, Koninklijke Baan 5, De Haan, Belgium

    Maria Van Helvoirt & Ann De Guchtenaere

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Contributions

All authors certify that they have participated in the study and take responsibility for the content. The study was designed by MY, AVE, KVH, SV, BDW, LB, MVH and ADG. Measurements were performed by MY, AVE and EV and the database was made by MY, EV and AVE. Data were analysed by EV, AVE under the supervision of SV, who has a Master’s degree in Statistics. Data interpretation was done by EV, AVE, SV, KVH, BDW and KVD. All authors were involved in the writing of the manuscript.

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Correspondence to Eline Vermeiren.

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The local ethics committee approved this study (EC n°B670201731779).

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Written informed consent was obtained from the patients and their parents or legal guardians.

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Vermeiren, E., Ysebaert, M., Van Hoorenbeeck, K. et al. Comparison of bioimpedance spectroscopy and dual energy X-ray absorptiometry for assessing body composition changes in obese children during weight loss. Eur J Clin Nutr 75, 73–84 (2021). https://doi.org/10.1038/s41430-020-00738-9

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