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Phenotyping in clinical nutrition

Comparison of body composition assessment across body mass index categories by two multifrequency bioelectrical impedance analysis devices and dual-energy X-ray absorptiometry in clinical settings

Abstract

Background

InBody-770 and SECA mBCA 515 are multifrequency bioelectrical impedance analysis (BIA) devices, which are commonly used in the clinic to assess fat-free mass (FFM) and body fat (BF). However, the accuracy between devices in clinical settings, across different body mass index (BMI) groups remains unclear.

Methods

Body composition for 226 participants (51% men, aged 18–80 years, BMI 18–56 kg/m²) was assessed by two commercial multifrequency BIA devices requiring standing position and using eight-contact electrodes, InBody 770 and SECA mBCA 515, and compared to results from dual-energy X-ray absorptiometry (DXA). Measurements were performed in a random order, after a 3 h fast and no prior exercise. Lin’s-concordance correlation and Bland–Altman analyses were used to compare between devices, and linear regression to assess accuracy in BF% across BMI groups.

Results

We found strong correlation between DXA results for study population BF% and those obtained by InBody (ρc = 0.922, 95% confidence interval (CI) 0.902, 0.938) and DXA and SECA (ρc = 0.940, CI 0.923, 0.935), with 95% limits of agreements between 2.6 and −8.9, and 7.1 and −7.6, respectively. BF% assessment by SECA was similar to DXA (−0.3%, p = 0.267), and underestimated by InBody (−3.1%, p < 0.0001). InBody deviations were largest among normal weight people and decreased with increasing BMI group, while SECA measurements remained unaffected.

Conclusions

Both BIA devices agreed well with BF% assessment obtained by DXA. Unlike SECA, InBody underestimated BF% in both genders and was influenced by BMI categories. Therefore, in clinical settings, individual assessment of BF% should be taken with caution.

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Fig. 1: Comparison of body fat between multifrequency bioelectrical impedance analysis (BIA) devices with DXA.
Fig. 2: Blant–Altman analysis for BF% differences from DXA, for both InBody and SECA.
Fig. 3: Distribution of absolute differences of BF% obtained by InBody () and SECA () from DXA.
Fig. 4: Comparison of the absolute difference of BF% obtained by InBody (gray circles) and SECA (gray balls) from DXA, within different clinically used BMI categories.

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Acknowledgements

We would like to thank Tal Sigawy, Registered Dietitian (R.D) for his contribution in data collection and measurements coordination.

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Conceptualization, YL, NG, and YG; methodology, YL and YG; formal analysis, NG; investigation, YL and NG; resources, YL and YG; data curation, YL and NG; writing—original draft preparation, YL, NG, and YG; writing—review and editing, YG; visualization, NG; supervision, YG; project administration, YL.

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Correspondence to Yftach Gepner.

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Lahav, Y., Goldstein, N. & Gepner, Y. Comparison of body composition assessment across body mass index categories by two multifrequency bioelectrical impedance analysis devices and dual-energy X-ray absorptiometry in clinical settings. Eur J Clin Nutr (2021). https://doi.org/10.1038/s41430-020-00839-5

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