The Validity of Bioelectrical Impedance Models in Clinical Populations

Nutrition in Clinical Practice - Tập 19 Số 5 - Trang 433-446 - 2004
Andrea C. Buchholz1, Cynthia Bartok1, Dale A. Schoeller1
1Department of Nutritional Sciences, University of Wisconsin, Madison

Tóm tắt

Bioelectrical impedance analysis (BIA) is the most commonly used body composition technique in published studies. Herein we review the theory and assumptions underlying the various BIA and bioelectrical impedance spectroscopy (BIS) models, because these assumptions may be invalidated in clinical populations. Single‐frequency serial BIA and discrete multifrequency BIA may be of limited validity in populations other than healthy, young, euvolemic adults. Both models inaccurately predict total body water (TBW) and extracellular water (ECW) in populations with changes in trunk geometry or fluid compartmentalization, especially at the level of the individual. Single‐frequency parallel BIA may predict body composition with greater accuracy than the serial model. Hand‐to‐hand and leg‐to‐leg BIA models do not accurately predict percent fat mass. BIS may predict ECW, but not TBW, more accurately than single‐frequency BIA. Segmental BIS appears to be sensitive to fluid accumulation in the trunk. In general, bioelectrical impedance technology may be acceptable for determining body composition of groups and for monitoring changes in body composition within individuals over time. Use of the technology to make single measurements in individual patients, however, is not recommended. This has implications in clinical settings, in which measurement of individual patients is important.

Từ khóa


Tài liệu tham khảo

10.1016/S0899-9007(96)00316-4

Baumgartner RN, 1996, Electrical Impedance and Total Body Electrical Conductivity, 79

Kushner RF, 1992, Bioelectrical impedance analysis: a review ofprinciples and applications, J Am Coll Nutr., 11, 199, 10.1080/07315724.1992.12098245

10.1152/jappl.1998.85.3.1056

Lukaski HC, 1996, Biological indexes considered in the derivation of thebioelectrical impedance analysis, Am J Clin Nutr., 64, 397S, 10.1093/ajcn/64.3.397S

Nyboer J, 1959, Electrical Impedance Plethysmography: The Electrical Resistive Measure of the Blood Pulse Volume

10.1152/jappl.1969.27.4.531

Foster KR, 1996, Whole‐body impedance: what does it measure?, Am J Clin Nutr., 64, 388S, 10.1093/ajcn/64.3.388S

10.1152/jappl.1999.87.3.1087

10.1152/physrev.2000.80.2.649

Anonymous, 1994, Bioelectrical Impedance Analysis in Body Composition Measurement: NIH Technology Assessment Conference

Buban P, 1975, Understanding Electricity and Electrons, 43

10.1152/jappl.1997.82.5.1542

Gudivaka R, 1994, Effect ofbody position, electrode placement, and time on prediction of total body waterby multifrequency bioelectrical impedance analysis, Age Nutr., 5, 111

10.1002/hep.1840140626

10.1016/S0899-9007(00)00473-1

10.1053/jhep.2000.20524

Zillikens MC, 1992, Whole‐body andsegmental bioelectrical‐impedance analysis in patients with cirrhosis of theliver: changes after treatment of ascites, Am J Clin Nutr., 55, 621, 10.1093/ajcn/55.3.621

10.1093/ajcn/50.2.255

van der Kooy K, 1992, Changes in fat‐free mass in obese subjects after weight loss: acomparison of body composition measures, Int J Obes Relat Metab Disord., 16, 675

10.1097/00005768-199907000-00023

10.1038/sj.ejcn.1601184

10.1093/ajcn/52.2.219

Deurenberg P, 1991, Sex and age specific prediction formulas for estimating body composition frombioelectrical impedance: a cross‐validation study, Int JObes., 15, 17

10.1093/ajcn/59.3.578

10.1016/S0140-6736(86)90837-8

10.1016/0022-4804(91)90025-H

10.1152/jappl.1994.77.1.98

10.1093/ajcn/50.2.221

10.1152/japplphysiol.00721.2002

10.1111/j.1749-6632.2000.tb06440.x

Bracco D, 1996, Segmental body composition assessed by bioelectrical impedance analysis and DEXA in humans, J Appl Physiol., 81, 2580, 10.1152/jappl.1996.81.6.2580

10.1038/sj.ijo.0801989

10.1038/sj.ejcn.1601643

Schloerb PR, 1996, Bioelectricalimpedance in the clinical evaluation of liver disease, Am J Clin Nutr., 64, 510S, 10.1093/ajcn/64.3.510S

10.1016/S0969-8043(97)00058-4

Klahr S, 1996, Renal Disease: Present Knowledge in Nutrition, 464

10.1093/ajcn/63.1.80

Chertow GM, 1995, Nutritional assessmentwith bioelectrical impedance analysis in maintenance hemodialysis patients, J Am Soc Nephrol., 6, 75, 10.1681/ASN.V6175

10.1080/07315724.1993.10718285

10.1093/ndt/18.1.101

10.1111/j.1753-4887.1988.tb05386.x

Visser M, 1995, Multi‐frequencybioelectrical impedance for assessing total body water and extracellular waterin elderly subjects, Eur J Clin Nutr., 49, 256

10.1093/ajcn/59.2.325

10.1016/S0003-9993(02)04950-X

10.1177/106002809502901103

10.1016/S0022-3476(96)70031-8

Pace N, 1945, Studies on body composition III: the body waterand chemically combined nitrogen content in relation to fat content, J Biol Chem., 158, 685

10.1093/ajcn/35.5.1169

10.1093/ajcn/73.4.687

10.1152/ajpendo.1985.249.2.E227

10.1038/sj.ejcn.1601254

10.1046/j.1440-6047.2002.00258.x

10.1016/S0899-9007(03)00166-7

10.1111/j.1651-2227.2000.tb00385.x

10.1017/S0007114500000155

10.1079/BJN2003983

10.1136/adc.85.3.263

10.1016/S1440-2440(03)80271-2

10.1007/978-1-4612-4654-1

10.1093/ajcn/64.3.489S

10.1210/jc.82.10.3349

10.1016/0960-8966(95)00015-1

10.1054/clnu.1999.0122

10.1038/sj.ijo.0800622

Olde Rikkert MG, 1997, Validation of multifrequency bioelectrical impedance analysis inmonitoring fluid balance in healthy elderly subjects, J Gerontol ABiol Sci Med Sci., 52, M137

10.1093/gerona/56.6.M344

10.1159/000177868

10.1079/BJN19960039

Deurenberg P, 1992, Loss of total body water andextracellular water assessed by multifrequency impedance, Eur JClin Nutr., 46, 247

Bedogni G, 1996, Altered body waterdistribution in subjects with juvenile rheumatoid arthritis and its effects onthe measurement of water compartments from bioelectric impedance, Eur J Clin Nutr., 50, 335

10.1093/ajcn/72.3.780

10.1159/000177748

10.1093/ajcn/60.2.159

10.1097/00005768-199910000-00017

10.1249/01.MSS.0000106855.47276.CD

10.1046/j.1523-1755.2000.00815.x

Hanai T, 1968, Electrical Properties of Emulsions. Emulsion Science, 354

Matthie JR, 1995, Impedance measurements of body‐watercompartments, Am J Clin Nutr., 61, 1167, 10.1093/ajcn/61.5.1167

10.1038/sj.ijo.0801123

10.1177/0148607102026002120

10.1177/106002809402800501

Van Loan MD, 1992, Use of Bioimpedance Spectroscopy to Determine Extracellular Fluid, Intracellular Fluid, Total Body Water, and Fat‐Free Mass: Human Body Composition: In Vivo Methods, Models and Assessment, 67

10.1097/00005768-199712000-00017

10.1080/03014469600004252

10.1038/ki.1994.416

10.1097/00003246-199803000-00017

10.1210/jcem.82.3.3833

10.1093/ajcn/78.6.1111

10.1054/clnu.1999.0078

10.1016/S0899-9007(98)00105-1

10.1016/S0969-8043(97)00060-2

10.1097/00003246-199611000-00011

10.1053/ajkd.2001.27703

10.1111/j.1749-6632.2000.tb06441.x

10.1111/j.1749-6632.2000.tb06451.x

10.1016/S0899-9007(99)00147-1

Oldham NM, 1996, Overview of bioelectrical impedance analyzers, Am J Clin Nutr., 64, 405S, 10.1093/ajcn/64.3.405S

10.2165/00007256-200232150-00001

10.1097/00042560-199505010-00003

Fein PA, 2002, Usefulness of bioelectrical impedance analysis in monitoring nutritionstatus and survival of peritoneal dialysis patients, Adv Perit Dial., 18, 195