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Bedside methods versus dual energy X‐ray absorptiometry for body composition measurement in COPD

M.C. Steiner, R.L. Barton, S.J. Singh, M.D.L. Morgan
European Respiratory Journal 2002 19: 626-631; DOI: 10.1183/09031936.02.00279602
M.C. Steiner
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R.L. Barton
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S.J. Singh
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M.D.L. Morgan
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  • Fig. 1.—
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    Fig. 1.—

    Intermethod agreement of fat-free mass (FFM) measurement for: a) dual energy X‐ray absorptiometry (DEXA) and bioelectric impedance analysis (BIA) (FFMDEXA - FFMBIA); and b) DEXA and skinfold anthropometry (SFA) (FFMDEXA - FFMSFA). Bland and Altman plots of the differences (Δ) between methods of measuring FFM (▵: females; ▴: males). Mean differences (solid line) and limits of agreement (±2sd; - - -) are shown for the whole population.

  • Fig. 2.—
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    Fig. 2.—

    Intermethod agreement of fat-free mass index (FFMI) measurement for: a) dual energy X‐ray absorptiometry (DEXA) and bioelectric impedance analysis (BIA) (FFMIDEXA - FFMIBIA); and b) DEXA and skinfold anthropometry (SFA) (FFMIDEXA - FFMISFA). Bland and Altman plots of the differences (Δ) between methods of measuring FFMI (▵: females; ▴: males). Mean differences (solid line) and limits of agreement (±2sd; - - -) are shown for the whole population.

  • Fig. 3.—
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    Fig. 3.—

    Sex differences in body composition measurements for: a) fat-free mass (FFM); and b) FFM index (FFMI) (□: total; ┘: males; └: females). Data are presented as mean±sem intermethod difference (Δ). DEXA: dual energy X‐ray absorptiometry; BIA: bioelectric impedance analysis; SFA: skinfold anthropometry. #: p=0.000; ¶: p=0.042; +: p=0.018.

  • Fig. 4.—
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    Fig. 4.—

    Validation of bioelectric impedance analysis as a means of measuring fat-free mass (FFM) against deuterium-dilution (total body water measurement). Data were obtained from a study of 117 chronic obstructive pulmonary disease patients (▪: males; •: females). Sex-specific regression equations for the calculation of FFM from impedance measurements were derived from this study (see Appendix). The regression line for the whole group is shown. (Reproduced with permission from A.M.W. Schols, University of Maastricht, Maastricht, the Netherlands).

Tables

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  • Table 1—

    Baseline patient characteristics

    MalesFemales
    Subjects n5332
    Age yrs67.7±8.465.6±8.7
    Height m1.72±0.071.59±0.06
    Weight kg70.2±13.060.2±10.5
    BMI kg·M−223.7±3.923.7±3.3
    FEV1 L0.91±0.380.84±0.36
    FVC L2.56±0.791.92±0.53
    FEV1 % pred30.9±12.840.6±13.7
    • Data are presented as mean±sd

    • BMI: body mass index

    • FEV1: forced expiratory volume in one second

    • FVC: forced vital capacity

    • % pred: percentage of the predicted value

  • Table 2—

    Fat-free mass (FFM) and FFM index (FFMI) by dual energy X‐ray absorptiometry (DEXA), bioelectric impedance analysis (BIA) and skinfold anthropometry (SFA)

    MalesFemales
    DEXA
    FFM kg50.6±7.636.4±5.0
    FFMI kg·m−217.0±1.914.4±1.4
    Depletion %3672
    BIA
    FFM kg48.8±6.437.5±4.6
    FFMI kg·m−216.5±2.014.8±1.3
    Depletion %4259
    SFA
    FFM kg51.7±6.939.1±5.0
    FFMI kg·m−217.4±1.815.4±1.4
    Depletion %2853
    • Data are presented as mean±sd

    • Patients were considered nutritionally depleted if they had a body mass index of ≤21 or an FFMI of ≤15 (females) or ≤16 (males)

  • Table 3—

    Reproducibility of fat-free mass (FFM) measurements

    Patient characteristicsMean difference*sd#p‐valueICC
    Weight kg0.430.970.0350.997
    FFMDEXA kg−0.171.390.540.991
    FFMBIA kg−0.201.370.480.987
    FFMSFA kg0.021.290.930.99
    • *: calculated by subtracting the first measurement from a second taken 7 weeks later

    • #: of mean difference

    • Significance was tested using paired t‐tests

    • ICC: intraclass correlation coefficient

    • DEXA: dual energy X‐ray absorptiometry

    • BIA: bioelectric impedance analysis

    • SFA: skinfield anthropometry

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Bedside methods versus dual energy X‐ray absorptiometry for body composition measurement in COPD
M.C. Steiner, R.L. Barton, S.J. Singh, M.D.L. Morgan
European Respiratory Journal Apr 2002, 19 (4) 626-631; DOI: 10.1183/09031936.02.00279602

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Bedside methods versus dual energy X‐ray absorptiometry for body composition measurement in COPD
M.C. Steiner, R.L. Barton, S.J. Singh, M.D.L. Morgan
European Respiratory Journal Apr 2002, 19 (4) 626-631; DOI: 10.1183/09031936.02.00279602
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