Several guidelines for bioelectrical impedance analysis (BIA) have been prepared for adults, but not for children. For that reason, there is a pressing need to develop a consensus set of guidelines to facilitate standardisation of BIA in this important group. This review provides an introduction to BIA, highlights critical factors that may impact on BIA and identifies areas where there is a need for further research in order to increase the quality of impedance measurements and prediction of body composition in children. Although the results of this review highlights a lack of studies in children to provide definitive BIA guidelines, the technique has, however, still proven valuable for body composition assessment in ill and healthy children. To fill the gaps in our knowledge, future studies should focus on methodological issues, particularly with regard to hydration, voiding, clothing, skin preparation and body position. The review may advantageously be used as a checklist in the planning of future studies. Finally, this review forms the basis for the development of guidelines for BIA assessment in this particular group; a task appropriately to be undertaken by scientific societies within the field.
If the BIA technique should be accepted clinically for routine use in paediatric populations, there is a need for an increased focus on the importance of improved standardisation and its reporting in future studies. Consequently, this review contains recommendations for performing and reporting BIA measurements in a standardised manner.
Measurement of phase angle using bioimpedance analysis (BIA) has become popular as an index of so-called “cellular health”. What precisely is meant by this term is not always clear but strong relationships have been found between cellular water status (the relative amounts of extra- and intracellular water), cell membrane integrity and cellular mass. Much of the current research is empirical observation and frequently pays little regard to the underlying biophysical models that underpin the BIA technique or attempts to provide mechanistic explanations for the observations. This brief review seeks to provide a basic understanding of the electrical models frequently used to describe the passive electrical properties of tissues with particular focus on phase angle. In addition, it draws attention to some practical concerns in the measurement of phase angle and notes the additional understanding that can be gained when phase angle are obtained with bioimpedance spectroscopy (BIS) rather than single frequency BIA (SFBIA) along with the potential for simulation modelling.
Background. Accumulation of extracellular water (ECW) is a major clinical manifestation of nephrotic syndrome (NS) in children. Bioimpedance spectroscopy (BIS) is a simple, noninvasive technique that reflects body water volumes. BIS can further measure cell membrane capacitance (CM), which may be altered in NS. The aims of the study were to explore how BIS measurements could reflect disease status in NS, while avoiding prediction equations which are often only validated in adult populations. Methods. The study involved 8 children (2-10 years) with active NS (ANS group), 5 of which were also studied at NS remission (NSR group), as well as 38 healthy children of similar age (HC group). BIS measurements determined resistances RINF, RE, and RI (reflecting total body water, extracellular water, and intracellular water) and CM. Also resistance indices based on height (H) were considered, RI = H2/R. Results. It was found that RE and RINF were significantly lower in the ANS group than in both NSR and HC groups (p < 0.001). Corresponding resistance indices were significantly higher in the ANS group than in the NSR (p < 0.01) and the HC (p < 0.05) groups, in accordance with elevated water volumes in NS patients. Indices of intracellular water were not significantly different between groups. CM was significantly lower in the ANS group than in NSR and HC groups (p < 0.05). Conclusion. BIS could distinguish children with active NS from well-treated and healthy children. Studies with more children are warranted.
Background Cardiometabolic risk increases with increasing body mass index (BMI). The exact mechanism is poorly understood, and traditional risk assessment of young adults with obesity has shown to be ineffective. Greater knowledge about potential new effective biomarkers and the use of advanced cardiac imaging for risk assessment in young adults is, therefore, necessary. Objective This study aims to explore traditional and novel cardiometabolic risk markers across strata of BMI in young adults. Methods Participants (N = 264, 50% women, age 28–30 years) were invited from an ongoing cohort study, based on BMI and sex. BMI‐strata were: BMI <25, 25–30, >30 kg/m2, representing normal weight (NW), overweight (OW), and obesity (OB). Participants underwent cardiac computed tomography to detect coronary artery calcification, measures of body composition, blood pressure measurements, and a comprehensive panel of circulating cardiometabolic risk markers. Results No significant coronary artery calcifications were detected in this study. Minor differences in median levels of traditional risk markers were detected across BMI‐strata, for example, total cholesterol (men‐ NW: 4.7 (4.3–5.1) and OB: 4.8 (4.2–5.6) mmol/L, p = 0.58; women‐ NW: 4.3 (3.9–4.8) and OB: 4.7 (4.2–5.3) mmol/L, p = 0.016), whereas substantial differences were seen in markers of inflammation and glucose metabolism, for example, high sensitive CRP (men‐ NW: 0.6 (0.3–1.1) and OB: 2.8 (1.5–4.0) mg/L, p < 0.001; women‐ NW: 0.7 (0.3–1.7) and OB: 4.0 (2.2–7.8) mg/L, p < 0.001) and insulin (men‐ NW: 47.0 (35.0–59.0) and OB: 113.5 (72.0–151.0) pmol/L, p < 0.001; women‐ NW: 44.0 (35.0–60.0) and OB: 84.5 (60.0–126.0) pmol/L, p < 0.001). Conclusion In young adults, obesity is associated with an early onset insulin resistance and inflammatory response prior to development of coronary artery calcification and deterioration of lipid profiles.
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