Agreement of Single-Frequency Electrical Bioimpedance in the Evaluation of Fat Free Mass and Fat Mass in Peritoneal Dialysis Patients

Reis, Nayrana Soares do Carmo; Vaninni, Francieli Cristina Delatim; Silva, Maryanne Zilli Canedo; Oliveira, Reinaldo Ayer de; Reis, Fabrício Moreira; Costa, Fabíola Medeiros da; Martin, Luís Cuadrado; Barretti, Pasqual

doi:10.3389/fnut.2021.686513

Cited by 4 publications

(6 citation statements)

References 26 publications

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“…However, a recent validation study showed that single‐frequency BIA had good correlation and agreement with dual‐energy X‐ray absorptiometry in patients on dialysis, which was more accurate than multifrequency BIA. 43 Fourth, in the stratification analysis, very few patients were classified in the poor ABI but normal VRI group because endothelial dysfunction usually develops in the early phase of atherosclerosis. 44 Also, there were some overlapped characteristics of vascular indices and endothelial biomarkers we measured ( Table S4 ).…”

Section: Discussionmentioning

confidence: 99%

Association of endothelial dysfunction and peripheral arterial disease with sarcopenia in chronic kidney disease

Hsu,

Wang,

Lai

et al. 2024

J cachexia sarcopenia muscle

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BackgroundEndothelial dysfunction and peripheral arterial disease (PAD), which disturb skeletal muscle microperfusion, are highly prevalent in patients with chronic kidney disease (CKD). We evaluated the association of endothelial dysfunction and PAD with sarcopenia in patients with non‐dialysis CKD.MethodsThis cross‐sectional study included 420 patients with stages 3–5 non‐dialysis CKD aged 69.0 ± 11.8 years. Skeletal muscle index (skeletal muscle mass/height2), handgrip strength, 6‐m gait speed and strength of hip flexion and knee extension were measured. Sarcopenia was defined according to the Asian Working Group for Sarcopenia 2019. Endothelial dysfunction and PAD were assessed using the vascular reactivity index (VRI) and ankle–brachial index (ABI), respectively. A VRI < 1.0 was classified as poor endothelial function, and an ABI < 0.9 was defined as PAD. Additionally, endothelial and inflammatory biomarkers, including intercellular adhesion molecule‐1 (ICAM‐1), vascular cell adhesion molecule‐1 (VCAM‐1), asymmetric dimethylarginine, endothelin‐1 (ET‐1) and interleukin‐6, were measured in a subgroup of 262 patients.ResultsAmong the participants, 103 (24.5%) were classified as having sarcopenia. Compared with patients without sarcopenia, those with sarcopenia had significantly lower ABI (1.04 ± 0.16 vs. 1.08 ± 0.15, P = 0.028 for the right ABI; 1.01 ± 0.16 vs. 1.06 ± 0.16, P = 0.002 for the left ABI) and VRI (0.83 ± 0.57 vs. 1.08 ± 0.56, P < 0.001) and had higher serum levels of ICAM‐1 (P < 0.001), VCAM‐1 (P = 0.003) and ET‐1 (P = 0.037). Multivariate logistic regression revealed that, beyond age and body mass index, the average ABI (odds ratio [OR]: 0.81/0.1 increase; 95% confidence interval [CI]: 0.67–0.98; P = 0.032) and VRI (OR: 0.93/0.1 increase; 95% CI: 0.88–0.98; P = 0.010) were independently associated with sarcopenia. Among the endothelial biomarkers measured, ICAM‐1 (OR: 2.47/1‐SD increase; 95% CI: 1.62–3.75) and VCAM‐1 (OR: 1.91/1‐SD increase; 95% CI: 1.27–2.87) were independent predictors of sarcopenia. Group stratification based on the cut‐offs of VRI and ABI showed that those with both poor VRI and ABI had the greatest risk for sarcopenia (OR: 4.22; 95% CI: 1.69–10.49), compared with those with normal VRI and ABI.ConclusionsEndothelial dysfunction and PAD are independently associated with sarcopenia in patients with stages 3–5 CKD, suggesting the dominant role of vascular dysfunction in sarcopenia.

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Section: Discussionmentioning

confidence: 99%

Association of endothelial dysfunction and peripheral arterial disease with sarcopenia in chronic kidney disease

Hsu,

Wang,

Lai

et al. 2024

J cachexia sarcopenia muscle

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“…Therefore, the assessment of muscle and fat mass by BIS should have a theoretical advantage such that the measurements seemed to be less biased by hydration status. On the other hand, a recent study that compared BIS to DEXA suggested that difference (if any) in body composition measurement between these two modalities had a significant correlation with OH [ 31 ]; but this finding could not be replicated in another study with similar design [ 32 ]. To this end, it is important to recognize that the estimation of LBM by DEXA was in fact strongly influenced by hydration status [ 33 ].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Volume Overload on the Longitudinal Change of Adipose and Lean Tissue Mass in Incident Chinese Peritoneal Dialysis Patients

Chan

Kam

et al. 2022

Nutrients

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Patients treated with peritoneal dialysis (PD) experience complex body composition changes that are not adequately reflected by traditional anthropometric parameters. While lean and adipose tissue mass can be readily assessed by bioimpedance spectroscopy (BIS), there is concern about the potential confounding effect of volume overload on these measurements. This study aimed to assess the influence of fluid status (by echocardiography) on body composition parameters measured by BIS and to describe the longitudinal changes in adipose and lean tissue mass. We conducted a prospective observational study in a tertiary hospital. Incident Chinese PD patients underwent baseline echocardiography and repeated BIS measurements at baseline and 12 months later. Among 101 PD patients, lean tissue index (LTI) or fat tissue index (FTI) was not associated with echocardiographic parameters that reflected left ventricular filling pressure (surrogate of volume status). Sixty-eight patients with repeated BIS had a significant increase in body weight and FTI, while LTI remained similar. Gains in fat mass were significantly associated with muscle wasting (beta = −0.71, p < 0.0001). Moreover, progressive fluid accumulation independently predicted decrease in FTI (beta = −0.35, p < 0.0001) but not LTI. Body composition assessments by BIS were not affected by fluid status and should be considered as part of comprehensive nutrition assessment in PD patients.

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“…Most of the studies demonstrated strong correlations (r > 0.7) between the parameters derived from bioimpedance techniques and those from DEXA in both PD and HD patients [ 48 , 49 , 50 , 51 , 52 , 53 ]. Konings et al were one of the first who compared the body composition parameters measured by MF-BIA and DEXA in 40 Caucasian PD patients [ 48 ].…”

Section: Principles and The Validation Of Bioimpedance In Eskdmentioning

confidence: 99%

“…These findings were confirmed in another study consisting of 50 PD patients, which again showed a good agreement in the FFM between BIS and DEXA. But BIS significantly overestimated FM by an average of 2.5 kg compared with DEXA, which became more pronounced in obese individuals [ 50 ].…”

Section: Principles and The Validation Of Bioimpedance In Eskdmentioning

confidence: 99%

“…Both the LTI and FTI were not associated with E/e’ or LAVi, thus suggesting the bioimpedance-derived nutrition indexes were not biased by volume overload [ 57 ]. When using BIS-derived hydration parameters, the difference in the FFM estimated by DEXA versus the bioimpedance technique were shown to correlate with the OH in some studies [ 49 , 53 ] but not others [ 50 ], and this effect was apparently more obvious in PD patents [ 53 ]. It is, however, crucial to realize that FFM measurement by DEXA itself is also influenced by hydration status [ 59 ].…”

Section: Principles and The Validation Of Bioimpedance In Eskdmentioning

confidence: 99%

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Nutritional Assessments by Bioimpedance Technique in Dialysis Patients

Ng,

Lau,

Chan

et al. 2023

Nutrients

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Bioelectrical impedance analysis (BIA) has been extensively applied in nutritional assessments on the general population, and it is recommended in establishing the diagnosis of malnutrition and sarcopenia. The bioimpedance technique has become a promising modality through which to measure the whole-body composition in dialysis patients, where the presence of subclinical volume overload and sarcopenic obesity may be overlooked by assessing body weight alone. In the past two decades, bioimpedance devices have evolved from applying a single frequency to a range of frequencies (bioimpedance spectroscopy, BIS), in which the latter is incorporated with a three-compartment model that allows for the simultaneous measurement of the volume of overhydration, adipose tissue mass (ATM), and lean tissue mass (LTM). However, clinicians should be aware of common potential limitations, such as the adoption of population-specific prediction equations in some BIA devices. Inherent prediction error does exist in the bioimpedance technique, but the extent to which this error becomes clinically significant remains to be determined. Importantly, reduction in LTM has been associated with increased risk of frailty, hospitalization, and mortality in dialysis patients, whereas the prognostic value of ATM remains debatable. Further studies are needed to determine whether modifications of bioimpedance-derived body composition parameters through nutrition intervention can result in clinical benefits.

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Agreement of Single-Frequency Electrical Bioimpedance in the Evaluation of Fat Free Mass and Fat Mass in Peritoneal Dialysis Patients

Cited by 4 publications

References 26 publications

Association of endothelial dysfunction and peripheral arterial disease with sarcopenia in chronic kidney disease

Association of endothelial dysfunction and peripheral arterial disease with sarcopenia in chronic kidney disease

The Impact of Volume Overload on the Longitudinal Change of Adipose and Lean Tissue Mass in Incident Chinese Peritoneal Dialysis Patients

Nutritional Assessments by Bioimpedance Technique in Dialysis Patients

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