Configuration of bioelectrical impedance measurements affects results for phase angle

Jensen, B.; Braun, Wiebke; Both, Markus; Gallagher, Dympna; Clark, Patricia; González, Desirée López; Klückmann, Kristin; Bosy‐Westphal, Anja

doi:10.1016/j.medengphy.2020.07.021

Cited by 19 publications

(10 citation statements)

References 21 publications

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“…These differences in BIA measurement can be explained by different fluid distribution according to the body position. BIA devices in standing position tend to measure lower R and Ζ values than BIA devices in supine position because of hydrostatic pressure reducing venous return and promoting fluid shifts from the blood vessels to the interstitium [19,25,26]. FM% underestimation was indeed observed with BIA devices in standing position compared to DXA [27].…”

Section: Discussionmentioning

confidence: 88%

“…Inaccuracy in subjects with low FM% may also be explained by the difficulty of whole-body BIAs in assessing visceral fat compared to DXA [28,29]. Another reason may be the difference in conduction of the electrodes depending on their type and placement on the body [19,30]. For BIA sup , the self-adhesive disposable electrodes were placed on the wrists and ankles, whereas for BIA std4 and BIA std8 , the stainless plate electrodes were in contact with the palms of the hands and the soles of the feet.…”

Section: Discussionmentioning

confidence: 99%

“…Newly released BIA scales with new algorithms and tetrapolar technologies could therefore facilitate body composition assessment in subjects who are able to stand and without the requirement of another operator. The fluid and electrolyte distribution in the body is however not the same when standing as when lying down [18], so the current does not flow in the same way and does not give the same R, Xc, Ζ and f values [19]. This is why new prediction equations have to be developed for every new BIA device using different technology to give FFM and FM values as close as possible to the true values given by a criterion method.…”

Section: Introductionmentioning

confidence: 99%

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Precision and accuracy of bioelectrical impedance analysis devices in supine versus standing position with or without retractable handle in Caucasian subjects

Hamilton-James

Collet

Pichard

et al. 2021

Clinical Nutrition ESPEN

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Background & aims: Bioelectrical impedance analysis (BIA) could be facilitated in subjects who are able to stand by using scales without (BIA std4 ) or with a retractable handle (BIA std8 ), provided that they are as precise as BIA devices commonly used in the supine position in the hospital setting (BIA sup ). This observational prospective cross-sectional study aimed to compare the precision and accuracy of BIA std4 , BIA std8 and BIA sup in a Caucasian population. Methods: Fat mass percentage (FM%) was measured in 160 healthy Caucasian subjects (80 men/80 women) aged 20e60 years, with a body mass index (BMI) !18.5 and < 30 kg/m 2 , using the HAGRID Body Fat Scales (Huawei Technologies Co., Ltd., China) in BIA std4 or BIA std8 mode, and the Nutriguard-M (Data Input GmbH, Germany) as BIA sup . Intra-unit and inter-unit precisions of each device were evaluated by calculating the coefficients of variation (CV%) of 3 measurements with 3 different units of each device. Inter-device precisions were evaluated with Pearson correlations, BlandeAltman plots, and repeated measures ANOVA followed by post-hoc Bonferroni tests. Accuracy of these BIA devices was estimated in a subgroup of 16 subjects, using comparison with dual-energy X-ray absorptiometry (DXA). Results: The study population was 40 ± 12 years old, with a body height and weight of 171 ± 10 cm and 72.2 ± 11.5 Kg, respectively. All three devices were very precise with intra-unit CV% of 0.5%, 0.9%, and 0.3% and inter-unit CV% of 0.5%, 1.1%, and 0.4% for BIA std4 , BIA std8 and BIA sup , respectively. Inter-device precision was ±2.1% for BIA std4 /BIA sup , ±1.9% for BIA std8 /BIA sup , and ±1.3% for BIA std8 /BIA std4 . Bland eAltman plots showed bias ±1.96 SD of 0.3 ± 5.2% for BIA std4 /BIA sup , À0.4 ± 4.5% for BIA std8 /BIA sup and À0.6 ± 3.1% for BIA std8 /BIA std4 . Compared to DXA, all three devices tended to underestimate FM% in men with low BMI, while only BIA std4 and BIA std8 tended to overestimate FM% in women with high BMI. FM% measurement accuracy was ±2.6% for BIA sup /DXA, ±3.3% for BIA std4 /DXA, and ±3.4% for BIA std8 /DXA. Conclusions: Both BIA std4 and BIA std8 show a good intra-and inter-unit precision close to BIA sup , making them suitable for rapid body composition assessment in non-bedridden subjects. However, all these three devices should not be used interchangeably, because BIA std4 and BIA std8 tend to accentuate FM% changes during body composition monitoring compared to BIA sup and DXA. Trial registration: ClinicalTrial.gov no. NCT04504799.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Precision and accuracy of bioelectrical impedance analysis devices in supine versus standing position with or without retractable handle in Caucasian subjects

Hamilton-James

Collet

Pichard

et al. 2021

Clinical Nutrition ESPEN

View full text Add to dashboard Cite

show abstract

“…Although some studies have evaluated the effect of body position using different BIA devices 26,32 , ample evidence suggests that BIA device types are not interchangeable [33][34][35] . Jensen et al 26 used two differing BIA devices in their study and concluded that electrode type explained approximately half of the observed differences in phase angle between body positions when they conducted additional analyses in a cohort of adults. However, this is likely related to the differing electrode positions, in addition to the electrode type (metal vs adhesive).…”

Section: Discussionmentioning

confidence: 99%

“…A recent study evaluated the effect of body position on phase angle in a cohort of 1298 Mexican children and adolescents aged 4 to 20 years 26 . Phase angle was higher when measured supine than standing, with differences between body positions increasing with increased phase angle, age, and height.…”

Section: Discussionmentioning

confidence: 99%

The influence of body position on bioelectrical impedance spectroscopy measurements in young children

Lyons-Reid

Ward

Tint

et al. 2021

Sci Rep

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Bioelectrical impedance techniques are easy to use and portable tools for assessing body composition. While measurements vary according to standing vs supine position in adults, and fasting and bladder voiding have been proposed as additional important influences, these have not been assessed in young children. Therefore, the influence of position, fasting, and voiding on bioimpedance measurements was examined in children. Bioimpedance measurements (ImpediMed SFB7) were made in 50 children (3.38 years). Measurements were made when supine and twice when standing (immediately on standing and after four minutes). Impedance and body composition were compared between positions, and the effect of fasting and voiding was assessed. Impedance varied between positions, but body composition parameters other than fat mass (total body water, intra- and extra-cellular water, fat-free mass) differed by less than 5%. There were no differences according to time of last meal or void. Equations were developed to allow standing measurements of fat mass to be combined with supine measurements. In early childhood, it can be difficult to meet requirements for fasting, voiding, and lying supine prior to measurement. This study provides evidence to enable standing and supine bioimpedance measurements to be combined in cohorts of young children.

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Fat and fat‐free mass measurement agreement by dual‐energy X‐ray absorptiometry versus bioelectrical impedance analysis: Effects of posture and waist circumference

Ellison,

Ehrlicher,

El Zein

et al. 2024

Obesity Science & Practice

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BackgroundBioelectrical impedance analysis (BIA) operates under the assumption that the conductor has a uniform cylindrical shape. However, this assumption may be violated if measures are taken in the seated position, especially in people with a high waist circumference (WC).AimsThe aims of this research were to determine whether posture (supine, standing, and seated) and WC affect agreement between BIA and dual‐energy X‐ray absorptiometry (DXA) measures of fat mass (FM) and fat‐free mass (FFM).Materials & MethodsBaseline data were collected from 28 adults (mean = 61.4 ± 6.9 years, 64.3% female) with obesity (BMI 38.6 ± 5.0 kg/m2). Body composition was measured using BIA in the supine, standing, and seated positions and by DXA while supine. Intraclass correlation coefficient (ICC) analyses with two‐way mixed effects and absolute agreement were performed to determine agreement.ResultsPoint estimates were excellent for FM and FFM while supine, excellent for FM and good for FFM while standing, and moderate for FM and good for FFM while seated. BIA measures in the supine position resulted in the narrowest 95% confidence intervals compared with other positions. Better agreement was observed across all positions in participants with a WC below the median (118.3 cm).DiscussionDespite the potential pragmatic value of measuring with BIA in a seated position, the results of this analysis demonstrate the poorest agreement between DXA and BIA methods, especially in individuals with high WC.ConclusionFindings from this study demonstrate that BIA, particularly when measured in a supine position, can serve as a viable alternative to DXA for measuring body composition in people with obesity.

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Configuration of bioelectrical impedance measurements affects results for phase angle

Cited by 19 publications

References 21 publications

Precision and accuracy of bioelectrical impedance analysis devices in supine versus standing position with or without retractable handle in Caucasian subjects

Precision and accuracy of bioelectrical impedance analysis devices in supine versus standing position with or without retractable handle in Caucasian subjects

The influence of body position on bioelectrical impedance spectroscopy measurements in young children

Fat and fat‐free mass measurement agreement by dual‐energy X‐ray absorptiometry versus bioelectrical impedance analysis: Effects of posture and waist circumference

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