Prediction of body composition in anorexia nervosa: Results from a retrospective study

Marra, Maurizio; Sammarco, Rosa; Filippo, E. De; Caldara, A.; Speranza, E.; Scalfi, Luca; Contaldo, Franco; Pasanisi, Fabrizio

doi:10.1016/j.clnu.2017.07.016

Cited by 21 publications

(16 citation statements)

References 23 publications

(21 reference statements)

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“…However, DXA is not routinely used in clinical practice, contrary to BIA [ 13 , 34 ] whereas no widely disease-specific equation has been accepted for the estimation of body composition in these AN patients. Recently, Marra et al assessed the accuracy of selected BIA equations [ 35 , 36 ] for FFM estimation in 82 female patients with AN and reported that all predictive equations underestimated FFM, while the percentage of accurate predictions varied from 12.2% to 35.4% [ 25 ]. Interestingly, in this recent study, predictive formulas based on body weight and BIA parameters such as RI (resistance index) and ZI100 (impedance index at 100 kHz) offered a rather accurate prediction of FFM (with high resistance squared) than that observed with anthropometric characteristics only.…”

Section: Discussionmentioning

confidence: 99%

Comparison of body composition assessment by DXA and BIA according to the body mass index: A retrospective study on 3655 measures

et al. 2018

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Background and aimsBody composition assessment is often used in clinical practice for nutritional evaluation and monitoring. The standard method, dual-energy X-ray absorptiometry (DXA), is hardly feasible in routine clinical practice contrary to Bioelectrical Impedance Analysis (BIA) method. We thus aimed to compare body composition assessment by DXA and BIA according to the body mass index (BMI) in a large cohort.MethodsRetrospectively, we analysed DXA and BIA measures in patients followed in a Nutrition Unit from 2010 to 2016. Body composition was assessed under standardized conditions in the morning, after a fasting period of 12 h, by DXA (Lunar Prodigy Advance) and BIA (Bodystat QuadScan 4000, Manufacturer’s equation). Bland-Altman test was performed for each class of BMI (kg/m2) and fat mass and fat free mass values were compared using Kruskal-Wallis test. Pearson correlations were also performed and the concordance coefficient of Lin was calculated.ResultsWhatever the BMI, BIA and DXA methods reported higher concordance for values of FM than FFM. Body composition values were very closed for patients with BMI between 16 and 18,5 (difference < 1kg). For BMI > 18,5 and BMI < 40, BIA overestimated fat free mass from 3,38 to 8,28 kg, and underestimated fat mass from 2,51 to 5,67 kg compared with DXA method. For BMI ≥ 40, differences vary with BMI. For BMI < 16, BIA underestimated fat free mass by 2,25 kg, and overestimated fat mass by 2,57 kg. However, limits of agreement were very large either for FM and FFM values, irrespective of BMI.ConclusionThe small bias, particularly in patients with BMI between 16 and 18, suggests that BIA and DXA methods are interchangeable at a population level. However, concordance between BIA and DXA methods at the individual level is lacking, irrespective of BMI.

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Section: Discussionmentioning

confidence: 99%

Comparison of body composition assessment by DXA and BIA according to the body mass index: A retrospective study on 3655 measures

et al. 2018

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“…Moreover, BIA may not be the ideal BC assessment tool for severe grade AN 40 , but several studies 1,41,42 found it to be appropriate in mild-to-AN clinics.…”

Section: Limitationsmentioning

confidence: 99%

Body composition and resting energy expenditure in women with anorexia nervosa: Is hyperactivity a protecting factor?

Manuelli

Blundell

Biino

et al. 2019

Clinical Nutrition ESPEN

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Background. In subjects with anorexia nervosa (AN) physical exercise may cause or even prevent weight loss, body composition alterations and adaptive thermogenesis. To investigate the influence of behavioral patterns on body composition and energy expenditure in women with AN, we conducted a retrospective analysis in 62 patients with AN referring to Materials and Methods. We assessed anthropometric measurement of weight, height, and BMI; body composition was assessed by bioelectrical impedance analysis; resting energy expenditure was P evaluation. Results. The subjects were both restricting type (ANR, n=39) and binge-eating/purging type (ANBP, n=23) according to DSM-5. We observed a lower reactance (58.63 (11.9) vs. 66.5 (15.5) Ohm, p < 0.05) and higher total body water in ANR subjects. No differences were found in phase angle, fat mass or fat-free mass, nor in REE measures. Within ANR subgroup, we identified two behavioral patterns, with or without physical hyperactivity. Compared to dieting and fasting subjects, hyperactive subjects showed higher phase angle [5.

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“…Finally, comparison of BC assessment by DXA and BIA in obese patients has been poorly documented. A few studies have shown good concordance between the two methods [ 39 , 40 ] while many others have not [ 15 , 17 , 41 , 42 , 43 , 44 , 45 , 46 ]. These conflicting results may probably be due to some limiting factors including the use of different BIA devices with different manufacturer equations, a small population size, and the differences in age, ethnicity and body weights in the sample studied.…”

Section: Strengths and Limitationsmentioning

confidence: 99%

Validity of Predictive Equations for Resting Energy Expenditure Developed for Obese Patients: Impact of Body Composition Method

et al. 2018

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Predictive equations have been specifically developed for obese patients to estimate resting energy expenditure (REE). Body composition (BC) assessment is needed for some of these equations. We assessed the impact of BC methods on the accuracy of specific predictive equations developed in obese patients. REE was measured (mREE) by indirect calorimetry and BC assessed by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA). mREE, percentages of prediction accuracy (±10% of mREE) were compared. Predictive equations were studied in 2588 obese patients. Mean mREE was 1788 ± 6.3 kcal/24 h. Only the Müller (BIA) and Harris & Benedict (HB) equations provided REE with no difference from mREE. The Huang, Müller, Horie-Waitzberg, and HB formulas provided a higher accurate prediction (>60% of cases). The use of BIA provided better predictions of REE than DXA for the Huang and Müller equations. Inversely, the Horie-Waitzberg and Lazzer formulas provided a higher accuracy using DXA. Accuracy decreased when applied to patients with BMI ≥ 40, except for the Horie-Waitzberg and Lazzer (DXA) formulas. Müller equations based on BIA provided a marked improvement of REE prediction accuracy than equations not based on BC. The interest of BC to improve REE predictive equations accuracy in obese patients should be confirmed.

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Prediction of body composition in anorexia nervosa: Results from a retrospective study

Cited by 21 publications

References 23 publications

Comparison of body composition assessment by DXA and BIA according to the body mass index: A retrospective study on 3655 measures

Comparison of body composition assessment by DXA and BIA according to the body mass index: A retrospective study on 3655 measures

Body composition and resting energy expenditure in women with anorexia nervosa: Is hyperactivity a protecting factor?

Validity of Predictive Equations for Resting Energy Expenditure Developed for Obese Patients: Impact of Body Composition Method

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