Single- and multi-frequency bioelectrical impedance analyses to analyse body composition in maintenance haemodialysis patients: comparison with dual-energy x-ray absorptiometry

Donadio, Carlo; Halim, Amir; Caprio, Francesca; Grassi, G; Khedr, B; Mazzantini, M

doi:10.1088/0967-3334/29/6/s43

Cited by 50 publications

(57 citation statements)

References 13 publications

(13 reference statements)

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“…As the reference test of body composition in the substudy of 118 subjects, DEXA was performed with a Hologic Series Delphi-A Fan Beam x-ray Bone Densitometer with software version 12.4 (Hologic, Bedford, MA), with participants wearing a hospital gown with no metal snaps and all artifacts removed (27)(28)(29). Participants were lying supine on the table, centered in the scan field with arms at their sides, palms down, and thighs separated.…”

Section: Dual Energy X-ray Absorptiometrymentioning

confidence: 99%

Mid-Arm Muscle Circumference and Quality of Life and Survival in Maintenance Hemodialysis Patients

Noori¹,

Kopple²,

Kövesdy³

et al. 2010

Clinical Journal of the American Society of Nephrology

277

198

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Background and objectives: Maintenance hemodialysis (MHD) patients with larger body or fat mass have greater survival than normal to low mass. We hypothesized that mid-arm muscle circumference (MAMC), a conveniently measured surrogate of lean body mass (LBM), has stronger association with clinical outcomes than triceps skinfold (TSF), a surrogate of fat mass.Design, settings, participants, & measurements: The associations of TSF, MAMC, and serum creatinine, another LBM surrogate, with baseline short form 36 quality-of-life scores and 5-year survival were examined in 792 MHD patients. In a randomly selected subsample of 118 subjects, LBM was measured by dual-energy x-ray absorptiometry.Results: Dual-energy x-ray absorptiometry-assessed LBM correlated most strongly with MAMC and serum creatinine. Higher MAMC was associated with better short form 36 mental health scale and lower death hazard ratios (HRs) after adjustment for case-mix, malnutrition-inflammation-cachexia syndrome, and inflammatory markers. Adjusted death HRs were 1.00, 0.86, 0.69, and 0.63 for the first to fourth MAMC quartiles, respectively. Higher serum creatinine and TSF were also associated with lower death HRs, but these associations were mitigated after multivariate adjustments. Using median values of TSF and MAMC to dichotomize, combined high MAMC with either high or low TSF (compared with low MAMC/TSF) exhibited the greatest survival, i.e., death HRs of 0.52 and 0.59, respectively.Conclusions: Higher MAMC is a surrogate of larger LBM and an independent predictor of better mental health and greater survival in MHD patients. Sarcopenia-correcting interventions to improve clinical outcomes in this patient population warrant controlled trials.

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Section: Dual Energy X-ray Absorptiometrymentioning

confidence: 99%

Mid-Arm Muscle Circumference and Quality of Life and Survival in Maintenance Hemodialysis Patients

Noori¹,

Kopple²,

Kövesdy³

et al. 2010

Clinical Journal of the American Society of Nephrology

277

198

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“…Dual-energy X-ray absorptiometry (DEXA) is considered the gold-standard method to measure body composition in hemodialysis patients (17)(18)(19)(20). In this study we performed an assessment of body composition using a Lunar iDEXA machine, encore 2007, v.11.40.004 (General Electric, Madison, WI) and GE Lunar Body Composition Software.…”

Section: Body Composition By Dual-energy X-ray Absorptiometrymentioning

confidence: 99%

“…Subjects were required to remain still on the DEXA bed in the supine position for approximately 6 to 10 minutes until the whole body scan was completed. We here provide standard measurements as previously reported (17)(18)(19)(20): whole body total fat mass, total fat mass percentage, and whole body lean body mass. The Lunar iDEXA also reports by body regions.…”

Section: Body Composition By Dual-energy X-ray Absorptiometrymentioning

confidence: 99%

A Comparison of Novel and Commonly-Used Indices of Insulin Sensitivity in African American Chronic Hemodialysis Patients

Hung

Sundell

Egbert

et al. 2011

Clinical Journal of the American Society of Nephrology

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SummaryBackground Insulin resistance (IR) is highly prevalent in chronic hemodialysis (CHD) patients and is associated with poor cardiovascular outcomes. Hyperinsulinemic euglycemic glucose clamp (HEGC) is the gold standard for measuring IR. The comparison of commonly-used indirect indices of IR to HEGC has not been adequately performed in this population. Furthermore, the validity of newly proposed adipokine-based IR indices has not been explored. Design, setting, participants, & measurementsThis is an observational study performed in a single center, involving 12 prevalent CHD patients (50 Ϯ 9 years old, 100% African American, 33% women, body mass index of 34.4 Ϯ 7.6 kg/m 2 ) who were studied three consecutive times. IR was assessed by HEGC (glucosedisposal rate [GDR]), homeostatic model assessment of IR (HOMA-IR), HOMA-IR corrected by adiponectin (HOMA-AD), leptin adiponectin ratio (LAR), QUICKI, and the McAuley's index at each time point.Results Eighty-three percent of the subjects displayed either glucose intolerance or overt insulin resistance by HEGC (GDR median, 5.71; interquartile range [IQR], 4.16, 6.81). LAR and HOMA-AD were the best correlates of IR measured by HEGC (r ϭ Ϫ0.72, P Ͻ 0.001, and Ϫ0.67, P Ͻ 0.001), respectively. Fat percentage, interleukin-6, and adipokines (leptin, adiponectin, and resistin) were strongly associated with GDR. HEGC, LAR, and HOMA-AD had the best intraclass correlation coefficients.Conclusion IR is common in CHD patients. Adipokine-based indices are the best correlates of IR measurements by HEGC. HOMA-IR and QUICKI are reasonable alternatives. Use of these indices may allow better detection of alterations in insulin sensitivity in CHD patients.

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“…These studies used bioelectrical impedance analysis [6] or skin fold thickness [11] and did not observe significant changes in body composition. Dual energy X-ray absorptiometry (DEXA), which is considered as the reference method because of its high accuracy [12,13], has not been used to study changes in body composition after the transition to NHD.…”

Section: Introductionmentioning

confidence: 99%

Effect of Nocturnal Haemodialysis on Body Composition

Ipema¹,

Westerhuis²,

Schans³

et al. 2014

Nephron Clin Pract

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Background: Haemodialysis patients have a high risk of malnutrition which is associated with increased mortality. Nocturnal haemodialysis (NHD) is associated with a significant increase in protein intake compared with conventional haemodialysis (CHD). It is unclear whether this leads to improved nutritional status. Therefore, we studied whether 1 year of NHD is associated with a change in body composition. Methods: Whole-body composition using dual-energy X-ray absorptiometry (DEXA) and normalised protein catabolic rate (nPCR) were measured in 11 adult patients before and 1 year after the transition from CHD (12 h dialysis/week) to NHD (28-48 h dialysis/week). Similar measurements were performed in a matched control group of 13 patients who stayed on CHD. Differences between groups were analysed with linear mixed models. Results: At baseline, nPCR, total mass, fat-free mass, and fat mass did not differ significantly between the CHD and NHD groups. nPCR increased in the NHD group (from 0.96 ± 0.23 to 1.12 ± 0.20 g/kg/day; p = 0.027) whereas it was stable in the CHD group (0.93 ± 0.21 at baseline and 0.87 ± 0.09 g/kg/day at 1 year, n.s.). The change in nPCR differed significantly between the two groups (p = 0.027). We observed no significant differences in the course of total mass, fat-free mass, and fat mass during the 1-year observation period between the NHD and CHD groups. Conclusions: One year of NHD had no significant effect on body composition in comparison with CHD, despite a significantly higher protein intake in patients on NHD.

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Single- and multi-frequency bioelectrical impedance analyses to analyse body composition in maintenance haemodialysis patients: comparison with dual-energy x-ray absorptiometry

Cited by 50 publications

References 13 publications

Mid-Arm Muscle Circumference and Quality of Life and Survival in Maintenance Hemodialysis Patients

Mid-Arm Muscle Circumference and Quality of Life and Survival in Maintenance Hemodialysis Patients

A Comparison of Novel and Commonly-Used Indices of Insulin Sensitivity in African American Chronic Hemodialysis Patients

Effect of Nocturnal Haemodialysis on Body Composition

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