Waist Circumference Measured by Bioelectrical Impedance Analysis Is Interchangeable with Manual Measurement: Increased Waist Circumference Is Associated with Locomotive Syndrome Risk

Abstract

Objectives The importance of preventive medicine in an aging society is increasing. Locomotive syndrome (LS) is attracting increasing attention. Recently, advances in bioelectrical impedance analysis (BIA) devices have made it possible to automatically measure waist circumference (WC). Nevertheless, there have been no reports evaluating the agreement or interchangeability between WC measured manually and using BIA. Therefore, we aimed to perform these analyses in the context of health checkups and investigated the associations with LS risk. Methods We enrolled 597 participants who underwent the following: two-step tests and stand-up tests; evaluations using a 25-question geriatric locomotive function scale for the LS risk test; anthropometric marker measurements including WC measured by manual and BIA; and measurements of total cholesterol and triglycerides. We used Bland–Altman analysis to calculate agreement and interchangeability of the WC measurement using BIA and the manual method. A statistical comparative study was then conducted between normal and LS risk groups. Subsequently, significant risk factors for LS were investigated using multivariate analysis. Results The Bland–Altman analysis showed that bias (BIA-manual) was negative overall (−2.024), for males (−1.418) and for females (−2.460), suggesting underestimation using BIA compared with manual measurements. Interchangeability was found between WC measurement by BIA and by manual methods, because the percentage error was less than 15% overall (12.3%), for males (10.2%) and for females (13.8%). Univariate analysis showed that WC was significantly higher in the LS risk group than in the normal group. Multivariate analysis adjusted for confounding factors showed that increase in WC significantly correlated with LS risk. Conclusions BIA and manual methods for measuring WC are interchangeable. The increase in WC measured by BIA was significantly associated with LS risk. It is important to continue focusing on increased WC and early detection of LS risk.

Bioelectrical Impedance Analysis and Manual Measurements of Neck Circumference Are Interchangeable, and Declining Neck Circumference Is Related to Presarcopenia

“…Through BIA, we collected anthropometric data: weight, body mass index (BMI), percentage of body fat (PBF), appendicular skeletal muscle index (aSMI) to represent muscle mass, and NC. We used the InBody 770 body composition and body water analyzer (InBody, Seoul, Republic of Korea), a BIA unit, to differentiate tissues (such as fat, muscle, and bone) according to their electrical impedance [ 12 , 13 ]. Measurements by this device in various contexts have been reported to be accurate [ 21 , 22 ].…”

“…We analyzed venous blood samples from each participant for levels of albumin (a marker of nutritional status), total cholesterol and triglycerides (which can indicate the presence of metabolic syndrome), and C-reactive protein (a marker of inflammation). Biochemical analyses of the blood samples were performed with the use of an autoanalyzer (JCA-RX20; Nihon Denshi, Tokyo, Japan) [ 12 , 13 ].…”

“…To interpret Spearman correlations, cutoff values of less than 0.20 were considered very weak; 0.20 to 0.39, as weak; 0.40 to 0.59, as moderate; 0.60 to 0.79, as strong; and 0.80 to 1.0, as very strong [ 26 , 30 ]. To interpret the ICC, cutoff values of less than 0.20 were considered slight; 0.20 to 0.39, as fair; 0.40 to 0.59, as moderate; 0.60 to 0.79, as substantial; and 0.80 to 1.0, as almost perfect [ 12 ]. To examine the level of agreement between the manual and BIA measurements, we used the Bland-Altman analysis [ 12 ].…”

“…To interpret the ICC, cutoff values of less than 0.20 were considered slight; 0.20 to 0.39, as fair; 0.40 to 0.59, as moderate; 0.60 to 0.79, as substantial; and 0.80 to 1.0, as almost perfect [ 12 ]. To examine the level of agreement between the manual and BIA measurements, we used the Bland-Altman analysis [ 12 ]. The mean of the difference between measurements (BIA versus manual) was defined as bias, and SD was also used to calculate 95% confidence limits of agreement (bias: ±1.96 SD).…”

“…Bioelectrical impedance analysis (BIA), a method of easily measuring water content and body fat mass, is commonly performed during general medical examinations [ 12 , 13 ]. Recent advances in BIA devices have enabled clinicians to quickly estimate not only NC but also the circumferences of the chest, abdomen, and hips [ 14 ].…”