Performance of bioelectrical impedance analysis compared to dual X-ray absorptiometry (DXA) in Veterans with COPD

Abstract

We examined the performance of a commercially-available handheld bioimpedance (BIA) device relative to dual X-ray absorptiometry (DXA) to assess body composition differences among Veterans with chronic obstructive pulmonary disease (COPD). Body composition was measured using DXA and BIA (Omron HBF-306C) at a single time point. Correlations between BIA- and DXA-assessed percent fat, fat mass, and fat-free mass were analyzed using Spearman (ρ) and Lin Concordance Correlation Coefficients (ρc). Mean differences in fat mass were visualized using Bland-Altman plots. Subgroup analyses by obesity status (BMI < 30 versus ≥ 30) were performed. Among 50 participants (96% male; mean age: 69.5 ± 6.0 years), BIA-assessed fat mass was strongly correlated (ρ = 0.94) and demonstrate excellent concordance (ρc = 0.95, [95%CI: 0.93-0.98]) with DXA, with a mean difference of 2.7 ± 3.2 kg between BIA and DXA. Although Spearman correlations between BIA- and DXA-assessed percent fat and fat-free mass were strong (ρ = 0.8 and 0.91, respectively), concordance values were only moderate (ρc = 0.67 and 0.74, respectively). Significantly stronger correlations were observed for obese relative to non-obese subjects for total percent fat (ρobese = 0.85 versus ρnon-obese = 0.5) and fat mass (ρobese = 0.96 versus ρnon-obese = 0.84). A handheld BIA device demonstrated high concordance with DXA for fat mass and moderate concordance for total percent fat and fat-free mass.ClinicalTrials.gov: NCT02099799.

Conflict of interest statement

The authors declare no competing interests.

© 2022. The Author(s).

Figures

Figure 1

Correlation between mean percent body fat measurements obtained using two bioimpedance devices. Scatter plot with best fit line (solid blue) of percent body fat measurements taken using two different Omron HBF-306C bioimpedance devices. Measurements were taken in triplicate using each advice. Mean of three measurements from each device is shown. Spearman correlation between devices was 0.996 (p 

Figure 2

Comparison between bioimpedance (BIA)-derived and dual X-ray absorptiometry (DXA)-assessed fat mass (in kilograms, kg). The left panel is a scatter plot of BIA-derived and DXA-assessed fat mass is shown with the best fit regression (solid red line) and 95% confidence intervals (blue dashed); Spearman ρ = 0.94 (p 

Figure 3

Comparison between bioimpedance (BIA)- and dual X-ray absorptiometry (DXA)-assessed total percent fat. The left panel is a scatter plot of BIA- and DXA-assessed total percent body fat with the best fit regression (solid red line) and 95% confidence intervals (blue dashed); Spearman ρ = 0.80 (p