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Comparative Study
. 2018 Jul 12;13(7):e0200465.
doi: 10.1371/journal.pone.0200465. eCollection 2018.

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

Najate Achamrah  1   2   3 , Guillaume Colange  1 , Julie Delay  1 , Agnès Rimbert  1   2 , Vanessa Folope  1   2 , André Petit  1   2 , Sébastien Grigioni  1   2 , Pierre Déchelotte  1   2   3 , Moïse Coëffier  1   2   3
Affiliations
Comparative Study

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

Najate Achamrah et al. PLoS One. .

Abstract

Background and aims: Body 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.

Methods: Retrospectively, 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.

Results: Whatever 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.

Conclusion: The 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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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Comparison of fat mass and fat-free mass measurements by DXA and BIA.
Fat mass (FM) and fat-free mass (FFM) were measured by DXA (Lunar Prodigy Advance) and BIA (BodyStat Quadscan 4000). Bland Altman plots were created with difference between DXA and BIA for FM and FFM and average of both values. Correlations between values of DXA and BIA were also performed and showed in insert graphs with Pearson r and the concordance coefficient of Lin (ρc).
Fig 2
Fig 2. Differences between fat mass and fat-free mass measurements by DXA and BIA in patients with low BMI.
Fat mass (FM) and fat-free mass (FFM) were measured by DXA (Lunar Prodigy Advance) and BIA (BodyStat Quadscan 4000) in patients with BMI < 16 kg.m-2 (n = 162, upper panels) and patients with BMI between 16 and 18.5 kg.m-2 (n = 217, lower panels). Differences of values obtained by DXA and BIA were compared according to the BMI. The blue line represents the linear regression.
Fig 3
Fig 3. Differences between fat mass and fat-free mass measurements by DXA and BIA in patients with normal BMI.
Fat mass (FM) and fat-free mass (FFM) were measured by DXA (Lunar Prodigy Advance) and BIA (BodyStat Quadscan 4000) in patients with BMI between 18.5 and 25 kg.m-2 (n = 237). Differences of values obtained by DXA and BIA were compared according to the BMI. The blue line represents the linear regression.
Fig 4
Fig 4. Differences between fat mass and fat-free mass measurements by DXA and BIA in overweight patients.
Fat mass (FM) and fat-free mass (FFM) were measured by DXA (Lunar Prodigy Advance) and BIA (BodyStat Quadscan 4000) in patients with BMI between 25 and 30 kg.m-2 (n = 328). Differences of values obtained by DXA and BIA were compared according to the BMI. The blue line represents the linear regression.
Fig 5
Fig 5. Differences between fat mass and fat-free mass measurements by DXA and BIA in obese patients.
Fat mass (FM) and fat-free mass (FFM) were measured by DXA (Lunar Prodigy Advance) and BIA (BodyStat Quadscan 4000) in patients with obesity grade 1 (n = 903, upper panels), grade 2 (n = 915, middle panels) or grade 3 (n = 893, upper panels). Differences of values obtained by DXA and BIA were compared according to the BMI. The blue line represents the linear regression.
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