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. 2013;8(3):e58533.
doi: 10.1371/journal.pone.0058533. Epub 2013 Mar 6.

Accuracy of specific BIVA for the assessment of body composition in the United States population

Roberto Buffa  1 , Bruno Saragat, Stefano Cabras, Andrea C Rinaldi, Elisabetta Marini
Affiliations

Accuracy of specific BIVA for the assessment of body composition in the United States population

Roberto Buffa et al. PLoS One. 2013.

Abstract

Background: Bioelectrical impedance vector analysis (BIVA) is a technique for the assessment of hydration and nutritional status, used in the clinical practice. Specific BIVA is an analytical variant, recently proposed for the Italian elderly population, that adjusts bioelectrical values for body geometry.

Objective: Evaluating the accuracy of specific BIVA in the adult U.S. population, compared to the 'classic' BIVA procedure, using DXA as the reference technique, in order to obtain an interpretative model of body composition.

Design: A cross-sectional sample of 1590 adult individuals (836 men and 754 women, 21-49 years old) derived from the NHANES 2003-2004 was considered. Classic and specific BIVA were applied. The sensitivity and specificity in recognizing individuals below the 5(th) and above the 95(th) percentiles of percent fat (FMDXA%) and extracellular/intracellular water (ECW/ICW) ratio were evaluated by receiver operating characteristic (ROC) curves. Classic and specific BIVA results were compared by a probit multiple-regression.

Results: Specific BIVA was significantly more accurate than classic BIVA in evaluating FMDXA% (ROC areas: 0.84-0.92 and 0.49-0.61 respectively; p = 0.002). The evaluation of ECW/ICW was accurate (ROC areas between 0.83 and 0.96) and similarly performed by the two procedures (p = 0.829). The accuracy of specific BIVA was similar in the two sexes (p = 0.144) and in FMDXA% and ECW/ICW (p = 0.869).

Conclusions: Specific BIVA showed to be an accurate technique. The tolerance ellipses of specific BIVA can be used for evaluating FM% and ECW/ICW in the U.S. adult population.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Distribution of bioelectrical vectors from individuals with different amounts of FMDXA% and ECW/ICW on the sex specific bivariate tolerance ellipses (men).
White dots: 5th percentile; black dots: 95th percentile.
Figure 2
Figure 2. Distribution of bioelectrical vectors from individuals with different amounts of FMDXA% and ECW/ICW on the sex specific bivariate tolerance ellipses (women).
White dots: 5th percentile; black dots: 95th percentile.
Figure 3
Figure 3. Mean specific vectors of athletic and lean men plotted on the sex specific bivariate tolerance ellipse.
SMI = skeletal muscle mass index; white dots: SMI>9.51; black dots: SMI<7.39.
Figure 4
Figure 4. ROC curves showing the comparison between classic (dotted lines and squared symbols) and specific (continuous lines and dots) BIVA in the assessment of FMDXA% and ECW/ICW in the two sexes.
Figure 5
Figure 5. Specific tolerance ellipses with the interpretation of different regions in terms of body composition.
Left: women; right: men.
Figure 6
Figure 6. Mean vectors and confidence ellipses distribution of deciles of FM% and ECW/ICW ratio on the specific tolerance ellipses (women).
Left: FM% (higher deciles on the right); right: ECW/ICW (higher deciles on the bottom). Ellipses in red represent the 5° and 95° percentiles used for the validation.
See this image and copyright information in PMC

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Grants and funding

This research was financially supported by the University of Cagliari. ACR acknowledges financial support from “Regione Autonoma della Sardegna” through a research grant on fundings of the Project PO Sardegna FSE 2007–2013, L.R.7/2007 Promozione della ricerca scientifica e dell’innovazione tecnologica in Sardegna. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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