Evaluation of Multi-Frequency Bioelectrical Impedance Analysis against Dual-Energy X-ray Absorptiometry for Estimation of Low Muscle Mass in Older Hospitalized Patients
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Setting
2.2. Patients and Recruitment
2.3. Variables and Data Collection
2.3.1. Patient Demographics
2.3.2. Muscle Mass Estimations
2.3.3. Hydration Assessment (Osmolarity and Medication Review)
2.3.4. Nutritional Screening
2.3.5. Appetite Assessment
2.4. Statistical Methods
3. Results
3.1. Patient Characteristics
3.2. The Evaluation of MF-BIA against DXA to Estimate Absolute Values of Muscle Mass
3.3. Agreement between MF-BIA and DXA to Estimate Low Muscle Mass
3.4. Associations between Absolute Values of Muscle Mass with Dehydration, Malnutrition, and Poor Appetite
4. Discussion
4.1. Main Findings
4.2. Comparison to Other Studies
4.3. Strengths and Limitations
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Muscle Mass Variable | Cut-Off Points Female | Cut-Off Points Male |
---|---|---|
Appendicular skeletal muscle mass (ASM, kg) 1 | <15 kg | <20 kg |
Appendicular skeletal muscle mass index (ASMI, kg/m2) 1 | <5.5 kg/m2 | <7 kg/m2 |
Fat-free mass index (FFMI, kg/m2) 2 | <15 kg/m2 | <17 kg/m2 |
Total (n = 42) | Female (n = 27) | Male (n = 15) | |
---|---|---|---|
Variable | |||
Age, years, mean (SD) | 78.9 (6.8) | 79.9 (6.7) | 76.9 (6.5) |
Weight, kg, mean (SD) | 75.8 (20.3) | 70.7 (20.7) | 85.1 (16.4) |
Height, cm, mean (SD) | 167.6 (7.8) | 163.8 (6.6) | 174.3 (4.7) |
BMI, mean (SD) | 27.0 (6.4) | 26.4 (7.0) | 28.2 (5.0) |
Admission diagnosis category 1 | |||
Cardiovascular, n (%) | 13 (31%) | 7 (26%) | 6 (40%) |
Gastrointestinal, n (%) | 3 (7%) | 3 (11%) | 0 (0%) |
Infectious, n (%) | 11 (26%) | 7 (26%) | 4 (27%) |
Lab abnormality, n (%) | 1 (2%) | 1 (4%) | 0 (0%) |
Mechanical, n (%) | 3 (7%) | 1 (4%) | 2 (13%) |
Nervous, n (%) | 5 (12%) | 4 (15%) | 1 (7%) |
Respiratory, n (%) | 5 (12%) | 3 (11%) | 2 (13%) |
Social, n (%) | 1 (2%) | 1 (4%) | 0 (0%) |
CCI = 0 2 | 25 (63%) | 18 (72%) | 7 (47%) |
CCI = 1 | 11 (28%) | 5 (20%) | 6 (40%) |
CCI = 2 | 4 (10%) | 2 (8%) | 2 (13%) |
LOS, days, median (IQR) 3 | 1.50 (0.00:3.25) | 0.50 (0.00:2.75) | 3.00 (0.25:4.00) |
Readmission, 30 days, n (%) | 31 (74%) | 20 (74%) | 11 (73%) |
Mortality, 3 months, n (%) | 3 (7%) | 1 (4%) | 2 (13%) |
Mortality, 1 year, n (%) | 3 (7%) | 1 (4%) | 2 (13%) |
MNA®-SF score 12–14, n (%) 4 | 13 (32%) | 9 (33%) | 4 (29%) |
MNA®-SF score 8–11, n (%) | 19 (46%) | 13 (48%) | 6 (41%) |
MNA®-SF score 0–7, n (%) | 9 (22%) | 5 (19%) | 4 (29%) |
SNAQ score > 15, n (%) | 22 (52%) | 15 (56%) | 7 (47%) |
SNAQ score ≤ 14, n (%) | 20 (48%) | 12 (44%) | 8 (53%) |
Dehydration > 295 mOsm/L, n (%) 5 | 12 (32%) | 6 (23%) | 6 (50%) |
Medication, dehydrating effect, n (%) 6 | 25 (60%) | 16 (59%) | 9 (60%) |
Medication, overhydrating effect, n (%) 7 | 22 (52%) | 12 (44%) | 10 (67%) |
All Patients (n = 42) | ||||
---|---|---|---|---|
ASM (kg) | ASMI (kg/m2) | FFMI (kg/m2) | ||
Absolute values of muscle mass | ||||
DXA, mean (SD) | 20.5 (5.5) | 7.3 (1.6) | 17.3 (2.6) | |
MF-BIA, mean (SD) | 21.2 (5.4) | 7.5 (1.4) | 18.0 (2.3) | |
Prevalence of low muscle mass | ||||
DXA, n (%) | 7 (17%) | 9 (21%) | 13 (31%) | |
MF-BIA, n (%) | 8 (19%) | 3 (7%) | 4 (10%) |
All Patients (n = 42) | |||
---|---|---|---|
ASM (kg) | ASMI (kg/m2) | FFMI (kg/m2) | |
Mean bias, mean (CI) 1 | 0.63 (−0.20:1.46) | 0.21 (−0.08:0.50) | 0.76 (0.31:1.22) |
Mean bias, % (CI) | 3.9 (0.2:7.6) | 3.9 (0.2:7.6) | 5.1 (2.4:7.8) |
LOA, lower, upper | −4.61, 5.87 | −1.62, 2.04 | −2.08, 3.61 |
5% accurate estimations, % (CI) | 33 (20:50) | 33 (20:50) | 48 (32:63) |
10% accurate estimations, % (CI) | 62 (46:76) | 62 (46:76) | 74 (58:86) |
15% accurate estimations, % (CI) | 79 (63:89) | 79 (63:89) | 88 (74:96) |
Sensitivity, (CI) | 0.86 (0.42:1.00) | 0.22 (0.03:0.60) | 0.23 (0.05:0.54) |
Specificity, (CI) | 0.94 (0.81:0.99) | 0.97 (0.84:1.00) | 0.97 (0.82:1.00) |
PPV, (CI) | 0.75 (0.35:0.97) | 0.67 (0.09:0.99) | 0.75 (0.19:0.99) |
NPV, (CI) | 0.97 (0.85:1.00) | 0.82 (0.67:0.92) | 0.74 (0.57:0.87) |
Kappa, (CI) | 0.76 (0.46:1.06) | 0.25 (0.00:0.50) | 0.24 (0.01:0.48) |
Agreement, % (Cl) | 93 (79:98) | 81 (65:91) | 74 (58:86) |
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Nielsen, R.L.; Andersen, A.L.; Kallemose, T.; Damgaard, M.; Bornæs, O.; Juul-Larsen, H.G.; Strejby Christensen, L.W.; Jawad, B.N.; Andersen, O.; Rasmussen, H.H.; et al. Evaluation of Multi-Frequency Bioelectrical Impedance Analysis against Dual-Energy X-ray Absorptiometry for Estimation of Low Muscle Mass in Older Hospitalized Patients. J. Clin. Med. 2024, 13, 196. https://doi.org/10.3390/jcm13010196
Nielsen RL, Andersen AL, Kallemose T, Damgaard M, Bornæs O, Juul-Larsen HG, Strejby Christensen LW, Jawad BN, Andersen O, Rasmussen HH, et al. Evaluation of Multi-Frequency Bioelectrical Impedance Analysis against Dual-Energy X-ray Absorptiometry for Estimation of Low Muscle Mass in Older Hospitalized Patients. Journal of Clinical Medicine. 2024; 13(1):196. https://doi.org/10.3390/jcm13010196
Chicago/Turabian StyleNielsen, Rikke Lundsgaard, Aino Leegaard Andersen, Thomas Kallemose, Morten Damgaard, Olivia Bornæs, Helle Gybel Juul-Larsen, Louise Westberg Strejby Christensen, Baker Nawfal Jawad, Ove Andersen, Henrik Højgaard Rasmussen, and et al. 2024. "Evaluation of Multi-Frequency Bioelectrical Impedance Analysis against Dual-Energy X-ray Absorptiometry for Estimation of Low Muscle Mass in Older Hospitalized Patients" Journal of Clinical Medicine 13, no. 1: 196. https://doi.org/10.3390/jcm13010196
APA StyleNielsen, R. L., Andersen, A. L., Kallemose, T., Damgaard, M., Bornæs, O., Juul-Larsen, H. G., Strejby Christensen, L. W., Jawad, B. N., Andersen, O., Rasmussen, H. H., Munk, T., Lund, T. M., & Houlind, M. B. (2024). Evaluation of Multi-Frequency Bioelectrical Impedance Analysis against Dual-Energy X-ray Absorptiometry for Estimation of Low Muscle Mass in Older Hospitalized Patients. Journal of Clinical Medicine, 13(1), 196. https://doi.org/10.3390/jcm13010196