Improved assessment of body cell mass by segmental bioimpedance analysis in malnourished subjects and acromegaly

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 22; no. 2; pp. 167 - 174
• Main Authors: PIRLICH, M., SCHÜTZ, T., OCKENGA, J., BIERING, H., GERL, H., SCHMIDT, B., ERTL, S., PLAUTH, M., LOCHS, H.
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01-04-2003
• Subjects: acromegaly; Acromegaly - complications; Acromegaly - diagnosis; Acromegaly - physiopathology; Adult; Anthropometry; Ascites - complications; Ascites - physiopathology; body cell mass; Body Composition; Body Water - metabolism; Cushing Syndrome - physiopathology; Electric Impedance; Female; Humans; Liver Cirrhosis - complications; Liver Cirrhosis - physiopathology; Male; malnutrition; Middle Aged; Multivariate Analysis; Nutrition Disorders - diagnosis; Nutrition Disorders - etiology; Nutrition Disorders - physiopathology; Nutritional Status; Potassium - analysis; segmental bioelectrical impedance; total-body potassium; total-body potassium; malnutrition; acromegaly; segmental bioelectrical impedance; body cell mass
• ISSN: 0261-5614; 1532-1983
• DOI: 10.1054/clnu.2002.0617

Background: Estimation of body cell mass (BCM) has been regarded valuable for the assessement of malnutrition.
Aim: To investigate the value of segmental bioelectrical impedance analysis (BIA) for BCM estimation in malnourished subjects and acromegaly.
Methods: Nineteen controls and 63 patients with either reduced (liver cirrhosis without and with ascites, Cushing's disease) or increased BCM (acromegaly) were included. Whole-body and segmental BIA (separately measuring arm, trunk, leg) at 50kHz was compared with BCM measured by total-body potassium. Multiple regression analysis was used to develop specific equations for BCM in each subgroup.
Results: Compared to whole-body BIA equations, the inclusion of arm resistance improved the specific equation in cirrhotic patients without ascites and in Cushing's disease resulting in excellent prediction of BCM (
R
2=0.93 and 0.92, respectively; both
P <0.001). In acromegaly, inclusion of resistance and reactance of the trunk best described BCM (
R
2=0.94,
P<0.001). In controls and in cirrhotic patients with ascites, segmental impedance parameters did not improve BCM prediction (best values obtained by whole-body measurements:
R
2=0.88 and 0.60;
P<0.001 and <0.003, respectively).
Conclusion: Segmental BIA improves the assessment of BCM in malnourished patients and acromegaly, but not in patients with severe fluid overload.