title: Critical assessment of body-composition measurements in malnourished subjects with Crohn's disease: the role of bioelectric impedance analysis.
abstract: Bioelectric impedance analysis (BIA) has been widely used for assessment of body composition in healthy subjects but has not been validated in malnourished patients. This study compared calculation of fat-free mass (FFM) by five methods to determine whether the currently used equations for total body water (TBW) as assessed by BIA were applicable to 19 malnourished patients with Crohn's disease. When compared with TBW assessed by H2(18)O dilution, BIA was higher by 5.9 +/- 1.1% (P < 0.005). A stepwise-multiple-regression equation was derived to validate BIA: TBW (kg) = 0.25 (ht2/resistance) + 0.29 (wt) + 3.63 (r = 0.97, SEE = 0.28). Comparison of the hydration of FFM (TBW by 18O dilution/FFM) between methods showed that total body potassium (TBK) gave a significantly higher value when compared with the reference method of body protein, mineral, and 18O analysis. Dual-energy x-ray absorptiometry (DXA) provided a value for TBW/FFM in close agreement with the reference method. We conclude that BIA overestimates TBW, and TBK underestimates FFM in malnourished patients. DXA provides an accurate measurement of body fat in malnutrition.
authors.affiliation: Toronto General Hospital, Department of Medicine, University of Toronto, Canada.
authors.forename: D
authors.initials: D
authors.lastname: Royall
authors.forename: G R
authors.initials: GR
authors.lastname: Greenberg
authors.forename: J P
authors.initials: JP
authors.lastname: Allard
authors.forename: J P
authors.initials: JP
authors.lastname: Baker
authors.forename: J E
authors.initials: JE
authors.lastname: Harrison
authors.forename: K N
authors.initials: KN
authors.lastname: Jeejeebhoy
mesh_terms: D015502:Absorptiometry, Photon; D000273:Adipose Tissue; D000704:Analysis of Variance; D000886:Anthropometry; D001823:Body Composition; D001827:Body Height; D001834:Body Water; D015519:Bone Density; D003424:Crohn Disease / Q000150:complications / Q000473:pathology*; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008297:Male; D009584:Nitrogen / Q000032:analysis; D009748:Nutrition Disorders / Q000209:etiology / Q000473:pathology*; D011188:Potassium / Q000032:analysis; D012044:Regression Analysis
chemical_list: D009584:Nitrogen; D011188:Potassium