Body composition in diabetic subjects with chronic kidney disease: interest of bio-impedance analysis, and anthropometry.
OBJECTIVE
Lean body mass (LBM) is reduced in uremia, but this has not been reported in diabetic nephropathy.


METHODS
We compared predicted % LBM to DEXA measurements in 10 non-diabetic uremic, 10 non-uremic diabetic and 10 uremic diabetic subjects matched for age, gender and BMI. We also measured % LBM by anthropometry, bio-impedance analysis (BIA) and compared them with DEXA in 49 diabetic subjects with a wide range of renal failure. The results were compared and a Bland & Altman procedure was performed. Associations between glomerular filtration rate (GFR) and % LBM were tested.


RESULTS
In matched groups, predicted % LBM values were overestimated in non-diabetic uremic subjects, and underestimated in non-uremic diabetic subjects. In uremic diabetic subjects, the error was intermediary. As compared to DEXA (% LBM: 69.0 +/- 7.1%), measurement of % LBM by anthropometry (71.4 +/- 8.0%, p < 0.05) and BIA (67.2 +/- 7.6%, p < 0.05) were biased in the 49 diabetic subjects. The mean of anthropometric and BIA (Ant+BIA) were similar to DEXA results (69.3 +/- 6.8%, p = 0.64), with best correlation coefficients and Bland & Altman plots. GFR was correlated to % LBM assessed by DEXA, BIA and Ant+BIA.


CONCLUSIONS
In diabetic subjects with chronic kidney disease, LBM should be measured, rather than predicted. A good evaluation is possible, even without DEXA.
Rigalleau
V
V
Nutrition-Diabétologie, Hôpital Haut-Lévêque, Avenue de Magellan, FR-33600 Pessac, France. vincent.regalleau@wanadoo.fr
Lasseur
C
C
Chauveau
P
P
Barthes
N
N
Raffaitin
C
C
Combe
C
C
Perlemoine
C
C
Baillet-Blanco
L
L
Gin
H
H
D000886:Anthropometry; D001823:Body Composition / Q000502:physiology*; D003920:Diabetes Mellitus / Q000503:physiopathology*; D003928:Diabetic Nephropathies / Q000503:physiopathology*; D017097:Electric Impedance; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000378:metabolism*; D011237:Predictive Value of Tests; D015203:Reproducibility of Results; D014511:Uremia / Q000503:physiopathology