title: Evaluation of bioelectrical impedance analysis for identifying overweight individuals at increased cardiometabolic risk: a cross-sectional study.
abstract: OBJECTIVE
  To investigate whether bioelectrical impedance analysis could be used to identify overweight individuals at increased cardiometabolic risk, defined as the presence of metabolic syndrome and/or diabetes.
  
  
  METHODS
  Cross-sectional study of a Scottish population including 1210 women and 788 men. The diagnostic performance of thresholds of percentage body fat measured by bioelectrical impedance analysis to identify people at increased cardiometabolic risk was assessed using receiver-operating characteristic curves. Odds ratios for increased cardiometabolic risk in body mass index categories associated with values above compared to below sex-specific percentage body fat thresholds with optimal diagnostic performance were calculated using multivariable logistic regression analyses. The validity of bioelectrical impedance analysis to measure percentage body fat in this population was tested by examining agreement between bioelectrical impedance analysis and dual-energy X-ray absorptiometry in a subgroup of individuals.
  
  
  RESULTS
  Participants were aged 16-91 years and the optimal bioelectrical impedance analysis cut-points for percentage body fat for identifying people at increased cardiometabolic risk were 25.9% for men and 37.1% for women. Stratifying by these percentage body fat cut-points, the prevalence of increased cardiometabolic risk was 48% and 38% above the threshold and 24% and 19% below these thresholds for men and women, respectively. By comparison, stratifying by percentage body fat category had little impact on identifying increased cardiometabolic risk in normal weight and obese individuals. Fully adjusted odds ratios of being at increased cardiometabolic risk among overweight people with percentage body fat ≥ 25.9/37.1% compared with percentage body fat <25.9/37.1% as a reference were 1.93 (95% confidence interval: 1.20-3.10) for men and 1.79 (1.10-2.92) for women.
  
  
  CONCLUSIONS
  Percentage body fat measured using bioelectrical impedance analysis above a sex-specific threshold could be used in overweight people to identify individuals at increased cardiometabolic risk, who could benefit from risk factor management.
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Maxine J E
authors.initials: MJ
authors.lastname: Lamb
authors.affiliation: Nutrition and Metabolism, Faculty of Medicine, University of Southampton, Southampton, United Kingdom; Southampton National Institute for Health Research Biomedical Research Centre, University Hospital Southampton, Southampton, United Kingdom.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Byrne
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom; MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, United Kingdom.
authors.forename: James F
authors.initials: JF
authors.lastname: Wilson
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, United Kingdom.
authors.forename: Sarah H
authors.initials: SH
authors.lastname: Wild
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition / Q000502:physiology*; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D017097:Electric Impedance; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000209:etiology* / Q000503:physiopathology; D008875:Middle Aged; D050177:Overweight / Q000150:complications* / Q000503:physiopathology; D012307:Risk Factors; D055815:Young Adult