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Evaluation of appendicular lean mass using bio impedance in persons aged 80+: A new equation based on the BUTTERFLY-study

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Abstract
Background: To date, the accuracy of bio-impedance (BIA) to assess body composition & sarcopenia in persons aged 80 and over remains unclear. Objective: We aimed to evaluate the agreement between dual energy X-ray absorptiometry (DXA) and BIA equations to determine lean mass, as well as their suitability to identify sarcopenia. Design: 174 community dwelling well-functioning persons (83 women, 91 men) aged 80 and over were included. Appendicular lean mass (ALM) was predicted using BIA-based equations available in literature, and compared to DXA outcomes. Through cross-validation and stepwise multiple linear regression, a new ALM-formula was generated suitable for this population. Results: Literature-based BIA equations systematically overestimated ALM. The new prediction formula that we propose for the 80þ is: ALM ¼ 0,827þ(0,19*Impedance Index)þ(2,101*Sex)þ(0,079*Weight); R2 ¼ 0,888; SEE ¼ 1,450 kg. Sarcopenia classification based on our new BIA equation for ALM showed better agreement with DXA (k  0,454) compared to literature-based BIA equations (k < 0,368). Conclusions: Despite the high correlation between both methods, literature-based BIA equations consistently overestimate ALM compared to DXA in persons aged 80 and over. We proposed a new equation for ALM, reaching higher agreement with DXA and thus improving the accuracy of BIA for this specific age group.
Keywords
Nutrition and Dietetics, Critical Care and Intensive Care Medicine

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Chicago
Vermeiren, S., D. Beckwée, R. Vella-Azzopardi, I. Beyer, V. Knoop, B. Jansen, A. Delaere, et al. 2018. “Evaluation of Appendicular Lean Mass Using Bio Impedance in Persons Aged 80+: A New Equation Based on the BUTTERFLY-study.” Clinical Nutrition.
APA
Vermeiren, S., Beckwée, D., Vella-Azzopardi, R., Beyer, I., Knoop, V., Jansen, B., Delaere, A., et al. (2018). Evaluation of appendicular lean mass using bio impedance in persons aged 80+: A new equation based on the BUTTERFLY-study. Clinical Nutrition.
Vancouver
1.
Vermeiren S, Beckwée D, Vella-Azzopardi R, Beyer I, Knoop V, Jansen B, et al. Evaluation of appendicular lean mass using bio impedance in persons aged 80+: A new equation based on the BUTTERFLY-study. Clinical Nutrition. Elsevier BV; 2018;
MLA
Vermeiren, S., D. Beckwée, R. Vella-Azzopardi, et al. “Evaluation of Appendicular Lean Mass Using Bio Impedance in Persons Aged 80+: A New Equation Based on the BUTTERFLY-study.” Clinical Nutrition (2018): n. pag. Print.
@article{8578121,
  abstract     = {Background: To date, the accuracy of bio-impedance (BIA) to assess body composition \& sarcopenia in persons aged 80 and over remains unclear.
Objective: We aimed to evaluate the agreement between dual energy X-ray absorptiometry (DXA) and BIA equations to determine lean mass, as well as their suitability to identify sarcopenia.
Design: 174 community dwelling well-functioning persons (83 women, 91 men) aged 80 and over were included. Appendicular lean mass (ALM) was predicted using BIA-based equations available in literature, and compared to DXA outcomes. Through cross-validation and stepwise multiple linear regression, a new ALM-formula was generated suitable for this population.
Results: Literature-based BIA equations systematically overestimated ALM. The new prediction formula that we propose for the 80{\th} is: ALM {\textonequarter} 0,827{\th}(0,19*Impedance Index){\th}(2,101*Sex){\th}(0,079*Weight); R2 {\textonequarter} 0,888; SEE {\textonequarter} 1,450 kg.
Sarcopenia classification based on our new BIA equation for ALM showed better agreement with DXA (k \unmatched{0002} 0,454) compared to literature-based BIA equations (k {\textlangle} 0,368).
Conclusions: Despite the high correlation between both methods, literature-based BIA equations consistently overestimate ALM compared to DXA in persons aged 80 and over. We proposed a new equation for ALM, reaching higher agreement with DXA and thus improving the accuracy of BIA for this specific age group.
},
  author       = {Vermeiren, S. and Beckw{\'e}e, D. and Vella-Azzopardi, R. and Beyer, I. and Knoop, V. and Jansen, B. and Delaere, A. and Antoine, A. and Bautmans, I. and Scafoglieri, A. and Bautmans, Ivan and Vert{\'e}, Dominque and Beyer, Ingo and Petrovic, Mirko and De Donder, Liesbeth and Kardol, Tinie and Rossi, Gina and Clarys, Peter and Scafoglieri, Aldo and Cattrysse, Erik and de Hert, Paul and Jansen, Bart},
  issn         = {0261-5614},
  journal      = {Clinical Nutrition},
  language     = {eng},
  publisher    = {Elsevier BV},
  title        = {Evaluation of appendicular lean mass using bio impedance in persons aged 80+: A new equation based on the BUTTERFLY-study},
  url          = {http://dx.doi.org/10.1016/j.clnu.2018.07.029},
  year         = {2018},
}

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