Dual-energy X-ray absorptiometry lean soft tissue hydration: independent contributions of intra- and extracellular water

Dual-energy X-ray absorptiometry (DEXA) provides a measure of lean soft tissue (LST). LST hydration, often assumed to be constant, is relevant to several aspects of DEXA body composition estimates. The aims of this study were to develop a theoretical model of LST total body water (TBW) content and to examine hydration effects with empirically derived model coefficients and then to experimentally test the model's prediction that, in healthy adults, LST hydration is not constant but varies as a function of extra- and intracellular water distribution (E/I). The initial phase involved TBW/LST model development and application with empirically derived model coefficients. Model predictions were then tested in a cross-sectional study of 215 healthy adults. LST was measured by DEXA, extracellular water (ECW) by NaBr dilution, intracellular water (ICW) by whole body (40)K counting, and TBW by (2)H(2)O dilution. TBW estimates, calculated as ECW + ICW, were highly correlated with (r = 0.97, SEE = 2.1 kg, P < 0.001) and showed no significant bias compared with TBW measured by (2)H(2)O. Model-predicted TBW/LST was almost identical to experimentally derived values (means +/- SD) in the total group (0.767 vs. 0.764 +/- 0.028). LST hydration was significantly correlated with E/I (total group, r = 0.30, SEE = 0.027, P < 0.001). Although E/I increased with age (men, r = 0.48; women, r = 0.37; both P < 0.001), the association between TBW/LST and age was nonsignificant. Hydration of the DEXA-derived LST compartment is thus not constant but varies predictably with ECW and ICW distribution. This observation has implications for the accuracy of body fat measurements by DEXA and the use of TBW as a means of checking DEXA system calibration.     

Effect of subclinical hypothyroidism on body fluid compartments.

OBJECTIVE: The present study was aimed to assess the effects of subclinical hypothyroidism on body composition (BC). SUBJECTS: Thirty-one women (age: 37 +/- 9.9 years) with a wide range of body mass index (BMI) were studied. Subclinical hypothyroidism was defined by a basal TSH > or = 4 mU/L and/or TRH stimulated peak > or = 30 mU/L. MEASUREMENTS: For each subject, weight, height, BMI, multifrequency bioelectrical impedance spectroscopy (BIS) and D2O and NaBr dilution tests were performed to assessed total body water (TBW) and extracellular water (ECW). Thyroid function (basal and TRH stimulated TSH, free T3, and free T4) were determined from fasting blood samples for all subjects. Total body dual energy X-ray absorptiometry (DXA) were used to measure fat mass (FM) and lean mass (Lean). RESULTS: The results of BIS were compared with the TBW and ECW estimated by the dilution techniques on the same individuals. The correlation was R2 = 0.65 for impedance at 5 kHz and ECW by NaBr and R2 = 0.72 for impedance at 100 kHz and TBW by D2O. Intracellular water (ICW) was calculated as differences between TBW and ECW measured by dilution methods. Percent of ECW and ICW were related to BMI (ANOVA, p < 0.001). No difference in TBW, body water distribution and body composition related to thyroid function was demonstrated. CONCLUSIONS: In our patients affected with subclinical hypothyroidism, with or without obesity, only obesity appeared related to TBW, ECW and ICW; the subclinical hypothyroidism, on the contrary, had no effect on compartments of body fluids. Bioimpedance is a valid tool to assess body fluid distribution in subclinical hypothyroidism.     

Equation for estimating total body water by bioelectrical impedance measurements in Japanese subjects]

This article reports a study in which the equation for total body water (TBW) estimated from deuterium (2H2O)-dilution method and bioelectrical impedance measurement (BIM) is described. Subjects were 60 healthy males aged 30 +/- 18.3 yr (18-74) and 31 healthy females aged 37 +/- 17.5 yr (19-70). Total body water determined by the analysis of the dilution of orally ingested deuterium oxide (1g2H2O, 99.75 atom % excess/kg body weight) in urine. Bioelectrical impedance was measured for each subjects in a supine position using an electrical impedance analyzer (500 microA, 50kHz, T-1988K, Toyo Physical Inc.) with a four electrodes (Y-250, Nihon Kohden). The mean values of total body water and the impedance in males and females subjects were 34.1 +/- 4.27 l and 25.7 +/- 2.42 l, 567 +/- 28.5 omega and 562 +/- 32.5 omega, respectively. Height squared divided by resistance (Ht2/R) correlated well with TBW as measured by 2H2 O, r = 0.530 (p less than 0.001) in males and r = 0.782 (p less than 0.001) in females. The best-fitting regression equation to predict TBW comprised Ht2/R(X1) and body weight (X2) (R = 0.915, SEE = 1.70 l in males and R = 0.834, SEE = 1.28 l in females). Equations were provided with BIM instrument for the prediction of TBW: for males TBW, l = 0.1983X1 + 0.4004X2 - 0.7938 and for females TBW, l = 0.3536X1 + 0.1269X2 + 3.3417. These results suggest that bioelectrical impedance measurement is a useful measure of total body water in Japanese subjects.     

Contribution of genetic and environmental factors to variation in body compartments--a twin study in adults

This study aimed at analyzing the contribution of genetic and environmental factors on phenotypic variation of various traits of body composition. Subjects were 30 same-sexed pairs of twins including 20 monozygous (MZ) and 10 dizygous (DZ) pairs, aged 19-62 years. Zygosity was determined by DNA typing and morphological diagnosis. Body composition parameters (fat mass FM, lean body mass LBM, body cell mass BCM, extracellular mass ECM, total body water TBW, extracellular water ECW, and intracellular water ICW) were estimated by tetrapolar bioelectrical impedance analysis. Potential environmental factors influencing body composition (number of children, sporting activity and smoking behaviour) were determined by questionnaires. Heritabilities for traits of body composition were calculated by use of the twin method. Intraclass correlation is > 0.80 for the variation of LBM, BCM, ECM, TBW, ECW, and ICW in both MZ and DZ twins. Estimated heritability (h2) for FM, LBM, BCM, ECW, TBW, ECW, and ICW is 65%, 77%, 79%, 83%, 76%, 68%, and 82%, respectively. The h2 values for FM and LBM are consistent with those reported in other twin studies. For BCM, ECM, ECW and ICW, no comparative h2 estimates exist. Within-pair differences in body compartments do not change with increasing age in MZ and DZ twin pairs (p > 0.05). Stepwise multiple regression analyses indicate that zygosity, age, sex, number of children, sporting level and smoking behaviour do not significantly predict within-pair differences for weight, BMI, FM, LBM, TBW, ECW and ICW (each, p > 0.05). In contrast, sex and the number of children explain together 27% of observed within-pair differences for BCM. Zygosity is the only significant predictor of within-pair differences for ECM and height, explaining 20% (p = 0.008) and 36% of variance, respectively (p < 0.0001). Results indicate that genetic factors exert stronger influences on body composition than the considered environmental traits.     

ESTIMATION OF TOTAL BODY WATER IN HARBOR SEALS: HOW USEFUL IS BIOELECTRICAL IMPEDANCE ANALYSIS?

We evaluated bioelectrical impedance analysis (BIA) as a means of rapidly and inexpensively estimating total body water (TBW) of harbor seals ( Phoca vitulina ). Deuterium oxide dilution was used to estimate TBW in 17 adult females and 16 of their pups between birth and late lactation. Isotope dilution was also used to determine TBW in 12 adult males early and 10 of these males late in the breeding season. At the same time, resistance ( Rs ) and reactance ( Xc ) measurements were taken using a tetrapolar, impedance plethysmograph (Model 101 A, RJL Systems). Seals were sedated with diazepam prior to taking BIA measurements. Within-day duplicate Rs measurements on pups and adults, taken 2-240 min apart, differed by an average of 3.0%± 1.4% ( n = 42, CV = 102%). Movement of the seal during BIA measurements caused variability in both Rs and Xc values. BIA measurements were generally poor predictors of TBW. Rs was significantly correlated with TBW in pups only ( Rs = 0.93, P = 0.001, n = 11). Bioelectrical conductor volume (length2/ Rs ) was significantly correlated with TBW only in adult females ( Rs = 0.63, P = 0.02, n = 14). We conclude that BIA is not a reliable method of estimating TBW in wild harbor seals.     

Estimation of body composition from bioelectrical impedance of body segments

This study provides values of anthropometric measurements and specific impedance, for a sample of 104 adults. The hypothesis that the body composition can be estimated more accurately from measurements of lengths and impedance values of the body segments than from the whole body was tested. The impedance of upper and lower extremities (arm and leg) and trunk were used to compute estimates of body composition parameters (FFM, FM, %F, TBW, ECW). The results were compared with those estimated by the impedance of the whole body. These comparisons demonstrated that significative differences resulted from body composition obtained by segmental impedance and by the whole body.     

Comparison of proximal and distal placements of electrodes to assess body composition by bioelectrical impedance in obese adults

The purpose of this study was to compare the variability and accuracy of proximal and traditional distal electrode placement to estimate body composition in obese adults. Fifty-two obese men and women had a mean age of 37 years and an average body mass index (BMI) of 30.6 kg.m(-2). Body composition was measured using DEXA and an RJL bioelectric impedance analysis 101A bioelectric impedance analyzer. Impedance was measured using the traditional distal electrode placement (hand and foot) and a proximal electrode placement where the current detecting electrodes were placed in the antecubital and popliteal fossae. The distal resistance was 482.4 +/- 79 Omega, which was more than double the mean proximal values of 193.2 +/- 27 Omega. Multiple regression analysis derived the best-fitting equation to predict DEXA-derived fat-free mass. The combination of Ht(2)/R (height(2)/resistance) and mass were the only significant predictors for both the proximal and distal electrode placements. The resulting R(2) values were 0.86 and 0.88, whereas standard errors of the estimate (SEEs) were 4.0 and 3.6 kg for the distal and proximal placements, respectively. An independent sample of 40 obese women was used to cross-validate this new equation. Mean impedance predictions using the distal and proximal electrode placements (45.78 +/- 1.07 and 45.29 +/- 0.97 Omega, respectively) were similar to the reference values (45.29 +/- 0.64 Omega) determined by DEXA. Fat-free mass predicted with the distal and proximal electrode placements correlated significantly (p < 0.001) with the reference fat-free mass value (r = 0.72 and 0.75, respectively). These data suggest that using a proximal electrode placement and a fatness-specific equation helps to reduce the variability of the bioelectric impedance analysis technique in obese adults.     

INDICES OF BODY CONDITION AND BODY COMPOSITION IN FEMALE ANTARCTIC FUR SEALS (ARCTOCEPHALUS GAZELLA)

An attempt was made to develop simple, inexpensive, rapid means of determining body composition in Antarctic fur seals ( Arctocephalus gazella ). Measurements of total body water ( TBW ) and total body lipid ( TBL ), obtained by hydrogen isotope dilution, were compared to the results of bioelectrical impedance analysis ( BIA ) and morphometric indices of body condition in 52 adult females. TBW was weakly correlated with BIA measurements of resistance ( v = -0.30, P < 0.03). Conductor volume (length2/resistance) was more highly correlated with TBW ( r = 0.75, P < 0.0001) and the inclusion of mass into the predictive equation improved the correlation further ( r = 0.95, P < 0.0001). A body condition index (mass/length) previously used in pinniped studies was positively correlated to TBL ( r = 0.77, P < 0.0001) validating its use as a relative index of condition. However, body mass alone was highly correlated to TBW ( r = 0.94, P < 0.0001) and appears to provide a simple, rapid means of estimating body composition in adult females. This technique may also be applicable to juvenile male Antarctic fur seals.     

Reliability in estimates of body composition of birds: oxygen-18 versus deuterium dilution

Body composition in birds was evaluated indirectly by 18O and 2H dilution. Body composition was determined by whole-body chemical analysis of eight adult roosters (Gallus gallus). In vivo measurements of total body water (TBW) were carried out using doubly labeled water (2H2 18O). Estimated dilution spaces using both the plateau and intercept approaches were compared with the results obtained by carcass lyophilization. Both 18O and 2H slightly overestimated TBW compared with the results obtained by lyophilization, by 2.2%+/-1.9% and 5.7%+/-0.2%, respectively; both differences were statistically significant (P<0.01). The difference between these isotope estimations was significant (P<0.001). However, isotope dilution spaces and TBW were highly correlated. There was a strong inverse relationship between total body fat and TBW percentages (r2=0.98, P<0.0001). The relation between TBW and body protein was significant. Water content in lean body mass (72.8%) obtained in our study was very close to that reported in mammals, demonstrating no fundamental difference in tissue water content between birds and mammals. Estimated body fat and protein values from isotopic dilution did not significantly differ from values obtained by direct chemical analysis (P>0.05), except for body fat in the Pace and Rathbun approach (Table 3). Although estimation of TBW and body composition by isotope dilution is time consuming and expensive, deuterium offers a reliable and low-cost alternative compared with 18O. The advantage of in vivo estimation of TBW with isotopic dilution in combination with the regression approach is that it permits repeated measurements of body composition on the same birds under laboratory and free-living conditions.     

Evaluation of bioimpedance spectroscopy for measurements of body water distribution in healthy women before, during, and after pregnancy.

Bioimpedance spectroscopy (BIS) is a technique of interest in the study of human pregnancy because it can assess extracellular (ECW), intracellular (ICW), and total body water (TBW) as ECW plus ICW. The technique requires appropriate resistivity coefficients and has not been sufficiently evaluated during the reproductive cycle. Therefore, in a methodological study, we estimated ECW, ICW, and TBW, by means of BIS, and compared the results with the corresponding estimates obtained by using reference methods. Furthermore, results obtained by means of population-specific resistivity coefficients were compared with results obtained by means of general resistivity coefficients. These comparisons were made before pregnancy, in gestational weeks 14 and 32, as well as 2 wk postpartum in 21 healthy women. The reference methods were isotope and bromide dilution. Average ICW, ECW, and TBW, estimated by means of BIS, were in agreement with reference data before pregnancy, in gestational week 14, and postpartum. The corresponding comparison in gestational week 32 showed good agreement for ICW, whereas estimates by means of BIS were significantly (P < 0.001) lower than the corresponding reference values for ECW and TBW. Thus the BIS technique, which was based on a model developed for the nonpregnant body, estimated increases in ICW accurately, whereas increases in ECW and TBW tended to be underestimated. Estimates obtained by using population-specific and general resistivity coefficients were very similar. In conclusion, the results indicated that BIS is potentially useful for studies during pregnancy but that further work is needed before it can be generally applied in such studies.     

Measurement of nutritional status in simulated microgravity by bioelectrical impedance spectroscopy.

The potential of bioelectrical impedance spectroscopy (BIS) for assessing nutritional status in spaceflight was tested in two head-down-tilt bed-rest studies. BIS-predicted extracellular water (ECW), intracellular water (ICW), and total body water (TBW) measured using knee-elbow electrode placement were compared with deuterium and bromide dilution (DIL) volumes in healthy, 19- to 45-yr-old subjects. BIS was accurate during 44 h of head-down tilt with mean differences (BIS - DIL) of 0-0.1 kg for ECW, 0.3-0.5 for ICW, and 0.4-0.6 kg for TBW (n = 28). At 44 h, BIS followed the within-individual change in body water compartments with a relative prediction error (standard error of the estimate/baseline volume) of 2.0-3.6% of water space. In the second study, BIS did not detect an acute decrease (-1.41 +/- 0.91 kg) in ICW secondary to 48 h of a protein-free, 800 kcal/day diet (n = 18). BIS's insensitivity to ICW losses may be because they were predominantly (65%) localized to the trunk and/or because there was a general failure of BIS to measure ICW independently of ECW and TBW. BIS may have potential for measuring nutritional status during spaceflight, but its limitations in precision and insensitivity to acute ICW changes warrant further validation studies.     

Use of bioelectrical impedance spectroscopy to provide a measure of body composition in sows

The ability to accurately estimate fat mass and fat-free mass (FFM) has the potential to improve the way in which sow body condition can be managed in a breeding herd. Bioelectrical impedance spectroscopy (BIS) has been evaluated as a practical technique for assessment of body composition in several livestock species, but similar work is lacking in sows. Bioelectrical impedance uses population-specific algorithms that require values for the apparent resistivities of body fluids and body proportion factors. This study comprised three major aims: (i) to derive apparent resistivity coefficients for extracellular water (ECW) and intracellular water (ICW) required for validation of BIS predictions of total body water (TBW) in live sows against standard reference tracer dilution methods; (ii) to develop predictions of TBW to body composition prediction algorithms, namely FFM, by developing a body geometry correction factor (Kb) and (iii) to compare the BIS predictions of FFM against existing impedance predictors and published prediction equations for use in sows, based on physical measurements of back-fat depth and BW (P2-based predictors). Whole body impedance measurements and the determination of TBW by deuterium dilution and ECW by bromide dilution were performed on 40 Large White x Landrace sows. Mean apparent resistivity coefficients of body fluids were 431.1 Ω.cm for ECW and 1827.8 Ω.cm for ICW. Using these coefficients, TBW and ECW were over-estimated by 6.5 and 3.3%, respectively, compared to measured reference values, although these differences were not statistically different (P > 0.05). Mean Kb was 1.09 ± 0.14. Fat-free mass predictions were 194.9 kg, which equates to 60.9% of total sow weight, and 183.0 kg for BIS and the deuterium dilution method, respectively. Mean differences between the predicted and measured FFM values ranged from − 8.2 to 32.7%, but were not statistically different (P > 0.05). Method validation (leave-one-out procedure) revealed that mean differences between predicted and measured values were not statistically significant (P > 0.05). Of the impedance-based predictors, equivalence testing revealed that BIS displayed the lowest test bias of 11.9 kg (8.2%), although the P2-based prediction equations exhibited the lowest bias and percentage equivalence, with narrow limits of agreement. Results indicate although differences between mean predicted and measured values were not significantly different, relatively wide limits of agreement suggest BIS as an impractical option for assessing body composition in individual sows compared to the use of existing prediction equations based on BW and back fat.     

Evaluation of the deuterium dilution method to estimate body composition in the barnacle goose: accuracy and minimum equilibration time

We examined body composition in barnacle geese (Branta leucopsis) by proximate carcass analysis and by deuterium isotope dilution. We studied the effect of isotope equilibration time on the accuracy of total body water (TBW) estimates and evaluated models to predict fat-free mass (FFM) and fat mass (FM) from different measurements varying in their level of invasiveness. Deuterium enrichment determined at 45, 90, and 180 min after isotope injection did not differ significantly. At all sampling intervals, isotope dilution spaces (TBW(d)) consistently overestimated body water determined by carcass analysis (TBW(c)). However, variance in the deviation from actual TBW was higher at the 45-min sampling interval, whereas variability was the same at 90 and 180 min, indicating that 90 min is sufficient time to allow for adequate equilibration. At 90 min equilibration time, deuterium isotope dilution overestimated TBW(c) by 7.1% +/= 2.6% (P < 0.001, paired t-test, n=20). This overestimate was consistent over the range of TBW studied, and TBW(c) could thus be predicted from TBW(d) (r2=0.976, P<0.001). Variation in TBW(c) and TBW(d) explained, respectively, 99% and 98% of the variation in FFM. FM could be predicted with a relative error of ca. 10% from TBW estimates in combination with body mass (BM). In contrast, BM and external body measurements allowed only poor prediction. Abdominal fat fresh mass was highly correlated to total FM and, if the carcass is available, allows simple means of fat prediction without dissecting the entire specimen.     

Total body water-to-lean body mass ratio in baboons (Papio sp.) of varying adiposity

Total body water (TBW), lean body mass (LBM), and triglyceride mass were measured in 23 5-yr-old baboons (13 females and 10 males). Male baboons weighed more, had more LBM, more TBW, and contained less triglyceride mass per unit body weight than female baboons. Among all baboons, triglyceride mass per unit body weight ranged from 2.4 to 33.5%. The ratio TBW:LBM ranged from 0.70 to 0.92, increasing (r = 0.98) with increased body triglyceride content (both percent and absolute mass) in both male and female baboons. However, the water content per unit weight of tissues free of fat cells (liver, lungs, kidneys, central nervous system, eyes, tongue) was nearly constant at 0.73 +/- 0.02. The increase in TBW:LBM is more than can be expected from the water in the increased adipose tissue mass. We conclude that TBW:LBM is not constant but is influenced by body triglyceride content in baboons.     

Comparison of body composition methods in overweight and obese children.

The objective of the present study was to investigate the accuracy of percent body fat (%fat) estimates from dual-energy X-ray absorptiometry, air-displacement plethysmography (ADP), and total body water (TBW) against a criterion four-compartment (4C) model in overweight and obese children. A volunteer sample of 30 children (18 male and 12 female), age of (mean +/- SD) 14.10 +/- 1.83 yr, body mass index of 31.6 +/- 5.5 kg/m, and %fat (4C model) of 41.2 +/- 8.2%, was assessed. Body density measurements were converted to %fat estimates by using the general equation of Siri (ADPSiri) (Siri WE. Techniques for Measuring Body Composition. 1961) and the age- and gender-specific constants of Lohman (ADPLoh) (Lohman TG. Exercise and Sport Sciences Reviews. 1986). TBW measurements were converted to %fat estimates by assuming that water accounts for 73% of fat-free mass (TBW73) and by utilizing the age- and gender-specific water contents of Lohman (TBWLoh). All estimates of %fat were highly correlated with those of the 4C model (r > or = 0.95, P < 0.001; SE < or = 2.14). For %fat, the total error and mean difference +/- 95% limits of agreement compared with the 4C model were 2.50, 1.8 +/- 3.5 (ADPSiri); 1.82, -0.04 +/- 3.6 (ADPLoh); 2.86, -2.0 +/- 4.1 (TBW73); 1.90, -0.3 +/- 3.8 (TBWLoh); and 2.74, 1.9 +/- 4.0 DXA (dual-energy X-ray absorptiometry), respectively. In conclusion, in overweight and obese children, ADPLoh and TBWLoh were the most accurate methods of measuring %fat compared with a 4C model. However, all methods under consideration produced similar limits of agreement.     

Percutaneous treatment of spontaneous left main coronary artery dissection using drug-eluting stent

Background

Previous studies indicated that the clustering of major cardiovascular disease (CVD) risk factors is common, and multiple unhealthy lifestyles are responsible for the clustering of CVD risk factors. However, little is known about the direct association between the volume load and the clustering of CVD risk factors in general population.

Methods

We investigated the association of the clustering of CVD risk factors (defined as two or more of the following factors: hypertension, diabetes, dyslipidemia and overweight) with volume load, which was evaluated by bioelectrical impedance analysis. Hypovolaemia was defined as extracellular water/total body water (ECW/TBW) at and under the 10th percentile for the normal population.

Results

Among the 7900 adults, only 29.3% were free of any pre-defined CVD risk factors and 40.8% had clustering of CVD risk factors. Hypovolaemia in clustering group was statistically higher than that either in the single or in the none risk factor group, which was 23.7% vs. 17.0% and 10.0%, respectively (P <0.001). As a categorical outcome, the percentage of the lowest quartiles of ECW/TBW and TBW/TBWwatson in clustering group were statistically higher than either those in the single or in the none risk factor group, which were 44.9% vs. 36.9% and 25.1% (P <0.001), 36.2% vs. 32.2% and 25.0%, respectively (P <0.001). After adjusting of potential confounders, hypovolaemia was significantly associated with clustering of CVD risk factors, with an OR of 1.66 (95% CI, 1.45-1.90).

Conclusions

Hypovolaemia was associated with clustering of major CVD risk factors, which further confirms the importance of lifestyle for the development of CVD.

     

Extracellular water: greater expansion with age in African Americans.

Aging is associated with the onset of chronic diseases that lead to pathological expansion of the extracellular water (ECW) compartment. Healthy aging, in the absence of disease, is also reportedly accompanied by a relative expansion of the ECW compartment, although the studies on which this observation is based are few in number, applied different ECW measurement methods, included small ethnically homogeneous subject samples, and failed to adjust ECW for non-age-related influencing factors. The aim of the current study was to examine, in a large (n = 1,538) ethnically diverse [African American (AA), Asian, Caucasian, Hispanic] subject group the cross-sectional relationships between ECW and age after controlling first for other potential factors that may influence fluid distribution. ECW and intracellular water (ICW) were derived from measured total body water (isotope dilution) and potassium (40K whole body counting). The cross-sectional relationships between ECW, ICW, and ECW/ICW (E/I), and age were developed using multiple regression modelling methods. Body weight, weight squared, height, age, sex, race, and interactions were all significant ECW predictors. The slope of the observed race x age interaction was significantly greater in AA (beta = 0.0005, P = 0.005) than in the three other race groups. Race, sex, and age differences in fluid distribution persisted after adjusting for body composition in a subgroup (n = 994) with dual-energy X-ray absorptiometry lean soft tissue and fat measurements. A relative ECW expansion (i.e., E/I) was present with greater age in most sex-race groups, although the effect was not significantly larger in AA males (P > 0.05) compared with the other race groups, except Asians (P < 0.05). For females, a larger E/I-age effect was found in AA compared with the other race groups, but only the comparison against Hispanics was significant (P < 0.05). The ECW compartment and E/I are thus variably larger, according to race, in healthy older subjects independent of sex, lean soft tissue, and fat mass.     

Single- and multifrequency models for bioelectrical impedance analysis of body water compartments.

The 1994 National Institutes of Health Technology Conference on bioelectrical impedance analysis (BIA) did not support the use of BIA under conditions that alter the normal relationship between the extracellular (ECW) and intracellular water (ICW) compartments. To extend applications of BIA to these populations, we investigated the accuracy and precision of seven previously published BIA models for the measurement of change in body water compartmentalization among individuals infused with lactated Ringer solution or administered a diuretic agent. Results were compared with dilution by using deuterium oxide and bromide combined with short-term changes of body weight. BIA, with use of proximal, tetrapolar electrodes, was measured from 5 to 500 kHz, including 50 kHz. Single-frequency, 50-kHz models did not accurately predict change in total body water, but the 50-kHz parallel model did accurately measure changes in ICW. The only model that accurately predicted change in ECW, ICW, and total body water was the 0/infinity-kHz parallel (Cole-Cole) multifrequency model. Use of the Hanai correction for mixing was less accurate. We conclude that the multifrequency Cole-Cole model is superior under conditions in which body water compartmentalization is altered from the normal state.     

Human hydrometry: comparison of multifrequency bioelectrical impedance with 2H2O and bromine dilution

The traditionalmethod of assessing total body water (TBW), extracellular water (ECW),and intracellular water (ICW) has been the use of isotopes, on thebasis of the dilution principle. Although the development ofbioelectrical impedance techniques has eliminated many of themeasurement constraints associated with the dilution methods, thedegree of interchangeability between the two methods remains uncertain.We used multifrequency bioelectrical impedance spectroscopy (BIS),²H₂Odilution, and bromine dilution to assess TBW, ECW, and ICW in 469 healthy subjects (248 males, 221 females) aged 3-29 yr. We foundthat the TBW, ECW, and ICW estimates for the BIS and dilution methodswere significantly correlated(r² = 0.80-0.96, P < 0.0001, SE ofthe estimate = 2.3-2.7 liters). On the basis of population, theconstants used in the BIS analysis could be adjusted so that the meandifferences with the dilution methods would become zero. The SD valuesfor the mean differences between the dilution and BIS methods, however,remained significant for both males and females: TBW (±2.1-2.8liters), ECW (±1.4-1.6 liters), and ICW (2.0-3.1 liters).To improve the accuracy of the BIS measurement for an individual withinthe age range we have examined, further refinement of the constantsused in the BIS analysis is needed.

     

Body composition assessment in extreme obesity and after massive weight loss induced by gastric bypass surgery

Body composition methods were examined in 20 women [body mass index (BMI) 48.7 +/- 8.8 kg/m(2)] before and after weight loss [-44.8 +/- 14.6 (SD) kg] after gastric bypass (GBP) surgery. The reference method, a three-compartment (3C) model using body density by air displacement plethysmography and total body water (TBW) by H(2)18O dilution (3C-H(2)18O), showed a decrease in percent body fat (%BF) from 51.4 to 34.6%. Fat-free mass hydration was significantly higher than the reference value (0.738) in extreme obesity (0.756; P < 0.001) but not after weight reduction (0.747; P = 0.16). %BF by H(2)18O dilution and air displacement plethysmography differed significantly from %BF by 3C-H(2)18O in extreme obesity (P < 0.05) and 3C models using (2)H(2)O or bioelectrical impedance analysis (BIA) to determine TBW improved mean %BF estimates over most other methods at both time points. BIA results varied with the equation used, but BIA better predicted %BF than did BMI at both time points. All methods except BIA using the Segal equation were comparable to the reference method for determining changes over time. A simple 3C model utilizing air displacement plethysmography and BIA is useful for clinical evaluation in this population.