Abstract
Study design
Cross-sectional study.
Objectives
This study: (1) investigated the accuracy of bioelectrical impedance analysis (BIA) and skinfold thickness relative to dual-energy X-ray absorptiometry (DXA) in the assessment of body composition in people with spinal cord injury (SCI), and whether sex and lesion characteristics affect the accuracy, (2) developed new prediction equations to estimate fat free mass (FFM) and percentage fat mass (FM%) in a general SCI population using BIA and skinfolds outcomes.
Setting
University, the Netherlands.
Methods
Fifty participants with SCI (19 females; median time since injury: 15 years) were tested by DXA, single-frequency BIA (SF-BIA), segmental multi-frequency BIA (segmental MF-BIA), and anthropometry (height, body mass, calf circumference, and skinfold thickness) during a visit. Personal and lesion characteristics were registered.
Results
Compared to DXA, SF-BIA showed the smallest mean difference in estimating FM%, but with large limits of agreement (mean difference = −2.2%; limits of agreement: −12.8 to 8.3%). BIA and skinfold thickness tended to show a better estimation of FM% in females, participants with tetraplegia, or with motor incomplete injury. New equations for predicting FFM and FM% were developed with good explained variances (FFM: R2 = 0.94; FM%: R2 = 0.66).
Conclusions
None of the measurement techniques accurately estimated FM% because of the wide individual variation and, therefore, should be used with caution. The accuracy of the techniques differed in different subgroups. The newly developed equations for predicting FFM and FM% should be cross-validated in future studies.
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Data availability
The datasets generated and/or analysed during the current study are available from the corresponding author on reasonable request.
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Acknowledgements
We thank Amsterdam University of Applied Sciences (Dr. Meurerhuis) and the rehabilitation center Reade in Amsterdam which have contributed to the organization of measurements. We appreciate the cooperation of all the participants, the master students who helped with the measurements and Drs. Robert G. Memelink for providing DXA training and guidance.
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Contributions
SDG conceived the study. WA and JA helped with the recruitment of participants. YM collected and analysed the data. YM, SDG, PW and TJ interpreted the data. YM drafted the paper. YM, SDG, PW and TJ revised the paper and all authors approved the final paper.
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The authors declare no competing interests.
Ethics approval
This study was approved by the Medical Ethical Committee of Slotervaart hospital and Reade (NL64704.048.18).
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Ma, Y., de Groot, S., Weijs, P.J.M. et al. Accuracy of bioelectrical impedance analysis and skinfold thickness in the assessment of body composition in people with chronic spinal cord injury. Spinal Cord 60, 228–236 (2022). https://doi.org/10.1038/s41393-021-00682-w
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DOI: https://doi.org/10.1038/s41393-021-00682-w
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