Use of bioelectrical impedance analysis to monitor changes in fat-free mass during recovery from colorectal cancer- a validation study

Linnea Bärebring; Ane Sørlie Kværner; Madeleine Skotnes; Hege Berg Henriksen; Anne Juul Skjetne; Christine Henriksen; Hanna Ræder; Ingvild Paur; Siv Kjølsrud Bøhn; Gro Wiedswang; Sigbjørn Smeland; Rune Blomhoff

doi:10.1016/j.clnesp.2020.09.021

Use of bioelectrical impedance analysis to monitor changes in fat-free mass during recovery from colorectal cancer- a validation study

Clin Nutr ESPEN. 2020 Dec:40:201-207. doi: 10.1016/j.clnesp.2020.09.021. Epub 2020 Oct 3.

Affiliations

¹ Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Department of Internal Medicine and Clinical Nutrition, Sahlgrenska Academy, University of Gothenburg, Sweden. Electronic address: linnea.barebring@gu.se.
² Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Section for Colorectal Cancer Screening, Cancer Registry of Norway, Norway.
³ Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
⁴ Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway; Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway.
⁵ Faculty of Chemistry, Biotechnology and Food Sciences, Norwegian University of Life Sciences, Ås, Norway.
⁶ Department of Gastroenterological Surgery, Oslo University Hospital, Ullevål, Norway.
⁷ Division of Cancer Medicine, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

PMID: 33183537
DOI: 10.1016/j.clnesp.2020.09.021

Abstract

Background & aims: Although previous research show high correlation between fat-free mass (FFM) measured by bioelectrical impedance analysis (BIA) and dual-energy X-ray absorptiometry (DXA), the validity of BIA to track longitudinal changes in FFM is uncertain. Thus, the aim of this study was to validate the ability of BIA to assess changes in FFM during 6 months of recovery from non-metastatic colorectal cancer (CRC).

Methods: A total of 136 women and men (50-80 years) with stage I-III CRC and a wide range of baseline FFM (35.7-73.5 kg) were included in the study. Body composition was measured at study baseline within 2-9 months of surgery and again 6 months later. Whole-body BIA FFM estimates (FFM_BIA) were calculated using three different equations (manufacturer's, Schols' and Gray's) before comparison to FFM estimates obtained by DXA (FFM_DXA).

Results: Correlation between changes in FFM_BIA and FFM_DXA was intermediate regardless of equation (r ≈ 0.6). The difference in change of FFM_BIA was significant compared to FFM_DXA, using all three equations and BIA overestimated both loss and gain. However, BIA showed 100% sensitivity and about 90% specificity to identify individuals with ≥5% loss in FFM, using all three equations. Sensitivity of FFM_BIA to detect a smaller loss of FFM (60-76%) or a gain in FFM of ≥5% (33-62%) was poor.

Conclusion: In a well-nourished population of non-metastatic CRC patients, a single-frequency whole-body BIA device yielded imprecise data on changes in FFM, regardless of equation. BIA is thus not a valid option for quantifying changes in FFM in individuals. However, BIA could be used to identify patients with loss in FFM ≥5% in this population. The validity of BIA to monitor changes in FFM warrants further investigation before implementation in clinical praxis.

Keywords: Bioelectrical impedance analysis; Body composition; Colorectal cancer; Dual-energy X-ray absorptiometry; Fat-free mass.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Absorptiometry, Photon
Body Composition*
Colorectal Neoplasms* / diagnosis
Electric Impedance
Female
Humans
Male
Reproducibility of Results