Dose-Response Relationships Between Body Composition Indices and All-Cause Mortality in Older Japanese Adults

ObjectivesWe examined the dose-response relationships of body composition indices with mortality and identified the best predictor.Design and settingKusatsu Longitudinal Study and Hatoyama Cohort Study, Japan.ParticipantsIn total, 1977 community-dwelling Japanese adults age ≥65 years (966 men and 1011 women) participated.MeasurementsBody mass index (BMI), fat mass index (FMI), fat-free mass index (FFMI), and skeletal muscle mass index (SMI) were determined by segmental multifrequency bioelectrical impedance analysis. The main outcome was all-cause mortality. We determined multivariate-adjusted hazard ratios for mortality relative to sex-specific medians of each body composition index and examined the association shapes.ResultsDuring the median follow-up of 5.3 years, 128 (13.3%) men and 75 (7.4%) women died. Compared with median BMIs (23.3 kg/m² in men and 22.8 kg/m² in women), a BMI >23.3 and ≤26.1 kg/m² was associated with significantly lower mortality risk in men, and a BMI <22.8 kg/m² was associated with significantly higher mortality risk in women. The inverse dose-response relationship with mortality was clearer for FFMI [hazard ratios (95% confidence interval) of 10th and 90th percentiles: 1.58 (1.23–2.03) and 0.58 (0.44–0.79), respectively, in men and 1.56 (1.12–2.16) and 0.68 (0.51–0.91), respectively, in women] and SMI [1.57 (1.22–2.01) and 0.60 (0.45–0.80), respectively, in men and 1.45 (1.05–2.01) and 0.77 (0.61–0.96), respectively, in women] than for BMI [1.30 (0.92–1.83) and 0.65 (0.41–1.03), respectively, in men and 1.87 (1.18–2.95) and 0.88 (0.54–1.42), respectively, in women]. FMI was not associated with mortality in either sex.Conclusions and ImplicationsFFMI and SMI were more definitive predictors of mortality than were BMI and FMI. The lower mortality risk with higher FFMI, regardless of FMI, may explain the age-related weakening of the association between higher BMI and mortality (the “obesity paradox”). FFMI and SMI evaluation should be introduced to clinical assessments of older adults because mortality risk might be reduced by maintaining muscle mass.     

健康群体人体成分与血脂的相关性分析

目的 探讨女护士群体人体成分指标与血脂的相关性,为更精准的个体化健康管理提供依据.方法 选取20～59岁健康体检女护士856名,使用两种衡量标准将所有体检者各分为4组,分别讨论.第一个维度是按年龄分为4组:20～29岁组(n=335),30～39岁组(n=344),40～49岁组(n=131),50～59岁组(n=46...     

Body Composition Assessment in Mexican Children and Adolescents. Part 2: Cross-Validation of Three Bio-Electrical Impedance Methods against Dual X-ray Absorptiometry for Total-Body and Regional Body Composition

The aim of our study was to validate three different bioelectrical impedance analysis (BIA) methods for estimating body composition (BC). First, we generated BIA prediction equations based on the 4-C model as the reference method for fat mass (FM) and fat-free mass (FFM), and on dual X-ray absorptiometry (DXA) estimations of appendicular lean mass (ALM) and truncal fat mass (tFM). Then, we performed cross-validation in an independent BMI-, sex-, and Tanner-stratified sample of 450 children/adolescents. The three BIA methods showed good correlation and concordance with DXA BC estimations. However, agreement analyses showed significant biases, with increasing subestimations of FM and tFM, and overestimations of ALM, by all three BIA methods. In conclusion, the three BIA methods analysed in this study, provide valid estimations of BC for total body and body segments, in children and adolescents who are of a healthy weight, overweight, or obese. It should be noted that this validation cannot be extrapolated to other BIA methods.     

慢性阻塞性肺病患者的人体组成

目的应用生物电阻抗分析法,检测慢性阻塞性肺病(COPD)患者的人体组成的改变。方法选择符合COPD诊断标准的37例住院患者作为研究对象,其中男性27例,女性10例,平均年龄(66.7±9.9)岁。49名健康志愿者作为对照,其中男性28名,女性21名,平均年龄为(64.3±8.3)岁。用生物电阻抗法测定人体组成。结果COPD患者的体重较健康志愿者显著降低(P<0.05),其中去脂体质(FFM)降低更加显著(P<0.01),脂肪含量(Fat%)相对增加(P<0.01);总体水(TBW)和TBW/体重明显低于健康志愿者(P<0.05),而女性患者TBW/FFM高于健康志愿者(P<0.05);男性患者的基础代谢率较健康志愿者显著降低(P<0.05)。结论COPD患者存在不同程度的瘦体质消耗增加,脂肪含量相对增加,造成机体总体水含量减少,基础代谢率降低。     

Body composition by X-ray absorptiometry and bioelectrical impedance in chronic respiratory insufficiency patients

Nutrition assessment is important during chronic respiratory insufficiency to evaluate the level of malnutrition or obesity and should include body composition measurements. The appreciation of fat-free and fat reserves in patients with chronic respiratory insufficiency can aid in designing an adapted nutritional support, e.g., nutritional support in malnutrition and food restriction in obesity. The purpose of the present study was to cross-validate fat-free and fat mass obtained by various bioelectric impedance (BIA) formulas with the fat-free and fat mass measured by dual-energy X-ray absorptiometry (DXA) and determine the formulas that are best suited to predict the fat-free and fat mass for a group of patients with severe chronic respiratory insufficiency. Seventy-five patients (15 women and 60 men) with chronic obstructive and restrictive respiratory insufficiency aged 45–86 y were included in this study. Body composition was calculated according to 13 different BIA formulas for women and 12 for men and compared with DXA. Because of the variability, calculated as 2 standard deviations, of ± 5.0 kg fat-free mass for women and ± 6.4 kg for men for the best predictive formula, the use of the various existing BIA formulas was considered not clinically relevant. Therefore disease-specific formulas for patients with chronic respiratory insufficiency should be developed to improve the prediction of fat-free and fat mass by BIA in these patients.     

New Reference Values for Body Composition by Bioelectrical Impedance Analysis in the General Population: Results From the UK Biobank

BackgroundLow fat-free mass (FFM) is a risk factor for morbidity and mortality in elderly and patient populations. Therefore, measurement of FFM is important in nutritional assessment. Bioelectrical impedance analysis (BIA) is a convenient method to assess FFM and FFM index (FFMI; FFM/height²). Although reference values have been established for individuals with normal body weight, no specific cutoff values are available for overweight and obese populations. Also, limited studies accounted for the age-related decline in FFM.ObjectiveTo determine BMI- and age-specific reference values for abnormal low FFM(I) in white-ethnic men and women free of self-reported disease from the general population.DesignThe UK Biobank is a prospective epidemiological study of the general population from the United Kingdom. Individuals in the age category 45 to 69 years were analyzed. In addition to body weight, FFM and FFMI were measured using a Tanita BC-418MA. Also, self-reported chronic conditions and ethnic background were registered, and lung function was assessed using spirometry.ResultsAfter exclusion of all individuals with missing data, nonwhite ethnicity, self-reported disease, body mass index (BMI) less than 14 or 36 kg/m² or higher, and/or an obstructive lung function, reference values for FFM and FFMI were derived from 186,975 individuals (45.9% men; age: 56.9 ± 6.8 years; BMI: 26.5 ± 3.6 kg/m²; FFMI 18.3 ± 2.4 kg/m²). FFM and FFMI were significantly associated with BMI and decreased with age. Percentiles 5, 10, 25, 50, 75, 90, and 95 were calculated for FFM, FFMI, and fat mass (index), after stratification for gender, age, and BMI.ConclusionsUsing the UK Biobank dataset, new reference values for body composition assessed with BIA were determined in white-ethnic men and women aged 45 to 69 years. Because these reference values are BMI specific, they are of broad interest for overweight and obese populations.     

Bioelectrical Impedance Analysis for the Assessment of Body Composition in Sarcopenia and Type 2 Diabetes

Sarcopenia is emerging as a severe complication in type 2 diabetes (T2DM). On the other hand, it has been documented that nutritional aspects, such as insufficient protein or total energy intake, increase sarcopenia risk. The analysis of body composition is a relevant approach to assess nutritional status, and different techniques are available. Among such techniques, bioelectrical impedance analysis (BIA) is particularly interesting, since it is non-invasive, simple, and less expensive than the other techniques. Therefore, we conducted a review study to analyze the studies using BIA for body composition analysis in T2DM patients with sarcopenia or at risk of catching it. Revised studies have provided important information concerning relationships between body composition parameters (mainly muscle mass) and other aspects of T2DM patients’ conditions, including different comorbidities, and information on how to avoid muscle mass deterioration. Such relevant findings suggest that BIA can be considered appropriate for body composition analysis in T2DM complicated by sarcopenia/muscle loss. The wide size of the patients’ cohort in many studies confirms that BIA is convenient for clinical applications. However, studies with a specific focus on the validation of BIA, in the peculiar population of patients with T2DM complicated by sarcopenia, should be considered.     

成年人去脂组织重、体脂含量与体重、身高和体围的关系

生物电阻抗法 (bioelectrical impedanceanalysis,BIA)用于人体组成成分分析的准确性已得到肯定 [1 ,2 ] 。本次对 95 5例健康成年人运用 BIA法测量去脂组织重、体脂量及常规方法测量体重、身高、上臂围、腰围、臀围 ,并探讨它们之间的关系。旨在建立更简单实用的计算去脂组织重和体脂含量的方法 ,应用于临床评价。1　材　料　与　方　法1 .1　对象　　挑选 1 0 0 5名健康查体人员 [3]中的 95 5人进行了 BIA法体脂测量 ,其中男性 3 92人 ,女性 5 63人。按年龄分为两组 ,年龄 1 8～ 45岁为 5 84人 ,年龄 46～ 74岁为 3 71人。均为汉族健…     

87例医务人员身体组成测定与分析

目的了解医务人员身体脂肪含量及肥胖率。方法用人体组成分析仪运用生物电阻抗法对87例医务人员进行身体组成的测定与分析。结果男性体重、肌肉组织量、骨矿物量、去脂组织量明显高于女性穴P<0.001雪,脂肪组织量男性与女性无明显差异穴P>0.05雪,身体脂肪率(F%)女性明显高于男性穴P<0.001雪。总体肥胖率以F%法判定为41.38%,体质指数(BMI)法判定为4.60%,超标准体重百分比法判定为21.84%。3种判定方法比较,总体肥胖检出结果F%法明显高于BMI法与超标准体重百分比法穴P<0.005雪。用F%法判定,小于30岁、30～50岁、大于50岁3个年龄段的总体肥胖率分别为33.33%、41.67%、55.56%,无显著性差异(P>0.05)。结论受试医务人员肥胖率偏高,应注意控制。     

应用人体成分分析仪评价COPD住院患者营养状况

营养不良是多数慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者预后不良的危险因素,且随病情发展程度会逐渐加重,导致治疗时间延长,病死率增加.因此,评价COPD患者营养状况尤为重要.生物电阻抗法(bioelectrical impedance analysis,BIA)是目前应用前景较好的营养状况检查方法,本研究用该Inbody-S20人体成分分析仪测量本院61例COPD住院患者的体质成分并进行营养状况评价.     

Body composition obtained from the body mass index

Background  Since obesity and related diseases are now considered epidemic, new and more accurate formulas for epidemiological studies are of interest to the scientific community. Several equations have been proposed to estimate the body composition simply from anthropometric measurements. However, with time, the body composition of the populations studied changes in relation to their food habits and lifestyle, and, therefore, the equations must be regularly updated and corrected. Aim of the study  The aim of the study was to develop new equations to determine the body composition among the Italian population using the body mass index and independently by variables such as age and body structure. Methods  Bioelectrical impedance and anthropometric analysis of 764 Italian Caucasian subjects (342 females and 422 males), 11 to 80 years of age, were analysed. Females and males were analysed separately. Multiple regression analyses were performed in order to estimate the body composition of the subjects. The estimated masses were then compared with the measured masses using Bland and Altman plots. We also calculated the differences between the estimated and measured masses, reported as % of the body weight, for the 95, 85 and 75° percentile of the female and male groups. Finally we compared our formulas with the Watson equations, which are used to estimate the total body water. Results  All body masses estimated were positively correlated to the measured values. Moreover, at any percentile analysed, our formulas resulted more precise than the Watson formula. Equations: Females: FM = 1.9337 BMI – 26.422; FFM = BW – FM; BCM = 0.3655 FFM + 4.865; TBW = 0.5863 FFM + 7.1732; Males: FM = 1.407 BMI – 21.389; FFM = BW – FM; BCM = 0.4485 FFM + 3.3534; TBW = 0.6997 + 1.4567. Conclusions  Although an inevitable inaccuracy must be expected in epidemiological studies, our equations are adequate to analyze the body composition state and changes occurring among the Italian population by simply considering weight and height.     

健康老年人静息能量消耗

目的 :　探讨老年人 REE与性别、年龄 ,人体测量学指标的相关性。方法 :　用间接能量测定仪测试 82名 (男 3 0、女 5 2 )平均年龄 80岁的中国健康汉族老年人的静息能量消耗 (rest-ing energy expenditure,REE)的水平 ,并将 REE测试值与根据 Harris- Benedict公式算出的基础能量消耗值 (basal energy expenditure,BEE)进行比较。同时应用生物电阻抗分析法 (bioelectricalimpedance analysis,BIA)测定去脂体重 (fatfree mass,FFM)和体脂重量 (fat mass,FM)等人体测量学数据。结果 :　 82名健康老人的 REE平均值为 (4.44± 0 .5 2 ) MJ/2 4 h,与公式计算的 BEE比无统计学差异 ,但比 FAO/WHO/UNU(1 985 )公式值低 9% ,比 Owen公式值低 1 9%。本研究观察到我国健康老年人的 REE与去脂体重、体重、体表面积 (body surface area,BSA)、年龄、身高、性别和体重指数 (body mass index,BMI)之间有相关性。老年男女的每公斤体重、每公斤去脂体重和单位体表面积所产生的 REE间无统计学差异。结论 :　 Harris- Benedict公式、FAO/WHO/UNU(1 985 )公式与 Owen公式都过高估计了我国健康老年人的基础能量消耗。由于老年人的REE存在较大的个体差异 ,其 REE值宜实测而不宜用公式预测。我国健康老年人的 REE与去脂体重、体?     

招募体检筛选工作中的人体成分检测

目的对人体成分检测在征兵工作中的应用进行研究,探讨人体成分检测和体能水平的相关性;方法选取662名应征青年,对其进行人体成分检测,并对其中633名进行3 000米体能测试,分及格组和不及格组进行t检验;结果①体脂百分比的参考值范围为10.50%～21.50%（男）和20.40%～31.70%（女）;BMI参考值范围为18.70～25.40（男）和18.00～24.00（女）;瘦体重百分比参考值范围为46.90%～65.10%（男）和37.60%～47.60%（女）;骨骼肌百分比参考值范围为31.40%～43.90%（男）和24.80%～30.90%（女）;②分别对3 000米跑及格组和不及格组进行均数比较,体脂百分比差异有统计学意义（男：p=0.0004,女：p=0.6135）;BMI差异无统计学意义（男：p=0.0827,女：p=0.4295）;瘦体重百分比差异有统计学意义（男：p=0.0001,女：P=0.0227）;骨骼肌百分比差异有统计学差异（男：p=0.0002,女：p=0.0003）。结论①应征入伍青年人体成分分布上相较于国外应征青年仍有差距;②单纯采用BMI并不能对体能水平进行判断;③瘦体重和骨骼肌百分比更能反应应征青年的体能水平。     

The Stayhealthy bioelectrical impedance analyzer predicts body fat in children and adults

Bioelectrical impedance analysis (BIA) is a time-efficient and cost-effective method for estimating body composition. We hypothesized that there would be no significant difference between the Stayhealthy BC1 BIA and the selected reference methods when determining body composition. Thus, the purpose of the present study was to determine the validity of estimating percent body fat (%BF) using the Stayhealthy BIA with its most recently updated algorithms compared to the reference methods of dual-energy x-ray absorptiometry for adults and hydrostatic weighing for children. We measured %BF in 245 adults aged 18 to 80 years and 115 children aged 10 to 17 years. Body fat by BIA was determined using a single 50 kHz frequency handheld impedance device and proprietary software. Agreement between BIA and reference methods was assessed by Bland and Altman plots. Bland and Altman analysis for men, women, and children revealed good agreement between the reference methods and BIA. There was no significant difference by t tests between mean %BF by BIA for men, women, or children when compared to the respective reference method. Significant correlation values between BIA, and reference methods for all men, women, and children were 0.85, 0.88, and 0.79, respectively. Reliability (test-retest) was assessed by intraclass correlation coefficient and coefficient of variation. Intraclass correlation coefficient values were greater than 0.99 (P < .001) for men, women, and children with coefficient of variation values 3.3%, 1.8%, and 1.7%, respectively. The Stayhealthy BIA device demonstrated good agreement between reference methods using Bland and Altman analyses.     

应用生物电阻抗法分析血液透析患者的人体组成

目的应用生物电阻抗法(BIA)检测血液透析(HD)患者身体组成的改变。方法将122例HD稳定患者按体质指数(BMI)分为消瘦组(BMI(18.5)、正常组(BMI18.5～23.9)和超重肥胖组(BMI≥24)。采用单频体脂肪测量仪测量透析后患者的体重(WT)、总体水(TBW)、脂肪组织(FM)和非脂肪组织(FFM),并与用Wat-son公式计算的TBW进行比较。同时计算尿素消除率(Kt/V)。结果(1)超重肥胖组人体组成各指标均明显高于正常组(P(0.005,P(0.001),消瘦组人体组成各指标均明显低于正常组(P均(0.001)。(2)Watson公式计算的男、女TBW分别为34.4±4.2和26.9±2.7,明显低于BIA法的36.0±5.2(P(0.001)和27.7±3.8(P(0.05)。(3)超重肥胖组Kt/V为1.3±0.2,明显低于正常组的1.5±0.2(P(0.001),Kt/V与BMI、TBW、FFM呈负相关(P(0.001)。结论不同BMIHD患者的人体组成变化明显,BIA对评估HD后体液平衡状态和营养状况有十分重要的意义。     

The Relationship between Body Composition,Dietary Intake,Physical Activity,and Pulmonary Status in Adolescents and Adults with Cystic Fibrosis

Measures of body fat and lean mass may better predict important clinical outcomes in patients with cystic fibrosis (CF) than body mass index (BMI). Little is known about how diet quality and exercise may impact body composition in these patients. Dual X-ray absorptiometry (DXA) body composition, 24-h dietary recall, and physical activity were assessed in a cross-sectional analysis of 38 adolescents and adults with CF and 19 age-, race-, and gender-matched healthy volunteers. Compared with the healthy volunteers, participants with CF had a lower appendicular lean mass index (ALMI), despite no observed difference in BMI, and their diets consisted of higher glycemic index foods with a greater proportion of calories from fat and a lower proportion of calories from protein. In participants with CF, pulmonary function positively correlated with measures of lean mass, particularly ALMI, and negatively correlated with multiple measures of body fat after controlling for age, gender, and BMI. Higher physical activity levels were associated with greater ALMI and lower body fat. In conclusion, body composition measures, particularly ALMI, may better predict key clinical outcomes in individuals with CF than BMI. Future longitudinal studies analyzing the effect of dietary intake and exercise on body composition and CF-specific clinical outcomes are needed.     

Lean Body Mass Associated with Upper Body Strength in Healthy Older Adults While Higher Body Fat Limits Lower Extremity Performance and Endurance

Impaired strength adversely influences an older person’s ability to perform activities of daily living. A cross-sectional study of 117 independently living men and women (age = 73.4 ± 9.4 year; body mass index (BMI) = 27.6 ± 4.8 kg/m²) aimed to assess the association between body composition and: (1) upper body strength (handgrip strength, HGS); (2) lower extremity performance (timed up and go (TUG) and sit to stand test (STS)); and (3) endurance (6-minute walk (SMWT). Body composition (% fat; lean body mass (LBM)) was assessed using bioelectrical impedance. Habitual physical activity was measured using the Minnesota Leisure Time Physical Activity Questionnaire (MLTPA) and dietary macronutrient intake, assessed using 24 h recalls and 3-day food records. Regression analyses included the covariates, protein intake (g/kg), MLTPA, age and sex. For natural logarithm (Ln) of right HGS, LBM (p < 0.001) and % body fat (p < 0.005) were significant (r² = 46.5%; p < 0.000). For left LnHGS, LBM (p < 0.000), age (p = 0.036), protein intake (p = 0.015) and LnMLTPA (p = 0.015) were significant (r² = 0.535; p < 0.000). For SMW, % body fat, age and LnMLTPA were significant (r² = 0.346; p < 0.000). For STS, % body fat and age were significant (r² = 0.251; p < 0.000). LBM is a strong predictor of upper body strength while higher % body fat and lower physical activity are associated with poorer outcomes on tests of lower extremity performance.     

2015年中国15省(自治区、直辖市)18~65岁居民体脂率人群分布及其与体质指数关系

目的描述2015年中国15省(自治区、直辖市)18~65岁居民体脂率(body fat percentage,BF%)和体脂肪量的地区和人群分布特征,探讨体脂率与体质指数(body mass index,BMI)的关系。方法本研究利用2015年"中国居民营养状况变迁的队列研究"项目中有完整体格测量及相关人口经济学调查资料的10561名18~65岁成年人数据进行分析。采用生物电阻抗法测量调查对象体脂率和体重,分析不同性别成年人体脂率和体脂肪量在年龄、教育水平、家庭人均收入、地区和城乡之间分布的差异,并根据世界卫生组织(World Health Organization,WHO)推荐的体脂率的肥胖判定标准判断人群肥胖率。结果2015年中国15省(自治区、直辖市)18~65岁成年女性体脂率、体脂肪量分别为33.6%、19.5 kg,成年男性分别为23.0%、15.7 kg。体脂率、体脂肪量均呈现北方地区高于南方,差异有统计学意义(P<0.0001)。男性不同年龄、教育水平、家庭年人均收入水平、地域及城乡人群的体脂率和体脂肪量差异均有统计学意义(P<0.0001)。女性不同年龄、教育水平、地域的体脂率和体脂肪量差异均有统计学意义(P<0.0001),城乡和家庭收入水平差异没有统计学意义。按照WHO推荐的体脂率的肥胖判定标准,女性肥胖率42.0%,随年龄增长不断上升,60~65岁女性肥胖率高达52.4%。男性肥胖率37.1%,随着年龄增长呈上升趋势,但在60~65岁组下降。北方地区男女性肥胖率分别41.9%、45.6%,明显高于南方地区的34.3%、39.9%。BMI与BF%密切相关,但在超重人群中,体脂率达到肥胖水平的人超过50%。结论2015年中国15省(自治区、直辖市)不同性别成年人体脂率和体脂肪量存在明显的地区和人群差异,北方人群的肥胖率明显高于南方。