15/12/21, 10:25 Body Mass Index and Agreement Between Bioimpedance and Anthropometry Estimates of Body Compartments in Anorexia N…

Journal of Parenteral and Enteral Nutrition / Volume 29, Issue 3 / p. 148-156

Original Communication

Body Mass Index and Agreement Between Bioimpedance and Anthropometry

Estimates of Body Compartments in Anorexia Nervosa

Antonio Piccoli MD, DSc , Marta Codognotto MD, Lorenza Di Pascoli MD, Gina Boffo RD
… See all authors 

First published: 01 May 2005

https://doi.org/10.1177/0148607105029003148
Citations: 32

Abstract
Background: In 74 women with anorexia nervosa (body mass index [BMI] 10–17.5 kg/m2),
a progressive disagreement between anthropometry and bioelectrical impedance
analysis (BIA) estimates of fat (FM) and fat-free mass (FFM) was documented with a BMI
<15 kg/m2. Below this threshold, an abnormal body composition was detected with
vector BIA independent on body weight (useful tool at the bedside). Both anthropometry
and BIA are used for body composition assessment. We evaluated the agreement
between their estimates of FFM and FM in extremely lean subjects with anorexia nervosa.
Methods: Observational study in 74 women (age 15–45 years; BMI 10.0–17.5 kg/m2) with
anorexia nervosa. Anthropometry FM and FFM were estimated by skinfold thicknesses.
Whole-body impedance vector components, resistance (R) and reactance (Xc), were
measured at the same time (BIA-101 analyzer, 50-kHz frequency; Akern/RJL Systems,
Clinton Twp., MI). BIA estimates of FFM and FM were obtained with Sun's equations (BMI
14–39 kg/m2). Vector BIA was performed with the RXc graph method. The frequency of
disagreement between anthropometry and BIA was evaluated as a function of increasing
BMI (receiver operating characteristic curve). Results: The correlation coefficient between
methods was 0.80–0.90. The BMI cutoff value of 15 kg/m2 predicted disagreement of FM
and FFM in patients with a BMI<15 kg/m2. In the RXc graph, the distribution of vectors
from patients with disagreement was significantly shifted out of the right border of the
reference tolerance ellipses. Conclusions: Anthropometry and BIA equations should not
be used in anorexic patients with a BMI <15 kg/m2. The distribution of vectors from
patients with disagreement of methods was shifted out of the right border of the
reference tolerance ellipses and was superposed to vectors from patients with a BMI <15
kg/m2. The identified impedance pattern for anorexia could be useful for feedback in
individual patient refeeding (vector back into the 75% reference ellipse).

https://aspenjournals.onlinelibrary.wiley.com/doi/abs/10.1177/0148607105029003148 1/2
15/12/21, 10:25 Body Mass Index and Agreement Between Bioimpedance and Anthropometry Estimates of Body Compartments in Anorexia N…

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https://aspenjournals.onlinelibrary.wiley.com/doi/abs/10.1177/0148607105029003148 2/2