Translated from Russian to English - www.onlinedoctranslator.com
ORIGINAL STUDY
Obesity and metabolism / Obesity and metabolism |13
CONSISTENCY OF ESTIMATES OF THE SHARE OF FAT TISSUE OBTAINED WITH THE
APPLICATION OF INDIRECT (INDIRECT) METHODS OF INVESTIGATION OF BODY
COMPOSITION
© E.A. Bondareva1*, O.I. Parfentiev2, A.A. Vasiliev2, ON THE. Kulemin1, A.N. Gadzhiakhmedova3, HE. Kovaleva3, B.A.
Sultanova4, N.V. Mazurin4, E.A. Troshina4
Federal Scientific and Clinical Center of Physical and Chemical Medicine named after V.I. Academician Yu.M.
Lopukhin Federal Medical and Biological Agency, Moscow, Russia
1
Moscow State University M.V. Lomonosov, Moscow, Russia
First Moscow State Medical University named after I.M. Sechenov (Sechenov University), Moscow, Russia
2
3
National Medical Research Center for Endocrinology, Moscow, Russia
4
Rationale.The steadily increasing number of obese people requires the development of simple and accurate
methods. logical approaches to quantify the absolute and relative amount of body fat. One of the indices proposed
for quantifying the relative amount of fat mass - the proportion of fat mass is the body fat index (IL, BAI, body
adiposity index). However, data on the consistency of estimates of the proportion of fat mass obtained using
common screening methods (bioimpedance analysis (BIA) and ultrasound (ultrasound)) and IL are not available for
the Russian population.
Target.Analysis of the consistency of the results of assessing the proportion of body fat mass obtained using methods BIA,
ultrasound and IL, in adult men and women.
Materials and methods.A survey was conducted of adult conditionally healthy men and women living in in
Moscow. Body length and weight, waist and hips were measured. The proportion of body fat mass was determined
using BIA (ABC-02 "Medass"), ultrasound (BodyMetrixTM, IntelaMetrix) and calculated IL.
Results.The study involved263 women and 134 men aged 18 to 73. The correlation coefficients of IL with the proportion
of fat mass (%BM), calculated from the results of BIA and ultrasound, were 0.749 and 0.763 (p<0.000), respectively. An
analysis of the consistency of the results of the assessment of % BM, determined by the value of IL, BIA and US, showed
that IL demonstrates weak agreement (concordant correlation coefficient (CCC) <0.90) with both instrumental methods
both at the level of the total sample and in subgroups by gender. At the same time, ultrasound and BIA methods
demonstrate the highest level of consistency (CCC=0.84 [0.80–0.86]) and no systematic bias. The least consistent were the
results of determining the % WM in the subgroup of men.
Conclusion.The results obtained allow us to conclude that the assessment of %WL by the value of IL on an
individual level cannot serve as a substitute for indirect methods, while at the group level in a mixed sample of
men and women, all three methods are interchangeable.
KEY WORDS: proportion of fat mass; body composition; ultrasound scanning; bioimpedance analysis; body fat index; B.A.I.
AGREEMENT OF BODY ADIPOSITY INDEX (BAI), BIOIMPEDANCE ANALYSIS AND ULTRASOUND
SCANNING IN DETERMINING BODY FAT
© Elvira A. Bondareva1*, Olga I. Parfenteva2Aleksandra A. Vasileva2, Nikolay A. Kulemin1, Aida N. Gadzhiakhmedova1.3Olga
N. Kovaleva3, Begimay A. Sultanova4, Natalya V. Mazurina4, Ekaterina A. Troshina4
Lopukhin Federal research and clinical center of physical-chemical medicine, Federal medical biological agency, Moscow,
Russia
2Lomonosov Moscow State University, Moscow, Russia
3First Moscow State Medical University (Sechenov University), Moscow, Russia
4Endocrinology Research Centre, Moscow, Russia
1
BACKGROUND:The steadily increasing number of people with obesity requires the development of simple and accurate
methodological approaches to assess the absolute and relative amount of body fat mass. The body adiposity index (BAI) is one
of the indices proposed to assess the body fat percentage. However, the comparison analysis of common methods, ie, of bioelectrical impedance analysis and ultrasound scanning, and BAI was not performed for the Russian population.
AIIM:Comparison analysis of the body fat percentage estimates by bio-electrical impedance analysis, ultrasound scanning, and
body adiposity index in the group of adult male and females.
MATERIALS AND METHODS:An examination of healthy males and females from Moscow was conducted. Height, weight, waist
and hip circumferences were measured. The body fat percentage was obtained by bio-electrical impedance analysis - BIA
(ABC-02 Medas), ultrasound scanning - US (BodyMetrixTM, IntelaMetrix), and body adiposity index.
* Corresponding author.
© Endocrinology Research Centre, 2023
Obesity and metabolism. - 2023. - T. 20. - No. 1. – pp. 13-21
Received: 01/18/2023. Accepted: 03/14/2023.
doi: https://doi.org/10.14341/omet12949
obesity and metabolism. 2023;20(1):13-21
SCIENTIFIC RESEARCH
14| Obesity and Metabolism /Obesity and metabolism
RESULT:263 females and 134 males aged 18 to 73 years participated in the study. Correlation coefficients between BAI values
and the body fat percentage obtained by BIA and US were 0.749 and 0.763 (p<0.000), respectively. Comparison of body fat
percentage measurements obtained by BAI, BIA and US showed the low agreement (CCC<0.90) between BAI and other methods
in pooled sample as well as in the female and male groups. Comparison of the US and BAI methods revealed higher level of
agreement (CCC=0.84 [0.80–0.86]) and no systematic bias. Lower level of agreement was obtained in the group of males.
CONCLUSION:Conducted study allows to conclude that, at the individual level, BAI is not an appropriate method for estimating
the body fat percentage relatively to other indirect methods. However, all three methods can be used in the group of pooled
males and females when testing at the population level.
KEYWORDS: percentage body weight; body composition; ultrasonic scanning; bio-electrical impedance analysis; body adiposity index; B.A.I.
RATIONALE
MATERIALS AND METHODS
The amount of fat and the nature of its deposition
play a leading role in the development of a number of
comorbid diseases in overweight and obese people [1].
Quantification of body fat mass (%BM) can be done by a
variety of methods, from powerful and costly to field
rapid assessments. Body mass index (BMI) is widely
used to diagnose and classify obesity. However, BMI
has little sensitivity at the individual level because it
does not reflect body composition. Many aspects are
known that make BMI inapplicable in the elderly,
people with neuromuscular pathology and athletes. The
steadily increasing number of people with obesity
requires the development of simple and accurate
methodological approaches to quantify the absolute
and relative amount of fat mass. In this regard, it is
relevant to analyze the feasibility of using various
anthropometric indices, which make it possible to
quantify body composition using simple
anthropometric indicators (body length and weight,
waist and hips). The use of informative anthropometric
indices will allow screening of the general population at
minimal cost to the health care system. One of the
indexes proposed for quantitative assessment of the
relative amount of fat mass - % BM, is the fat deposition
index (IL, BAI, body adiposity index). IL was developed
on a group of adult Mexican men [2] and was
successfully validated in a group of African American
men and women, which suggests its universality for
various populations [3]. Using DEXA as a standard, it
has been shown that IL is better than BMI in
determining % WM [2]. High IL values were associated
with an increased concentration of fasting glucose,
glycated hemoglobin, and high IL values were
associated with the risk of developing type 2 diabetes
mellitus and metabolic syndrome in the European
population, regardless of gender, age, level of physical
activity and drug therapy [4].
Study Design
An observational, single-center, single-stage,
uncontrolled study was conducted.
Eligibility Criteria
Inclusion Criteria:age over17 years. Exclusion
Criteria:the presence of metal implants, a
pacemaker, pregnancy and lactation, the presence of
diabetes mellitus and thyroid dysfunction.
Conditions for conducting and duration of
the study
The study included volunteers who met the inclusion
criteria. Data collection took place from February 2021
to November 2022.
Description of medical intervention (for
interventional research)
The examination program included measurements of
body length (laser anthropometer, KAFA, Russia) and body
weight (Seca, Germany), waist and hip circumferences with
an inelastic measuring tape. BIA of body composition
components was performed using ABC-02 Medass (STC
Medass, Russia) according to the wrist-ankle pattern [5].
We used disposable film bioadhesive electrodes for ECG
(FIAB 3001, Italy). Ultrasound was performed using a
BodyMetrix scannerTM(IntelaMetrix, USA) [6]. The
measurements were carried out at seven points on the
body and limbs, corresponding to skin-fat folds for the
Jackson–Pollock equations for seven folds [7, 8].
Main outcome of the study
The following parameters were taken as the main
endpoints of the study: mean difference of values, limits
of agreement, Lin's concordant correlation coefficient
and effect size (difference of means for paired samples),
as well as the value of the test of statistical equivalence
for %WM determined with using ABC-02 "Medass",
BodyMetrixTMand IZH.
Additional study outcomes
PURPOSE OF THE STUDY
To assess the consistency of the results of
determining the % FM obtained using the methods of
bioimpedance analysis (BIA), ultrasound (ultrasound)
and IL in adult men and women.
Obesity and metabolism. - 2023. - T. 20. - No. 1. – pp. 13-21
The following parameters were taken as additional
endpoints of the study: the values of the coefficients of
the Passing-Bablok regression equation for pairwise
comparisons of the % FM indicators, determined using
ABC-02 "Medass", BodyMetrixTMand IL, having the form
of a point estimate [95% CI].
doi: https://doi.org/10.14341/omet12949
obesity and metabolism. 2023;20(1):13-21
ORIGINAL STUDY
Obesity and metabolism / Obesity and metabolism |15
Subgroup Analysis
Methods of statistical data analysis. Gardner–Altman plots (package “dabestr”) were used to visualize the
All study participants were divided into two
subgroups: men and women.
comparison of paired measurements and Bland–Altman plots (Bland–Altman) and Passing–Bablok regression
were used to demonstrate their consistency. When analyzing the consistency of repeated measurements, we were
guided by international standards (CLSI EP09-A3 and GOST R 50779.60-2017 (ISO 13528:2015)) and the Guidelines for
Outcome Registration Methods
Reporting Reliability and Consistency Studies (GRRAS) [9] . In particular, a robust nonparametric method, the Passing–
Nutritional status was diagnosed by BMI according
to WHO recommendations. The % FM was assessed
using three methods: according to the results of BIA
(ABC-02 "Medass", STC "Medass", Russia) in the
software ABC01-0362, fat mass (FM, kg), % FM and fatfree mass were determined (BFM, kg), according to the
results of ultrasound (BodyMetrix, IntelaMetrix, USA),
%FM, FM, and FFM were calculated using the Jackson–
Pollock formulas implemented in the BodyViewProFit
software (IntelaMetrix, Inc., Livermore, CA). The IL was
also calculated using the formula proposed by Bergman
[2]:
BAI (IL) \u003d [(hip circumference, cm / body length, m1.5)
− 18]. The studies were carried out in the first half of the
day at rest and at a comfortable temperature (room
temperature 24°C). The time interval between BIA and
ultrasound was no more than 30 minutes.
Bablok regression, was used [10]. Lin's concordance correlation coefficient (CCC) (package "epiR") was used as a
measure of consistency. The method is considered to be suitable for research and clinical practice (reliable), when the
lower limit of the 95% confidence interval (CI) for CCC>0.99. If the upper limit of 95% CI<0.90, then the degree of
agreement is low [11]. The analysis of the statistical equivalence of the two methods was carried out using the TOST
(two one-side tests), NHST (null hypothesis significance test) tests (TOSTER package). The agreement of the
distribution with the normal law was checked using bootstrap algorithms (PAST), descriptive statistics, exploratory
data analysis, and correlation analysis were performed using the PAST [12] and JASP [13] programs. To analyze
differences between subgroups formed by gender, the Wilcoxon test for independent samples was used. The
Bonferroni correction was used to control the error of the first kind. The analysis of the statistical equivalence of the
two methods was carried out using the TOST (two one-side tests), NHST (null hypothesis significance test) tests
(TOSTER package). The agreement of the distribution with the normal law was checked using bootstrap algorithms
(PAST), descriptive statistics, exploratory data analysis, and correlation analysis were performed using the PAST [12]
and JASP [13] programs. To analyze differences between subgroups formed by gender, the Wilcoxon test for
independent samples was used. The Bonferroni correction was used to control the error of the first kind. The analysis
of the statistical equivalence of the two methods was carried out using the TOST (two one-side tests), NHST (null
hypothesis significance test) tests (TOSTER package). The agreement of the distribution with the normal law was
checked using bootstrap algorithms (PAST), descriptive statistics, exploratory data analysis, and correlation analysis
were performed using the PAST [12] and JASP [13] programs. To analyze differences between subgroups formed by
Ethical review
A positive conclusion was received from the local
committee on bioethics of the Faculty of Biology of Moscow
State University named after M.V. Lomonosov (No. 116-d of
09/08/2020). All volunteers who participated in the survey
were aware of the objectives and methods of the survey and
gave their informed consent.
gender, the Wilcoxon test for independent samples was used. The Bonferroni correction was used to control the error
of the first kind. descriptive statistics, exploratory data analysis, and correlation analysis — in the PAST [12] and JASP
[13] programs. To analyze differences between subgroups formed by gender, the Wilcoxon test for independent
samples was used. The Bonferroni correction was used to control the error of the first kind. descriptive statistics,
exploratory data analysis, and correlation analysis — in the PAST [12] and JASP [13] programs. To analyze differences
between subgroups formed by gender, the Wilcoxon test for independent samples was used. The Bonferroni
correction was used to control the error of the first kind.
Statistical analysis
Sample size calculation principles.
To achieve 80% research power with a type I error
level of 5% (α=0.05) in the statistical equivalence test
(TOST), the sample size must be at least 96 pairs of
measurements.
RESULTS
Objects (participants) of the study
The study involved 263 women and 134 men aged
18 to 73 living in Moscow. Underweight according to
BMI has been identified
Table 1.General characteristics of the surveyed sample
sign
Age, years*
Median [95% CI]
Women
Men
28 [25–31]
24.5 [21.5–26]
Body length, cm
166 [165–168]
177.8 [176–179.1]
Body weight, kg
62.9 [61–65.3]
75.9 [72–78.8]
BMI kg/sq. m*
22.2 [22–22.8]
23.1 [22.7–23.5]
%FM (BIA)
28.5 [27.6–30]
16.8 [15.9–18.9]
ZhM, kg (BIA)*
17.9 [16.9–19.3]
12.3 [11.6–14.3]
BZhM, kg (BIA)
44.5 [43.8–45.4]
61.9 [60.1–63.7]
% ZhM (ultrasound)
27.6 [27.2–28.7]
15.1 [14.2–16.7]
ZhM, kg (ultrasound)
17 [16.4–17.7]
11.2 [10.2–12.1]
BZhM, kg (ultrasound)
44.7 [43.8–46]
64.4 [61.7–66.5]
IZH
26.8 [25.8–27.5]
22.6 [21.8–23.4]
Waist, cm
71.7 [70.4–73.5]
78.9 [77.4–81]
97.1 [96–99]
96.7 [95.3–99]
Hip circumference, cm*
Note.* — no significant differences between subgroups. note.* —
absence of significant differences between subgroups.
Obesity and metabolism. - 2023. - T. 20. - No. 1. – pp. 13-21
doi: https://doi.org/10.14341/omet12949
obesity and metabolism. 2023;20(1):13-21
SCIENTIFIC RESEARCH
16| Obesity and Metabolism /Obesity and metabolism
in 28 (20 women and 8 men) examined, normal body
weight according to BMI - in 258 (179 women and 79
men), overweight - in 68 (40 women and 28 men) and
obesity - in 43 ( 24 women and 19 men).
Main results of the study
The values of the main studied characteristics in
the subgroups of men and women, as well as the
significance of intergroup differences are presented in
Table 1. For all characteristics, except for age, BMI, the
absolute value of the FM, determined by the BIA
method and hip girth, significant differences were
found between the subgroups formed by sex .
Correlation coefficients of IL with % VM, calculated from
the results of BIA and ultrasound, were 0.749 and 0.763
(p<0.000), respectively.
The Gardner–Altman plots (Fig. 1) show negligible
effect sizes for pairs of comparisons of %FM,
as well as sexual dimorphism of %FM values, which is
detected by all the studied methods. Probably, when
comparing large samples, the average group estimates
of % FM obtained by the methods of BIA, ultrasound
and IL can be combined or compared directly. The
analysis of statistical equivalence for pairs of
measurements of US-BIA, US-IV, and BIA-IV allowed us
to draw the following conclusions: at the group level, %
VM US and IV are statistically equivalent. In a subgroup
of women, the results of a pair of ultrasound-BIA were
statistically equivalent. For a subgroup of men, no pair
of comparisons showed statistical equivalence of the
studied methods for estimating % WM. These groupwide comparison findings illustrate the effect size and
its 95% CI, presented in the Gardner–Altman plots.
The Bland–Altman analysis (Fig. 2) revealed a slight
systematic bias for
50
50
thirty
0
20
- 10
40
Sex
F
M
%ZHM
10
Paired mean difference
10
thirty
0
20
10
10
- 20
BF_ABC02
N=397
BAI
N=397
- 20
BAI
BF_BM
N=397
minus BF_ABC02
50
BAI
N=397
BAI
minus BF_BM
50
20
thirty
0
20
- 10
10
- 20
BF_ABC02
N=397
BF_BM
BF_BM
N=397 minus BF_ABC02
40
Sex
F
M
%ZHM
10
20
Paired mean difference
40
%ZHM
Sex
F
M
- 10
10
thirty
0
20
Paired mean difference
%ZHM
40
Paired mean difference
20
20
- 10
WHO_group
high
low
normal
obese
10
- 20
BF_ABC02
N=397
BF_BM
BF_BM
N=397 minus BF_ABC02
Picture 1.Gardner–Altman plots for % WM calculated from the results of BIA, ultrasound and IL in subgroups of women and
men, as well as in subgroups by BMI value. Note. Paired mean difference — effect size for paired samples; Sex - gender; F women; M - men; BF -% ZhM; WHO_group — nutritional status of the person examined according to the WHO classification.
Figure 1.Gardner-Altman plots for %BF calculated from the results of BIA, ultrasound and BAI in subgroups of women and men, as well as in
subgroups by BMI value. note. Paired mean difference - effect size for paired samples. Sex - gender, F - women, M - men. BF-%BF.
WHO_group - nutritional status of the examined according to the WHO classification.
Obesity and metabolism. - 2023. - T. 20. - No. 1. – pp. 13-21
doi: https://doi.org/10.14341/omet12949
obesity and metabolism. 2023;20(1):13-21
Obesity and metabolism / Obesity and metabolism |17
10
6.87
0
- 1.01
10
9.84
0
- 0.15
- 10
- 10
10
difference (%FM, BodyMetrix - BAI)
difference (%FM, BodyMetrix - BAI)
ORIGINAL STUDY
- 11.09
20
- 20
40
thirty
- 10.62
10
difference
thirty
40
50
average (%FM, ABC-02 + BAI)/2
average (%FM, BodyMetrix + BAI)/2
(%FM, BodyMetrix + %FM, ABC-02)
20
20
10
6.52
0
- 1.00
- 8.14
- 10
10
20
thirty
40
average
(%FM, BodyMetrix + %FM, ABC-02)/2
Figure 2.Blend–Altman plots for pairs of %FM values calculated from the results of BIA, ultrasound, and IL. The gray area is
gra- 95% CI values for the boundaries of agreement. The central dotted line is the offset. Note. BAI - fat deposition index
niya (IL).
figure 2.Bland-Altman plots for pairs of %BF values calculated from the results of BIA, ultrasound and BAI. The gray area is the 95% CI
bounds for the concordance bounds. The central dotted line is the bias. note. BAI - body adiposity index.
all pairwise comparisons. For pairs of measurements of
US-IV and BIA-IV, a change in the difference between
the pairs of measurements depending on the value of
% VF was found: in the region of low values of 10–20 %
VF, IV gives a greater estimate of % VF, compared with
30% FM ultrasound and BIA show higher values than
IL. This dependence is absent in the ultrasound-BIA
pair. Consistency limits for US-IV and BIA-IV pairs were
17.9 and 20.5, respectively. For a pair of ultrasound-BIA,
the boundaries of agreement were the narrowest and
amounted to 14.7.
The calculation of IL is based, unlike many other
anthropometric indices, on the girth of the hips (buttocks). It is
well known that there are gender differences in the
topography of fat deposition, for example, the gluteofemoral
type is more characteristic for women, and the abdominal
type for men. In the surveyed sample, between
Obesity and metabolism. - 2023. - T. 20. - No. 1. – pp. 13-21
subgroups of men and women, there are significant
differences in LI and body length, but the data of
subgroups do not differ in hip circumference (see Table 1).
Therefore, a study was conducted on the consistency of
estimates in subgroups of men and women. Consistency
for all pairs of measurements was higher for the women
subgroup (Table 2, Fig. 3), although it was weak for both
subgroups (CCC<0.90). The presumably pronounced
features of the figure (fat deposition on the hips) can
significantly affect the assessment of % FB according to IL,
in contrast to the calculation using formulas that take into
account the thickness of the skin-fat folds on the body and
limbs, implemented in the ultrasound software. scanner.
The analysis of the consistency of the results of the assessment of
% BM, determined by the value of IL, BIA and ultrasound, showed that
IL demonstrates weak agreement with both
doi: https://doi.org/10.14341/omet12949
obesity and metabolism. 2023;20(1):13-21
SCIENTIFIC RESEARCH
18| Obesity and Metabolism /Obesity and metabolism
Men
Women
38
42
33
37
28
BAI
BAI
32
27
23
18
22
13
17
8
12
12
17
22
27
32
37
3
42
3
8
13
18
52
42
47
37
42
32
37
27
32
22
27
17
22
12
17
7
12
12
17
22
27
32 37
BF_M
23
28
33
38
BF_BM
BAI
BAI
BF_BM
42
47
2
52
2
7
12
17
22 27
BF_M
32
37
42
Figure 3Passing-Bablok regression for pairs of %FM values in subgroups of men and women. The red line is the ideal line
consistency (CCC=1), dotted lines are predictive intervals, black solid line is the regression line.
Note.BAI - body fat index; BF_M - %ZHM defined in BIA; BF_BM - % FM, determined in the ultrasound.
Figure 3.Passing-Bablok regression for pairs of %BF values, in subgroups of men and women. The red line is the line of perfect agreement
(CCC = 1), the dotted lines are predictive intervals, the black solid line is the regression line.
note.BAI - body adiposity index, BF_M - %BF, determined in BIA, BF_BM - %BF, determined in ultrasound.
instrumental methods both at the level of the general
sample and in subgroups by gender (Fig. 3, Table 2). At the
same time, ultrasound and BIA methods demonstrate the
highest level of consistency and the absence of a
systematic bias (see Figs. 1 and 2). The least consistent
were the results of determining the % WM in the subgroup
of men. For this subgroup, the differences in the
assessment of % VM turned out to be the most
pronounced: the effect size reaches medium and large for
BIA-IV and US-IV pairs, respectively (see Table 2). For
comparison, in the pooled sample for all pairs, the effect
size should be considered negligible.
Obesity and metabolism. - 2023. - T. 20. - No. 1. – pp. 13-21
Additional research findings
Passing–Bablok equations were obtained for
subgroups of women:
1.
IL = 10.56 [8.68÷12.40] + 0.58 [0.51÷0.65] ×
2.
IL = 5.76 [3.83÷7.78] + 0.74 [0.67÷0.82] ×
and men:
%ZHM(ABC-02);
%ZHM(BM);
3.
IL = 15.19 [14.16÷16.23] + 0.42 [0.36÷0.48] ×
4.
IL = 13.52 [12.47÷14.75] + 0.59 [0.51÷0.67] ×
%ZHM(ABC-02);
doi: https://doi.org/10.14341/omet12949
%ZHM(BM).
obesity and metabolism. 2023;20(1):13-21
ORIGINAL STUDY
Obesity and metabolism / Obesity and metabolism |19
Table 2.Values of Lin's concordant correlation coefficientCCC and Cowan effect size d [95% CI]
BIA vs IZH
BIA vs ultrasound
Group
CCC
d
CCC
Ultrasound vs IL
d
CCC
d
General
0.84 [0.80–0.86]
- 0.14 [-0.19–0.08] 0.63 [0.58–0.67]
- 0.04 [-0.11 - 0.03]
0.65 [0.61–0.69]
- 0.19 [-0.26–-0.13]
Women
0.77 [0.72–0.81]
- 0.07 [-0.15-0.01] 0.60 [0.53-0.66]
0.25 [0.15–0.35]
0.72 [0.66–0.77]
0.21 [0.12–0.29]
Men
0.71 [0.62–0.77]
- 0.34 [-0.45 - -0.23] 0.49 [0.41 - 0.56]
- 0.52 [-0.64 - -0.39] 0.37 [0.29 - 0.44]
Adverse events
- 1.18 [-1.33 - -1.03]
body weight, waist circumference, hip circumference) in 675 people, of which 80% were women, whose average age was 38±17
No adverse events were recorded during the
examination. All measuring methods and procedures are
non-invasive and approved for use in children from 6 years
of age. The implementation of these procedures was not
accompanied by a deterioration in health or other
complaints from the surveyed volunteers.
years, the average BMI was 38±6 kg/m2. For a group of people with neuromuscular pathology who were overweight and obese, it
was shown that TSH was positively correlated with LI (p<0.001), BMI (p=0.0002), % BM (p<0.001) and negatively with waist/hip index
(WHI) (p<0.017). St. T4 was not associated with any of the anthropometric indicators. F.T3 positively correlated with waist
circumference (p<0.001), STB (p<0.001) and negatively with %WF (p<0.001), IL (p=0.002) [16]. LI in the group of adults over 40 years
of age who had less than three cardiometabolic disorders at the time of the study was 26.4, in the group where the number of
cardiometabolic disorders was more than three — 29.7. However, Despite significant differences between groups with and without
pathologies, IL cannot be used to assess cardiometabolic risks in men and women over 40 years of age due to its low specificity and
DISCUSSION
sensitivity [17]. LI in the group of elderly Chinese without diabetes was 28.9 (26.3-31.7), in the group with diabetes - 29.7 (26.8-32.9),
which does not allow the use of IL in this population in ka as a diagnostic tool for diagnosing type 2 diabetes mellitus. For a group of
Summary of the main result of the study
women older than 40 years, it was shown that IL is a good predictor of a lack of lean body mass. The value of IL in elderly women
Estimation of %FM using IL at the individual level in
subgroups of men and women cannot be a substitute
for BIA and/or ultrasound. However, at the group level,
mean % WM values obtained using BIA or ultrasound
can be used for direct comparison with the IL value.
without a lack of BFM was 36.3 ± 4.36, and in the group with a lack of muscle tissue - IL cannot be used to assess cardiometabolic
risks in the group of men and women older than 40 years due to its low specificity and sensitivity [17]. LI in the group of elderly
Chinese without diabetes was 28.9 (26.3-31.7), in the group with diabetes - 29.7 (26.8-32.9), which does not allow the use of IL in this
population in ka as a diagnostic tool for diagnosing type 2 diabetes mellitus. For a group of women older than 40 years, it was
shown that IL is a good predictor of a lack of lean body mass. The value of IL in elderly women without a lack of BFM was 36.3 ± 4.36,
and in the group with a lack of muscle tissue - IL cannot be used to assess cardiometabolic risks in the group of men and women
older than 40 years due to its low specificity and sensitivity [17]. LI in the group of elderly Chinese without diabetes was 28.9
Discussion of the main result of the study
(26.3-31.7), in the group with diabetes - 29.7 (26.8-32.9), which does not allow the use of IL in this population in ka as a diagnostic
For the first time, for a Russian sample of men and
women, an analysis was made of the possibility of using IL
to assess % WM at the individual and group levels. The
results obtained allow us to conclude that the assessment
of % WM by the value of IL at the individual level cannot
serve as a substitute for indirect methods, while at the
group level in a mixed sample of men and women, all
three methods are interchangeable. A similar result was
obtained during the validation of IL in a group of adults
living in Brazil. The authors identified similar trends: IL
overestimates %FM in the range of low %FM values
determined by the DEXA method, and underestimates in
the range of high %FM values [14]. An analysis of the
consistency of IL and air replacement plethysmography
(ARP) in a group of people with morbid obesity revealed a
systematic bias: in the range of 38–50% WM, IL shows
values lower than CDW. In the area above 50% - higher
than the CDW; SSS for a pair of IL-CDW measurements was
0.551 [3].
As mentioned above, IL demonstrates associations
with various pathological conditions comorbid with
obesity. However, the results of studies on the
possibility of using IL as a diagnostic tool for assessing
the risk of cardiometabolic pathologies are
contradictory. An analysis of the possibility of using
various anthropometric indices for the diagnosis of
non-alcoholic fatty liver disease in the Chinese
population revealed the advantage of BMI and waist
circumference over IL [15]. In this study, a correlation
analysis of the relationship between thyroid function
(thyroid-stimulating hormone (TSH), free
triiodothyronine (f. T3), free thyroxine (f. T4)) and
anthropometric parameters (long-term
Obesity and metabolism. - 2023. - T. 20. - No. 1. – pp. 13-21
tool for diagnosing type 2 diabetes mellitus. For a group of women older than 40 years, it was shown that IL is a good predictor of a
lack of lean body mass. The value of IL in elderly women without a lack of BFM was 36.3 ± 4.36, and in the group with a lack of
muscle tissue - which does not allow the use of IL in this population as a diagnostic tool for diagnosing type 2 diabetes mellitus. For
a group of women older than 40 years, it was shown that IL is a good predictor of a lack of lean body mass. The value of IL in elderly
women without a lack of BFM was 36.3 ± 4.36, and in the group with a lack of muscle tissue - which does not allow the use of IL in
this population as a diagnostic tool for diagnosing type 2 diabetes mellitus. For a group of women older than 40 years, it was shown
that IL is a good predictor of a lack of lean body mass. The value of IL in elderly women without a lack of BFM was 36.3 ± 4.36, and in
the group with a lack of muscle tissue -
42.8±5.04 [18]. The correlation of IL with BFM, determined by the
results of ultrasound and BIA, in the group of Russian adults was
weak (-0.11 and -0.18, respectively) and did not reach the level of
statistical significance. The analysis in the subgroups of men and
women showed that the consistency of % FM estimates in the
subgroup of men is weak and the methods cannot be considered
statistically equivalent. It is likely that the estimate of % VM based
on the circumference of the hips cannot be a reliable indicator of
% VM in men due to sex differences in the topography of fat
deposition.
Summary of Additional Research Findings
Regression equations were obtained for subgroups
of men and women, which can later be used to create
equations for recalculating the values of IL in % FM
obtained by ultrasound and BIA.
Discussion of additional research findings
The possibility of using IL for estimating % FM,
comparable to the estimates obtained in BIA and
ultrasound, can be realized if population-specific
conversion formulas are available. In perspective
doi: https://doi.org/10.14341/omet12949
obesity and metabolism. 2023;20(1):13-21
SCIENTIFIC RESEARCH
20| Obesity and Metabolism /Obesity and metabolism
it seems expedient to carry out this methodological
work and check the accuracy of the obtained corrected
estimates of %FM.
endogenous and exogenous factors on the development of various types of
obesity”.
Conflict of interest.Troshina E.A. - member of the editorial team gi of
the journal "Obesity and Metabolism".
Study Limitations
The main limitation of the study is the lack of a gold
standard for determining body fat. This did not allow us
to assess the accuracy of determining %FM using BIA,
ultrasound, and IL methods.
Author participation.Bondareva E.A. — development of a
protocol research, data collection and analysis, writing the text of the
article; Parfent'eva O.I. – conducting ultrasound scanning, writing the
text of the article; Vasilyeva A.A. – carrying out bioimpedansometry;
Kulemin N.A. - data analysis; Gadzhiakhmedova A.N. — carrying out an
anthropometric survey; Kovaleva O.N. – conducting an anthropometric
CONCLUSION
survey, preparing a manuscript; Sultanova B.A. — analysis of data
Individual-level BMI assessment of IL (BAI) for men
and women is not equivalent to BIA and/or ultrasound.
obtained during the examination of patients with overweight and
obesity; Mazurina N.V. — data analysis, writing the text of the article;
Troshina E.A. — critical interpretation of the results, approval of the
final text of the manuscript. All authors approved the final version of
the article before publication, agreed to be responsible for all aspects
ADDITIONAL INFORMATION
of the work, which implies proper study and resolution of issues,
Sources of financing.The study was carried out with financial
support of the RSF grant No. 22-75-10122 “Assessment of the impact
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INFORMATION ABOUT AUTHORS [AUTHORS INFO]:
* Bondareva Elvira Alexandrovna, Ph.D. [Elvira A. Bondareva, PhD in biology];
ORCID: https://orcid.org/ 0000-0003-3321-7575; eLibrary SPIN: 6732-2072; e-mail: Bondareva.E@gmail.com
Parfentyeva Olga Ivanovna, Ph.D. [Olga I. Parfenteva, PhD in biology]; ORCID: https://orcid.org/0000-0001-7895-6887; eLibrary
SPIN: 6237-1920; e-mail: parfenteva.olga@gmail.com
Vasilyeva Alexandra Alexandrovna, [Aleksandra A. Vasilieva]; ORCID: https://orcid.org/0000-0002-8025-8444; eLibrary
SPIN: 6077-4558; e-mail: vasileva@mail.bio.msu.ru
Kulemin Nikolai Alexandrovich, Ph.D. [Nikolay A. Kulemin, PhD]; ORCID: https://orcid.org/0000-0002-8588-3206; SPIN
code: 5926-6356; e-mail: maveriksvao@gmail.com
Obesity and metabolism. - 2023. - T. 20. - No. 1. – pp. 13-21
doi: https://doi.org/10.14341/omet12949
obesity and metabolism. 2023;20(1):13-21
ORIGINAL STUDY
Obesity and metabolism / Obesity and metabolism |21
GadzhiakhmedovaAida Nurmagomedovna[Aida N. Gadzhiakhmedova]; ORCID: https://orcid.org/0000-0003-2557-5647;
eLibrary SPIN: 7410-4182; e-mail: ai.kidman@mail.ru
Kovaleva Olga Nikolaevna, Ph.D. [Olga N. Kovaleva, PhD in biology]; ORCID: https://orcid.org/0000-0001-7391-5103; eLibrary
SPIN: 1879-7964; e-mail: olgakovaljeva@gmail.com
Mazurina Natalya Valentinovna, MD [Natalya V. Mazurina, MD, PhD]; ORCID: http://orcid.org/0000-0001-8077-9381; eLibrary
SPIN: 9067-3062; e-mail: natalyamazurina@mail.ru
Sultanova Begimai Abdykaparovna, postgraduate student [Begimay A. Sultanova, postgraduate student];
ORCID: https://orcid.org/0000-0001-7895-6887; eLibrary SPIN: 6237-1920; e-mail: begimaysultanova1@gmail.com Troshina
Ekaterina Anatolievna, MD, Professor [Ekaterina A. Troshina, MD, PhD, Professor]; ORCID: https://orcid. org/
0000-0002-8520-8702; eLibrary SPIN: 8821-8990; e-mail: troshina@inbox.ru
QUOTE:
Bondareva E.A., Parfentyeva O.I., Vasilyeva A.A., Kulemin N.A., Gadzhiakhmedova A.N., Kovaleva O.N., Sultanova B.A.,
Mazurina N.V., Troshina E. .A. Consistency of estimates of the proportion of body fat mass obtained using indirect
(indirect) methods of studying body composition // Obesity and metabolism. - 2023. - V. 20. - No. 1. - C. 13-21. doi: https://
doi.org/10.14341/omet12949
TO CITE THIS ARTICLE:
Bondareva EA, Parfenteva OI, Vasilieva AA, Kulemin NA, Gadzhiakhmedova AN, Kovaleva ON, Sultanova BA, Mazurina NV,
Troshina EA. Agreement of body adiposity index (BAI), bioimpedance analysis and ultrasound scanning in determining body fat.
Obesity and metabolism. 2023;20(1):13-21. doi: https://doi.org/10.14341/omet12949
Obesity and metabolism. - 2023. - T. 20. - No. 1. – pp. 13-21
doi: https://doi.org/10.14341/omet12949
obesity and metabolism. 2023;20(1):13-21