Diagnosis of sarcopenia by evaluating skeletal muscle mass by adjusted bioimpedance analysis validated with dual-energy X-ray absorptiometry
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Abstract Background This study aimed to adjust and cross‐validate skeletal muscle mass measurements between bioimpedance analysis (BIA) and dual‐energy X‐ray absorptiometry (DXA) for the screening of sarcopenia in the community and to estimate the prevalence of sarcopenia in Hong Kong. Methods Screening of sarcopenia was provided to community‐dwelling older adults. Appendicular skeletal muscle mass (ASM) was evaluated by BIA (InBody 120 or 720) and/or DXA. Handgrip strength and/or gait speed were assessed. Diagnosis of sarcopenia was based on the 2019 revised Asian Working Group for Sarcopenia cut‐offs. Agreement analysis was performed to cross‐validate ASM measurements by BIA and DXA. Multiple regression was used to explore contribution of measured parameters in predicting DXA ASM from BIA. Results A total of 1587 participants (age = 72 ± 12 years) were recruited; 1065 participants were screened by BIA (InBody 120) with 18 followed up by DXA, while the remaining 522 participants were assessed by the BIA (InBody 720) and DXA. The appendicular skeletal muscle mass index (ASMI) evaluated by BIA showed a mean difference of 2.89 ± 0.38 kg/m 2 (InBody 120) and 2.97 ± 0.45 kg/m 2 (InBody 720) against DXA gold standard. A significant overestimation of muscle mass was measured by BIA compared with DXA ( P < 0.005). BIA data were adjusted using prediction equation and mean difference reduced to −0.02 ± 0.31 kg/m 2 in cross‐validation. Prevalence of sarcopenia in older adults ≥65 ranged from 39.4% (based on ASMI by DXA) to 40.8% (based on predicted DXA ASMI from BIA). Low ASMI by DXA was found in 68.5% of the older adults screened. The percentage of older adults exhibited low handgrip strength ranged from 31.3% to 56%, while 49% showed low gait speed. Conclusions Bioimpedance analysis was found to overestimate skeletal muscle mass compared with DXA. With adjustment equations, BIA can be used as a quick and reliable tool for screening sarcopenia in community and clinical settings with limited access to better options.
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BIA-measured muscle mass index (InBody 120) is 2.89 ± 0.38 kg/m2 higher than DXA-measured.
“We previously found that the value of muscle mass index detected by BIA (InBody 120) was 2.89 ± 0.38 kg/m2 higher than measured by dual-energy X-ray absorptiometry (DXA) (Horizon, Hologic, Marlborough, MA, USA), which was considered the gold standard (18).”
From The role of obesity in sarcopenia and the optimal body composition to prevent against sarcopenia and obesity (2023) · cites this paper as [18]
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- Authors
- Cheng, K. Y., Chow, S. K., Hung, V. W., Wong, C. H., Wong, R. M., Tsang, C. S., Kwok, T., & Cheung, W.
- Affiliations
- Chinese University of Hong Kong (HK)
- Corresponding author
- Chow, Simon Kwoon‐Ho
- ORCID
- Venue
- Journal of Cachexia Sarcopenia and Muscle
- Publisher
- Wiley
- Published
- 2021-10-04
- Volume
- 12
- Issue
- 6
- Pages
- 2163-2173
- ISSN
- 2190-5991 (ISSN-L)
- 2190-6009
- PMC
- PMC8718029
- OpenAlex
- W3202032823
- Cited by
- 154
- References
- 31
- Citations by year
- 2026: 28 · 2025: 50 · 2024: 49 · 2023: 15 · 2022: 11 · 2021: 1
- FWCI
- 11.94
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Cachexia Sarcopenia and Muscle (publishedVersion, cc-by-nc-nd)
- PubMed Central (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- Chinese University of Hong Kong (4054479)
- Health and Medical Research Fund (HCPS 02180118)
- Topics
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Geriatrics and Gerontology › Frailty in Older Adults
- Keywords
- sarcopenia, skeletal muscle mass, bioelectrical impedance analysis, dual-energy X-ray absorptiometry, appendicular skeletal muscle mass index, cross-validation, prediction equations, sarcopenia screening, older adults, grip strength, walking speed, sarcopenia prevalence, Hong Kong, Asian Working Group for Sarcopenia criteria, measurement overestimation, community-dwelling
- MeSH terms
- Aged, Aged, 80 and over, Body Composition, Humans, Middle Aged, Absorptiometry, Photon, Electric Impedance, Muscle, Skeletal, Hand Strength, Sarcopenia
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