Cited by 467Body Composition Measurement TechniquesNutrition and Health in AgingMuscle metabolism and nutrition

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Assessing appendicular skeletal muscle mass with bioelectrical impedance analysis in free-living Caucasian older adults

Sergi, Giuseppe, De Rui, Marina, Veronese, Nicola, Bolzetta, Francesco, Berton, Linda, Carraro, Sara, Bano, Giulia, Coin, Alessandra, Manzato, Enzo, Perissinotto, Egle·2015·Clinical Nutrition

DOI 10.1016/j.clnu.2014.07.010

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Abstract

Background & aims Aging is characterized by a loss of appendicular skeletal muscle mass (ASMM) leading to physical disability and death. Bioelectrical impedance analysis (BIA) is reliable in estimating ASMM but no prediction equations are available for elderly Caucasian subjects. The aim of the study was to develop and validate an equation derived from bioelectrical impedance analysis (BIA) to predict appendicular skeletal muscle mass (ASMM) in healthy Caucasian elderly subjects, taking dual X-ray absorptiometry (DXA) as the reference method, and comparing the reliability of the new equation with another BIA-based model developed by Kyle et al. (Kyle UG, Genton L, Hans D, Pichard C, 2003).Methods With a cross-sectional design, 296 free-living, healthy Caucasian subjects (117 men, 179 women) over 60 years of age were enrolled. Lean mass of limbs was measured with DXA to ascertain ASMM (ASMMDxA). Whole-body tetrapolar BIA was performed to measure resistance (Rz), resistance normalized for stature (RI), and reactance (Xc). The BIA multiple regression equation for predicting ASMM was developed using a double cross-validation technique. The predicted ASMM values were compared with ASMMKyle, i.e. ASMM estimates derived from the model developed by Kyle et al. (Kyle et al., 2003).Results Cross-validation resulted in a unique equation using the whole sample: ASMM (kg) = -3.964 + (0.227*RI) + (0.095*weight) + (1.384*sex) + (0.064*Xc) [R(2) = 0.92 and SEE = 1.14 kg]. In our sample, ASMMKyle differed significantly from the ASMMDxA (p < 0.0001), with a mean error of -0.97 ± 1.34 kg (5.1 ± 6.9%). Unlike the present BIA prediction equation, the Kyle et al. model showed a correlation between the bias and the mean of ASMMDxA and ASMMKyle (r = -0.406, p < 0.001).Conclusion The new BIA equation provides a valid estimate of ASMM in older Caucasian adults.

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Clinical calculator for calculating appendicular musculoskeletal mass of elderly patients according to anthropometry and bioimpedance analysis
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“Regarding the parameters of anthropometry, hand grip strength, BIA and muscle ultrasound of RF, the results of this study are in line with others previously published on malnutrition and sarcopenia [16,19,23].”
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“AMM was calculated using the Sergi formula [26].”
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“In both cases, appendicular skeletal muscle mass was estimated using the Sergi equation [18].”
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“3 Appendicular skeletal muscle mass (ASMM) was calculated using the equation by Sergi et al, 7 which is based on weight and BIA ‐ derived resistance and reactance.”
Association of sarcopenia and pancreatic exocrine insufficiency in older adults type 2 diabetes mellitus patients
Gunes, S., Altınkaynak, M., Akpınar, T. S., et al. (2025) · Aging Clinical and Experimental Research · doi:10.1007/s40520-025-03184-4 · Cited by 1
“This formula demonstrated a high degree of accuracy, with R² = 0.92 and a standard error of estimate (SEE) of 1.14 kg [ 16].”
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АВТОМАТИЗИРОВАННАЯ СИСТЕМА ПЕРСОНАЛИЗАЦИИ ТЕРАПЕВТИЧЕСКОЙ ТАКТИКИ ВЕДЕНИЯ КОМОРБИДНЫХ ПОЖИЛЫХ ПАЦИЕНТОВ С САХАРНЫМ ДИАБЕТОМ 2-го ТИПА
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Longitudinal study on the relationship between extracellular water distribution changes and muscle mass in severe sarcopenia patients using multi-frequency bioelectrical impedance analysis combined with phase angle measurements
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“Phase angle (PhA) was measured at 50 kHz, ASM was calculated using the Sergi et al. [21] equation, and SMI (ASM/height 2 ) was derived accordingly.”
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“Thus, ASMM, defined as the sum of arm and leg muscle mass, was calculated using the equations implemented in the manufacturer’s software (Akern, Bodygram Plus), which are based on the validated equation proposed by Sergi et al. [16].”
Influential
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“Using a multifrequency bioimpedance analysis device (Quadscan 4000, Bodystat, Douglas, British Isles), we calculated the appendicular skeletal muscle mass following Sergi et al. , 16 which was subsequently divided by height squared to calculate the ASMI, in line with the GLIM and EWSGOP2 criteria.”
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“ASM was calculated according to the Sergi et al. [16] .”
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Peball, M., Schörghuber, P., Carbone, F., Zinganell, A., Pauli, F. D., Schwarzová, K., Djamshidian, A., Seppi, K., & Heim, B. (2025) · Journal of Neural Transmission · doi:10.1007/s00702-025-02991-3 · Cited by 1
“ASM was calculated using raw BIA measurements at 50 kHz based on a recommended equation (Sergi et al. 2015).”
Osteosarcopenia
Miedany, Y. M. E. (2022) · Springer eBooks · doi:10.1007/978-3-030-87950-1_3 · Cited by 1
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Visser, M., & Schaap, L. S. (2020) · Bohn Stafleu van Loghum eBooks · doi:10.1007/978-90-368-2453-8_7 · Cited by 1
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“Dual-energy X-ray absorptiometry (DXA) [13–15] and Bioelectrical Impedance Analysis (BIA) [13,16,17] are included as tools for objective assessment of body composition from which measures of fat mass, lean soft-tissue mass (comprising muscle, inner organs and body water), and bone mineral content can be obtained (e.g.…”
Method
Measurements of Muscle Mass, Equations and Cut‐off Points
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Öztürk, Y., Güner, M., Baş, A. O., Ceylan, S., Koca, M., Eşme, M., Balcı, C., Doğu, B. B., Cankurtaran, M., & Halil, M. G. (2024) · Research Square · doi:10.21203/rs.3.rs-3770246/v1 · Cited by 1
Erfassung der Körperzusammensetzung
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“Yes 18 (40,0) 27 (60,0) 0,841 No 24 (38,1) 39 (61,9)”
BackgroundInfluential
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“In order to estimate the appendicular skeletal musclemass (ASMM), we used the raw BIA measures and the cross-validated Sergi equation (36, 53):”
Method
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de Souza, E. D. S., Melo, D. D. A., Silva, M. G. C., Pinho, C. P. S., de Carvalho, T. R., Duarte, R. D. S., de Almeida, I. K. G., Silva, R. P. P., Maio, R., & de Lemos, M. D. C. C. (2022) · Research Society and Development · doi:10.33448/rsd-v11i12.34715
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Sarcopenie
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do Nascimento, S. B., dos Santos, R. C. B., Santos, L. S., Mendes, T. D. S. R., Pereira, J. P. D. C., de Lemos, M. D. C. C., & Pinho, C. P. S. (2023) · Research Square · doi:10.21203/rs.3.rs-3249660/v1
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“57.7% of our sample were overweight, while abdominalobesity was found in 55.2%.”
BackgroundInfluential
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(2023) · Research Square · doi:10.21203/rs.3.rs-3249660/v2
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“Appendicular skeletal muscle mass was calculated according to a formula by Sergi et al. 17 , and the appendicular skeletal muscle mass index was determined using the formula: appendicular skeletal muscle mass/height 2 .”
Method
Skeletal muscle mass or appendicular muscle mass? That is the question
Rahal, L. (2024) · European Journal of Clinical Nutrition · doi:10.1038/s41430-023-01397-2
“Alternatively, it can be evaluated by equations speci ﬁ cally generated from a sample of elderly individuals such as the one proposed by Sergi et al. [10] and Scafoglieri et al. [11].”
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Neutrophil-to-lymphocyte ratio is not associated with muscle mass, strength, and functional capacity in hemodialysis patients
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Biomarkers of Frailty
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Araújo, A. D. A., Silva, N. K. D. A., Barbosa, M. S. D. S., Silva, P. F. D. O. A., Oliveira, J. S., Leal, V. S., de Lemos, M. D. C. C., & de Arruda, I. K. G. (2024) · Revista Eletrônica Acervo Saúde · doi:10.25248/reas.e15891.2024
“A MMAE foi calculada por meio da seguinte fórmula: MMAE (Kg) = [-3.964+(0.227*altura 2 /R) + (0.095*peso) + (1.384*sexo) + (0.064*Xc)], onde: altura (cm); peso (kg), R = Resistência em ohms; sexo = 0, Xc= reactância em ohms (SERGI G, et al., 2015).”
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“Appendicular Skeletal Muscle Mass (ASM) was determined with BIA through Bodystat® 1500MDD (Bodystat Ltd., Douglas, UK).”
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“Appen-dicular skeletal muscle mass (ASMM) will be calculated using the equations developed by Sergi et al. [32].”
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“Skeletal muscle mass (SMM) was estimated using the Janssen equation (33), and appendicular skeletal muscle mass (ASM) was calculated using the Sergi formula (34).”
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“Appendicular muscle mass (AMM) estimation was obtained using the formula validated by Sergi et al. [14]: AMM (kg) = −3.964 + (0.227*talla2) + (0.095*peso) + (1.384*sex) + (0.064*Xc) ASMMi was calculated as AMM/height (Kg/m 2 ).”
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“ASMMI was assessed using Sergi’s equation [21]: ASMMI (kg/m 2 ) = [ − 3.964 + (0.227 × (Height 2 (cm)/R) + (0.095 × Weight + (1.384 × Sex) + (0.064 × Xc)/Height (m 2 )].”
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“Out of the available variables, we focused on the percent body fat and the appendicular skeletal muscle mass (ASMM) as well as the appendicular skeletal muscle index (ASMI), which is used as parameter for diagnosis of sarco - penia [31].”
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“Appendicular skeletal muscle mass (ASM) was calculated using the Sergi et al. Equation [ 25], validated for use in older European populations.”
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Nguyen, V.-T., Jeong, Y., & Lee, T. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15072650
“BIA has been widely used in large epidemiological studies and provides reliable estimates of appendicular skeletal muscle mass in population-based settings [24,25].”
Serum carboxymethyl-lysine levels inversely correlate with appendicular skeletal muscle index in female patients with non-dialysis chronic kidney disease
Yang, Y., Li, Y., Fan, Y., Liu, Y., Hu, S., Wen, L., Zhu, P., Li, C., & Tan, R. (2026) · BMC Nephrology · doi:10.1186/s12882-026-04948-4
“Additionally, appendicular skeletal muscle mass (ASMM) and appendicular skeletal muscle index (ASMI) were calculated using the following Eqs [10–12]: where RI is the resistive index (height 2 in cm/R in ohms); for sex, male = 1 and female = 0; and Xc is reactance in ohms [10].”
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Nigro, E., Marra, M., Santis, F. D., Sammarco, R., Leo, C., Nardone, O. M., Calabrese, G., Guarino, A. D., Castiglione, F., Daniele, A., et al. (2026) · Frontiers in Nutrition · doi:10.3389/fnut.2026.1753532 · Cited by 1
Interpreting body composition in disease-related malnutrition beyond kilograms and liters: Consistency of bioelectrical impedance vector analysis scores (NP and HP) with classical bioimpedance estimates
Jara-Vidal, M., Gonzalvo-Díaz, C., Gallach-Martínez, M., LozanoGarcía, J., Quílez-Toboso, R. P., García-Blasco, L., Sánchez-Sáez, P., Milla-Tobarra, M., Lamas-Oliveira, C., & Alfaro-Martínez, J. (2026) · Endocrinología Diabetes y Nutrición · doi:10.1016/j.endinu.2026.501827
УНИВЕРСАЛЬНАЯ МАТРИЦА СРАВНИТЕЛЬНОГО КЛИНИЧЕСКОГО ИССЛЕДОВАНИЯ ПАЦИЕНТОВ ПОЖИЛОГО ВОЗРАСТА С САХАРНЫМ ДИАБЕТОМ 2-ГО ТИПА
Pervyshin, N. A. (2026) · Успехи геронтологии · doi:10.34922/ae.2025.38.6.004
Relação entre níveis de paratormônio e status de sarcopenia e estado nutricional em pacientes em hemodiálise
Leal, C. C., Melo, D. D. A., dos Santos, A. M., et al. (2026) · Brazilian Journal of Nephrology · doi:10.1590/2175-8239-jbn-2025-0083pt

Authors: Sergi, G., De Rui, M., Veronese, N., Bolzetta, F., Berton, L., Carraro, S., Bano, G., Coin, A., Manzato, E., & Perissinotto, E.
Affiliations: University of Padua (IT)
ORCID: Sergi, Giuseppe
De Rui, Marina
Veronese, Nicola
Bolzetta, Francesco
Coin, Alessandra
Manzato, Enzo
Perissinotto, Egle
Venue: Clinical Nutrition
Publisher: Elsevier BV
Published: 2015-08
Volume: 34
Issue: 4
Pages: 667-673
ISSN: 0261-5614 (ISSN-L)
DOI: 10.1016/j.clnu.2014.07.010
OpenAlex: W2149295929
Cited by: 467
References: 27
Citations by year: 2026: 66 · 2025: 78 · 2024: 65 · 2023: 56 · 2022: 60 · 2021: 54 · 2020: 37 · 2019: 15 · 2018: 14 · 2017: 7 · 2016: 8 · 2015: 5
FWCI: 4.27
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Clinical Nutrition (publishedVersion)
PubMed (publishedVersion)
Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion)
Padua Research Archive (University of Padova) (submittedVersion)
Topics: Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
Health Sciences › Nursing › Nutrition and Dietetics › Muscle metabolism and nutrition
Keywords: appendicular skeletal muscle mass, bioelectrical impedance analysis, prediction equations, older adults, aging, muscle mass assessment, dual-energy X-ray absorptiometry, Caucasian population
MeSH terms: Aged, Aged, 80 and over, Body Composition, Body Weight, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Reproducibility of Results, Absorptiometry, Photon, Body Mass Index, Linear Models, Electric Impedance, Muscle, Skeletal, White People

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Assessing appendicular skeletal muscle mass with bioelectrical impedance analysis in free-living Caucasian older adults

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