Validation of bioelectrical impedance analysis for estimating limb lean mass in free-living Caucasian elderly people
Abstract
Background & aims Aging is characterized by a loss of limb lean mass (LLM) that can lead to physical disability and death. Regional bioelectrical impedance analysis (BIA) may be a reliable method for estimating LLM, but no prediction equations are available for elderly Caucasian subjects. The aim of this study was to develop and validate a BIA-based equation for predicting LLM in healthy elderly Caucasians, taking dual X-ray absorptiometry (DXA) as the reference method.Methods Using a cross-sectional design, 244 free-living healthy Caucasian subjects (117 men, 179 women) over 60 years of age were enrolled. LLM was measured with DXA (LLM DXA), and the resistance (Rz) and reactance (Xc) of each limb were measured with a regional bioelectrical impedance analyzer. A resistive index (RI) was calculated from stature in meters divided by Rz of each arm. A BIA-based multiple regression equation for predicting the lean mass (LM) of dominant and non-dominant limbs was developed using a double cross-validation technique.Results Using the sample as a whole, cross-validation resulted in an equation specific for each limb, as follows, where sex equals 1 for males, and 0 for females: LM (kg) = -0.081 + (0.061*RI) + (0.010*body weight) + (0.299*sex) for the dominant arm; LM (kg) = -0.026 + (0.014*RI) + (0.009*body weight) + (0.352*sex) for the non-dominant arm; LM (kg) = -0.462 + (0.027*RI) + (0.047*body weight) + (0.639*sex) + (0.026*Xc) for the dominant leg; and for the non-dominant leg, LM (kg) = -0.522 + (0.029*RI) + (0.045*body weight) + (0.569*sex) + (0.025*Xc). The DXA-measured and BIA-predicted LLM for each limb did not differ significantly.Conclusion Our newly-developed BIA equations seem to provide a valid estimation of LLM in older Caucasian adults.
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Five equations for elderly are for assessing FFM in both sexes.
“Two different equations are available to determine FM in males and females [53], while there are two equations for assessing FFM in males [36, 49], three in females only [36, 49, 97], and five suitable for both sexes [89, 91].”
From High-standard predictive equations for estimating body composition using bioelectrical impedance analysis: a systematic review (2024) · cites this paper as [91]
Cites
STATISTICAL METHODS FOR ASSESSING AGREEMENT BETWEEN TWO METHODS OF CLINICAL MEASUREMENT
Martin Bland, J., & Altman, D. (1986) · The Lancet · doi:10.1016/s0140-6736(86)90837-8 · Cited by 47,965 · see citing works
Estimating the Dimension of a Model
Schwarz, G. (1978) · The Annals of Statistics · doi:10.1214/aos/1176344136 · Cited by 47,033 · see citing works
Assessment of Older People: Self-Maintaining and Instrumental Activities of Daily Living
Lawton, M. P., & Brody, E. M. (1969) · The Gerontologist · doi:10.1093/geront/9.3_part_1.179 · Cited by 18,540 · see citing works
Information Theory and an Extension of the Maximum Likelihood Principle
Akaike, H. (1998) · Springer series in statistics · doi:10.1007/978-1-4612-1694-0_15 · Cited by 18,384 · see citing works
Lower-extremity function in persons over the age of 70 years as a predictor of subsequent disability
Guralnik, J. M., Ferrucci, L., Simonsick, E. M., Salive, M. E., & Wallace, R. B. (1995) · New England Journal of Medicine · doi:10.1056/nejm199503023320902 · Cited by 4,083 · see citing works
Katz, S. (1963) · JAMA · doi:10.1001/jama.1963.03060120024016 · Cited by 2,421 · see citing works
CUMULATIVE ILLNESS RATING SCALE
Linn, B. S., Linn, M. W., & Gurel, L. (1968) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1968.tb02103.x · Cited by 2,319 · see citing works
Estimation of skeletal muscle mass by bioelectrical impedance analysis
Janssen, I., Heymsfield, S. B., Baumgartner, R. N., & Ross, R. (2000) · Journal of Applied Physiology · doi:10.1152/jappl.2000.89.2.465 · Cited by 1,482 · see citing works
Delmonico, M. J., Harris, T. B., Lee, J., Visser, M., Nevitt, M., Kritchevsky, S. B., Tylavsky, F. A., Newman, A. B., & for the Health, A. A. B. C. S. (2007) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2007.01140.x · Cited by 819 · see citing works
Sun, S. S., Chumlea, W. C., Heymsfield, S. B., Lukaski, H. C., Schoeller, D., Friedl, K., Kuczmarski, R. J., Flegal, K. M., Johnson, C. L., & Hubbard, V. S. (2003) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/77.2.331 · Cited by 701 · see citing works
Assessment methods in human body composition
Lee, S. Y., & Gallagher, D. (2008) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/mco.0b013e32830b5f23 · Cited by 694 · cited 1× · see citing works
“It is commonly taken as a reference for the purpose of validating other tools that are easier to use [3,4] because the use of DXA is limited by its being costly and not portable, having to be done by trained personnel, and entailing exposure to radiation.”
BackgroundLing, C. H. Y., de Craen, A. J. M., Slagboom, P. E., Gunn, D. A., Stokkel, M. P. M., Westendorp, R. G. J., & Maier, A. B. (2011) · Clinical Nutrition · doi:10.1016/j.clnu.2011.04.001 · Cited by 646 · see citing works
The developmental origins of sarcopenia
Sayer, A. A., Syddall, H., Martin, H., Patel, H., Baylis, D., & Cooper, C. (2008) · The Journal of nutrition, health and aging · doi:10.1007/bf02982703 · Cited by 450 · see citing works
Sergi, G., De Rui, M., Veronese, N., Bolzetta, F., Berton, L., Carraro, S., Bano, G., Coin, A., Manzato, E., & Perissinotto, E. (2015) · Clinical Nutrition · doi:10.1016/j.clnu.2014.07.010 · Cited by 448 · cited 2× · see citing works
“The difference between these two reports [9,12] and the present study may relate to the fact that the lean mass of a single arm is naturally lower than the total ASMM, and the equation is less precise the smaller the mass to be estimated.”
ResultSelf-citationNovâk, L. P. (1972) · Journal of Gerontology · doi:10.1093/geronj/27.4.438 · Cited by 358 · see citing works
Segmental bioelectrical impedance analysis: theory and application of a new technique
Organ, L. W., Bradham, G. B., Gore, D. T., & Lozier, S. L. (1994) · Journal of Applied Physiology · doi:10.1152/jappl.1994.77.1.98 · Cited by 274 · see citing works
Kyle, U. G., Genton, L., Hans, D., & Pichard, C. (2003) · Clinical Nutrition · doi:10.1016/s0261-5614(03)00048-7 · Cited by 246 · cited 4× · see citing works
“Our findings confirm the dominant role of RI in predicting the leanmass of single limbs in the elderly, as already seen for appendicular skeletal muscle mass estimates [9,11], irrespective of the abovementioned factors that might influence BIA parameters with aging.”
MethodResultInfluentialThe use of bioelectrical impedance analysis for body composition in epidemiological studies
Böhm, A., & Heitmann, B. L. (2013) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2012.168 · Cited by 206 · see citing works
Body composition assessment by dual-energy X-ray absorptiometry (DXA)
Andréoli, A., Scalzo, G., Masala, S. A., Tarantino, U., & Guglielmi, G. (2009) · La radiologia medica · doi:10.1007/s11547-009-0369-7 · Cited by 202 · see citing works
All-age relationship between arm span and height in different ethnic groups
Quanjer, P. H., Capderou, A., Mazıcıoğlu, M. M., Aggarwal, A. N., Banik, S. D., Popovic, S. R., Tayie, F., Golshan, M., Ip, M., & Zelter, M. (2014) · European Respiratory Journal · doi:10.1183/09031936.00054014 · Cited by 138 · see citing works
Kim, J. H., Choi, S. H., Lim, S., Kim, K. W., Lim, J. Y., Cho, N. H., Park, K. S., & Jang, H. C. (2014) · Archives of Gerontology and Geriatrics · doi:10.1016/j.archger.2013.11.002 · Cited by 67 · see citing works
Noppa, H., Andersson, M., Bengtsson, C., Bruce, Å., & Isaksson, B. (1979) · American Journal of Clinical Nutrition · doi:10.1093/ajcn/32.7.1388 · Cited by 50 · see citing works
Alemán-Mateo, H., Rush, E. C., Esparza‐Romero, J., Ferriolli, E., Ramírez‐Zea, M., Bour, A., Yuchingtat, G., Ndour, R., Mokhtar, N., Valencia, M. E., et al. (2010) · The journal of nutrition health & aging · doi:10.1007/s12603-010-0031-z · Cited by 33 · see citing works
Powers, C., Fan, B., Borrud, L. G., Looker, A. C., & Shepherd, J. (2013) · Journal of Clinical Densitometry · doi:10.1016/j.jocd.2013.09.010 · Cited by 22 · see citing works
Cereda, E., Bertoli, S., Vanotti, A., & Battezzati, A. (2010) · The journal of nutrition health & aging · doi:10.1007/s12603-010-0004-2 · Cited by 19 · see citing works
Measurements of total body water with a foot-to-foot impedancemeter
Jaffrin, M. Y., & Moreno, M. V. (2007) · Medical Engineering & Physics · doi:10.1016/j.medengphy.2007.05.009 · Cited by 15 · see citing works
Wang, J., Wong, M., Liu, Y., Tsai, W.-L., Chuang, Y.-F., & Huang, S.-C. (2013) · Biomedical Journal · doi:10.4103/2319-4170.117892 · Cited by 7 · see citing works
A Symmetric Extended Logistic Model with Applications to Experimental Toxicity Data
El‐Saidi, M. A. (1995) · Biometrical Journal · doi:10.1002/bimj.4710370213 · Cited by 6 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Sarcopenia: assessment of disease burden and strategies to improve outcomes
Liguori, I., Russo, G., Aran, L., Bulli, G., Curcio, F., Della‐Morte, D., Gargiulo, G., Testa, G., Cacciatore, F., Bonaduce, D., et al. (2018) · Clinical Interventions in Aging · doi:10.2147/cia.s149232 · Cited by 302 · see citing works
Sergi, G., De Rui, M., Stubbs, B., Veronese, N., & Manzato, E. (2017) · Aging Clinical and Experimental Research · doi:10.1007/s40520-016-0622-6 · Cited by 291 · see citing works
Self-citationCurrent body composition measurement techniques
Lemos, T., & Gallagher, D. (2017) · Current Opinion in Endocrinology Diabetes and Obesity · doi:10.1097/med.0000000000000360 · Cited by 281 · see citing works
Biomarkers in sarcopenia: A multifactorial approach
Curcio, F., Ferro, G., Basile, C., Liguori, I., Parrella, P., Pirozzi, F., Della‐Morte, D., Gargiulo, G., Testa, G., Tocchetti, C. G., et al. (2016) · Experimental Gerontology · doi:10.1016/j.exger.2016.09.007 · Cited by 225 · see citing works
Osaka, T., Hamaguchi, M., Hashimoto, Y., Ushigome, E., Tanaka, M., Yamazaki, M., & Fukui, M. (2018) · Diabetes Research and Clinical Practice · doi:10.1016/j.diabres.2018.02.025 · Cited by 174 · see citing works
Al-Rawi, N. H., Madkour, M. I., Jahrami, H., Salahat, D., Alhasan, F., BaHammam, A. S., & Faris, M. E. (2020) · PLoS ONE · doi:10.1371/journal.pone.0237922 · Cited by 114 · see citing works
Beaudart, C., Bruyère, O., Geerinck, A., Hajaoui, M., Scafoglieri, A., Perkisas, S., Bautmans, I., Gielen, E., Reginster, J.-Y., & Buckinx, F. (2020) · Clinical Nutrition ESPEN · doi:10.1016/j.clnesp.2019.09.012 · Cited by 113 · see citing works
Campa, F., Coratella, G., Cerullo, G., Noriega, Z., Francisco, R., Charrier, D., Irurtia, A., Lukaski, H., Silva, A. M., & Paoli, A. (2024) · Journal of Translational Medicine · doi:10.1186/s12967-024-05272-x · Cited by 80 · see citing works
“The selected studies encom-passed Central[36, 38, 49] and Southern American [46, 67], European [53, 63, 89–91, 93, 95, 97], and Asian [68, 94] male and female participants.”
BackgroundSardinha, L. B., Correia, I. R., Magalhães, J. P., Júdice, P. B., Silva, A. M., & Hetherington-Rauth, M. (2020) · European Journal of Clinical Nutrition · doi:10.1038/s41430-020-0666-8 · Cited by 38 · see citing works
Jeon, K. C., Kim, S.-Y., Jiang, F. L., Chung, S., Ambegaonkar, J. P., Park, J.-H., Kim, Y.-J., & Kim, C.-H. (2020) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph17165847 · Cited by 38 · see citing works
Update on Lean Body Mass Diagnostic Assessment in Critical Illness
Rosa, S. D., Umbrello, M., Pelosi, P. P., & Battaglini, D. (2023) · Diagnostics · doi:10.3390/diagnostics13050888 · Cited by 29 · see citing works
Two-megahertz impedance index prediction equation for appendicular lean mass in Korean older people
Kim, H., Song, K.-H., Ambegaonkar, J. P., Chung, S., Jeon, K., Jiang, F. L., Eom, J. J., & Kim, C.-H. (2022) · BMC Geriatrics · doi:10.1186/s12877-022-02997-6 · Cited by 12 · see citing works
Sardinha, L. B., Rosa, G. B., Hetherington-Rauth, M., Correia, I. R., Magalhães, J. P., Silva, A. M., & Lukaski, H. (2023) · European Journal of Clinical Nutrition · doi:10.1038/s41430-022-01224-0 · Cited by 10 · see citing works
Tomaszewska, E., Wojtysiak, D., Grzegorzewska, A. K., Świątkiewicz, M., Donaldson, J., Arciszewski, M. B., Dresler, S., Puzio, I., Szymańczyk, S., Dobrowolski, P., et al. (2024) · International Journal of Molecular Sciences · doi:10.3390/ijms25168735 · Cited by 4 · see citing works
Impact of vitamin D levels on mortality in older covid-19 vaccinated patients
Ceolin, C., Vergadoro, M., Simonato, C., Cazzavillan, S., Papa, M. V., Trapella, G. S., Marzio, B. D., Sermasi, R., Zanforlini, B. M., Curreri, C., et al. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-05873-1 · Cited by 4 · see citing works
Self-citationMontgomery, M. M., & Tritsch, A. J. (2019) · Athletic Training & Sports Health Care · doi:10.3928/19425864-20191024-01 · Cited by 3 · see citing works
Nikitinskaya, O. A., & Toroptsova, N. V. (2021) · Medical alphabet · doi:10.33667/2078-5631-2021-16-30-34 · Cited by 3 · see citing works
Predicting Hamstring Strains in Soccer Players Based on ROM: An Analysis From a Gender Perspective
Molina-Cárdenas, Á., Álvarez‐Yates, T., & García-García, Ó. (2022) · Research Quarterly for Exercise and Sport · doi:10.1080/02701367.2021.2011091 · Cited by 3 · see citing works
Monitoring of Muscle Mass in Critically Ill Patients
Umbrello, M., Formenti, P., Brogi, E., & Forfori, F. (2024) · Springer eBooks · doi:10.1007/978-3-031-66541-7_10 · Cited by 1 · see citing works
A IMPORTÂNCIA DA AVALIAÇÃO E PREVENÇÃO DO RISCO DE QUEDA
Nascimento, R., Figueiredo, J., & Carvalho, A. B. (2022) · Brazilian Journals Editora eBooks · doi:10.35587/brj.ed.0001717
PEDAGOGIA DO JOGO: CONCEITOS E REFLEXÕES PARA O ENSINO DO FUTEBOL
Júnior, A. L. G., Júnior, J. B., Machado, J. C., & Scaglia, A. J. (2022) · Brazilian Journals Editora eBooks · doi:10.35587/brj.ed.0001713
TREINAMENTO NO FUTEBOL: MONITORAMENTO DE CARGAS DE TREINO E APLICAÇÃO DE JOGOS REDUZIDOS
Mendonça, R., Alcântara, C. H., Fernandes, J., & Machado, J. C. (2022) · Brazilian Journals Editora eBooks · doi:10.35587/brj.ed.0001715
Zhang, T., Yuan, Y., Sun, X., Liu, Y.-Q., Huang, S., Li, M., & Song, Q. (2025) · BMC Geriatrics · doi:10.1186/s12877-025-06596-z
Association Between Muscle Metrics and Pressure Pain Sensitivity in Older Adults
Singh, J., Mohapatra, S., & Girish, N. (2025) · Sage Open Aging · doi:10.1177/30495334251404272
Campa, F., Coratella, G., Cerullo, G., Noriega, Z., Francisco, R., Charrier, D., Irurtia, A., Lukaski, H. C., Silva, A. M., & Paoli, A. (2024) · Figshare · doi:10.6084/m9.figshare.26727262
Rosa, G. B., Francisco, R., Correia, I., Bernardino, A., Magalhães, J., Pires, M., Lukaski, H. C., Silva, A. M., & Sardinha, L. B. (2026) · Research Square · doi:10.21203/rs.3.rs-9224431/v1
- Authors
- De Rui, M., Veronese, N., Bolzetta, F., Berton, L., Carraro, S., Bano, G., Trevisan, C., Pizzato, S., Coin, A., Perissinotto, E., Manzato, E., & Sergi, G.
- Affiliations
- University of Padua (IT)
- ORCID
- Venue
- Clinical Nutrition
- Publisher
- Elsevier BV
- Published
- 2017-04
- Volume
- 36
- Issue
- 2
- Pages
- 577-584
- ISSN
- 0261-5614 (ISSN-L)
- OpenAlex
- W2344815480
- Cited by
- 26
- References
- 28
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 4 · 2023: 1 · 2022: 6 · 2021: 1 · 2020: 3 · 2019: 2 · 2018: 2 · 2017: 1 · 2016: 2
- FWCI
- 1.88
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Nova Science Publishers (Nova Science Publishers, Inc.) (submittedVersion)
- Institutional Research Information System University of Ferrara (University of Ferrara) (submittedVersion)
- Padua Research Archive (University of Padova) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Body Composition Measurement Techniques
- Health Sciences › Medicine › Physiology › Nutrition and Health in Aging
- Physical Sciences › Engineering › Electrical and Electronic Engineering › Electrical and Bioimpedance Tomography
- Keywords
- bioelectrical impedance analysis, prediction equations, older adults, aging, sarcopenia, dual-energy X-ray absorptiometry, resistance index, Caucasian adults
- 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, Electric Impedance, Muscle, Skeletal, White People
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