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Single prediction equation for bioelectrical impedance analysis in adults aged 20–94 years
Abstract
Existing equations for bioelectrical impedance analysis (BIA) are of limited use when subjects age or become overweight because these equations were developed in young, normal-weight subjects and are not valid in elderly or overweight people. The purpose of this study was to validate a single BIA equation in healthy white subjects aged 22--94 y with a body mass index between 17.0 and 33.8 kg/m(2). Healthy subjects (202 men and 141 women) aged 20--94 y were measured by two methods: fat-free mass (FFM) was measured by dual-energy x-ray absorptiometry (Hologic QDR-4500) and by a bioelectrical impedance analyzer (Xitron 4000B). Validity of BIA was assessed by double cross validation. Because correlations were high (r = 0.986--0.987) and prediction errors low, a single equation was developed using all subjects, as follows: FFM = -4.104 + (0.518 x height(2)/resistance) + (0.231 x weight) + (0.130 x reactance) + (4.229 x sex: men = 1, women = 0). FFM predicted with dual-energy x-ray absorptiometry was 54.0 +/- 10.7 kg. BIA-predicted FFM was 54.0 +/- 10.5 kg (r = 0.986, standard error of the estimate = 1.72 kg, technical error = 1.74 kg). In conclusion, the new Geneva BIA equation was valid for prediction of FFM in healthy adults aged 22--94 y with body mass indexes between 17.0 and 33.8 kg/m(2). Inclusion of reactance in the single prediction equation appeared to be essential for use of BIA equations in populations with large variations in age or body mass.
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“The best BIA equations developed for specific population groups have been properly validated [22-24].”
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“Prediction equations have been validated for multiethnic adults [36] and reference values established for adult white men and women, including older subjects [37–39].”
BackgroundBioelectrical impedance analysis?part I: review of principles and methods
KYLE, U. (2004) · Clinical Nutrition · doi:10.1016/j.clnu.2004.06.004 · Cited by 3,200
Self-citationBioelectrical impedance analysis—part II: utilization in clinical practice
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“BIA has been shown to be valid with BMIs to 34 kg/m(2).(24,43) In morbid obesity, most predictive equations are unable to predict static body composition and are not reproducible for individuals over time.”
BackgroundSelf-citationQuantification of Lean Bodyweight
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“Several studies were conducted using the BIA method on children [68,105] adults [13], and elders [106,107].”
BackgroundMethodInfluentialFat-free mass index and fat mass index percentiles in Caucasians aged 18–98 y
Schutz, Y., Kyle, U. G., & Pichard, C. (2002) · International Journal of Obesity · doi:10.1038/sj.ijo.0802037 · Cited by 691
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“, (2001) indicated that Japanese men and women had 10–12% higher body fat than Swiss men and women [55].”
BackgroundBody composition interpretation
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“For example, Kyle et al. (2011) proposed a single equation to predict FFM in subjects from 22 to 94 years old as function of resistance and reactance measured at 50 kHz, height, weight and gender.”
BackgroundPichard, C., Kyle, U. G., Morabia, A., Perrier, A., Vermeulen, B., & Unger, P. (2004) · The American Journal of Clinical Nutrition · doi:10.1093/ajcn/79.4.613 · Cited by 392
“Body composition was determined by bioelectrical impedance analysis (BIA) as previously described (19) with the use of a 50-kHz generator (RJL-101 analyzers; RJL Systems Inc, Clinton Township, MI) (20).”
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“[27] and divided by height squared to obtain the fat free mass index (FFMI).”
MethodAnalysis of Body Composition: A Critical Review of the Use of Bioelectrical Impedance Analysis
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“FFM was calculated from resistance and reactance at the frequency of capacitance by using the Kyle Geneva equation (34).”
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“…of the major limitations of this method is that it requires predictive equations for the determination of FFM that are specifically developed for different populations, ethnicities, age groups, and both sexes (Chumlea et al., 2000; Heymsfield et al., 1997; Kyle et al., 2001; Peltz et al., 2007a).”
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“The reference we used seemed appropriate for our sample because it was determined in a population similar to ours and the method was validated for older (>65 years) and obese subjects [ 41 ].”
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“…since it is known that body geometry may affect the electrical properties of the body (Ward et al, 2000) and that relative leg length may vary between different populations (Norgan, 1995) and may be dependent on factors affecting early childhood growth (Davey Smith et al, 2001; Leitch, 2001).”
BackgroundExercise habits during middle age are associated with lower prevalence of sarcopenia: the ROAD study
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“Skeletal muscle mass was measured by bioimpedance analysis [21–25] using the Body Composition Analyzer MC190 (Tanita Corp.”
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“FFM was calculated using a previously validated multiple regression BIA equation (30): FFM= 4.”
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“Fat-free mass (FFM), in kg, was estimated using bioelectrical impedance analysis (BIA 101, RJL systems, Detroit, MI, USA) according to European Society Parenteral Enteral Nutrition guidelines [19] using specific equations for COPD patients and healthy controls [20, 21 ].”
MethodBiolo, G., Di Girolamo, F. G., Breglia, A., Chiuc, M., Baglio, V., Vinci, P., Toigo, G., Lucchin, L., Jurdana, M., Pražnikar, Z. J., et al. (2015) · Clinical Nutrition · doi:10.1016/j.clnu.2014.03.015 · Cited by 113
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“The use of a prediction equation for body composition that included both H(2)/R and Xc (12) also failed to show an increase in percentage fat mass with age at the same BMI (results not shown).”
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Comparison of Four Bioelectrical Impedance Analysis Formulas in Healthy Elderly Subjects
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Bioelectric impedance phase angle is associated with hospital mortality of geriatric patients
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Kyle, U. G., Morabia, A., Slosman, D. O., Mensi, N., Unger, P., & Pichard, C. (2001) · British Journal Of Nutrition · doi:10.1079/bjn2001470 · Cited by 84
“The BIA equation used in the present study was validated in healthy subjects (Kyle et al. 2001a), stable in- and outpatients (Kyle et al. 2001b), and elderly subjects (Genton et al. 2001).”
BackgroundMethodInfluentialSelf-citationRæder, H., Kværner, A. S., Henriksen, C., Florholmen, G., Henriksen, H. B., Bøhn, S. K., Paur, I., Smeland, S., & Blomhoff, R. (2018) · Clinical Nutrition · doi:10.1016/j.clnu.2016.12.028 · Cited by 77
“These included the equations incorporated into the manufacturers software, The Kyle (“Geneva”) equation [14] recommended by the European Society for Clinical Nutrition and Metabolism (ESPEN) and equations previously tested in cancer populations, see Appendix 1 [14e23].”
MethodImpact of Rehabilitation on Breast Cancer Related Fatigue: A Pilot Study
Invernizzi, M., Alessandro de, S. I. R. E., Lippi, L., Venetis, K., Sajjadi, E., Gimigliano, F., Gennari, A., Criscitiello, C., Cisari, C., & Fusco, N. (2020) · Frontiers in Oncology · doi:10.3389/fonc.2020.556718 · Cited by 79
Kyle, U. G., Unger, P., Mensi, N., Genton, L., & Pichard, C. (2002) · Nutrition · doi:10.1016/s0899-9007(01)00804-8 · Cited by 82
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Desplan, M., Mercier, J. G., Sabaté, M., Ninot, G., Prefaut, C., & Dauvilliers, Y. A. (2014) · Sleep Medicine · doi:10.1016/j.sleep.2013.09.023 · Cited by 86
Aging, physical activity and height-normalized body composition parameters
Kyle, U. G., Genton, L., Gremion, G., Slosman, D. O., & Pichard, C. (2004) · Clinical Nutrition · doi:10.1016/s0261-5614(03)00092-x · Cited by 76
Self-citationDey, D. K., Bosaeus, I., Lissner, L., & Steen, B. (2003) · European Journal of Clinical Nutrition · doi:10.1038/sj.ejcn.1601625 · Cited by 75
Nutrition Status and Pressure Ulcer: What We Need for Nutrition Screening
Hengstermann, S., Fischer, A., Steinhagen‐Thiessen, E., & Schulz, R. J. (2007) · Journal of Parenteral and Enteral Nutrition · doi:10.1177/0148607107031004288 · Cited by 77
Pataky, Z., Genton, L., Spahr, L., Lazarevic, V., Terraz, S., Gaïa, N., Rubbia-Brandt, L., Golay, A., Schrenzel, J., & Pichard, C. (2016) · Digestive Diseases and Sciences · doi:10.1007/s10620-016-4179-1 · Cited by 75
“Resistance and reactance were converted to FFM using the Geneva formula [18].”
MethodSelf-citationMainenti, M. R. M., Rodrigues, É. C., de Oliveira, J. F., Ferreira, A. D. S., Dias, C. M., & Silva, A. L. D. S. (2011) · Clinics · doi:10.1590/s1807-59322011000900001 · Cited by 73
Beberashvili, I., Azar, A., Sinuani, I., Yasur, H., Feldman, L., Averbukh, Z., & Weissgarten, J. (2010) · Nephrology Dialysis Transplantation · doi:10.1093/ndt/gfq031 · Cited by 71
“validated by dual-energy X-ray absorptiometry on 343 healthy adult subjects [27]:”
MethodPlayer, E., Morris, P., Thomas, T. R., Chan, W. Y., Vyas, R., Dutton, J. J., TANG, J. C. Y., Alexandre, L., & Forbes, A. (2018) · Clinical Nutrition · doi:10.1016/j.clnu.2018.08.003 · Cited by 72
“course not the first study to support the use of BIA in assessment of nutritional status ([25]), nor the 272 first to find particular value from the standardized PA, in general ([26]), and in the context of 273 disease states that substantially alter body fluid such as cirrhosis, and chronic renal failure ([27-30]).”
BackgroundKyle, U. G., Genton, L., & Pichard, C. (2002) · Current Opinion in Clinical Nutrition & Metabolic Care · doi:10.1097/00075197-200207000-00012 · Cited by 70
Self-citationLangkamp‐Henken, B., Hudgens, J., Stechmiller, J. K., & Herrlinger‐Garcia, K. A. (2005) · Journal of the American Dietetic Association · doi:10.1016/j.jada.2005.07.005 · Cited by 70
IL-6 Levels, Nutritional Status, and Mortality in Prevalent Hemodialysis Patients
Beberashvili, I., Sinuani, I., Azar, A., et al. (2011) · Clinical Journal of the American Society of Nephrology · doi:10.2215/cjn.01770211 · Cited by 68
The new ESPEN diagnostic criteria for malnutrition predict overall survival in hospitalised patients
Rondel, A. L., Langius, J. A. E., de van der Schueren, M. A. E., & Kruizenga, H. M. (2016) · Clinical Nutrition · doi:10.1016/j.clnu.2016.11.018 · Cited by 67
Norman, K., Stobäus, N., Kulka, K., & Schulzke, J. (2013) · European Journal of Clinical Nutrition · doi:10.1038/ejcn.2013.261 · Cited by 66
Beberashvili, I., Azar, A., Sinuani, I., Kadoshi, H., Shapiro, G., Feldman, L., Sandbank, J., & Averbukh, Z. (2014) · Nutrition · doi:10.1016/j.nut.2013.08.017 · Cited by 66
Prevalence of low muscle mass according to body mass index in older adults
Graf, C. E., Pichard, C., Herrmann, F. R., Sieber, C. C., Zekry, D., & Genton, L. (2016) · Nutrition · doi:10.1016/j.nut.2016.10.002 · Cited by 65
“Geneva BIA formula (5), which was validated against dual-energy x-ray absorptiometry in 65”
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Similarities in Acquired Factors Related to Postmenopausal Osteoporosis and Sarcopenia
Sirola, J. P., & Kröger, H. (2011) · Journal of Osteoporosis · doi:10.4061/2011/536735 · Cited by 68
“[31] U.”
MethodGuerrero, K., Wuyam, B., Mezin, P., et al. (2005) · American Journal of Physiology-Regulatory, Integrative and Comparative Physiology · doi:10.1152/ajpregu.00229.2005 · Cited by 65
“Moreover, LR patients received tacrolimus as anticalcineurin therapy and were not exposed to cyclosporin A (15).”
Backgroundvan der Meij, B. S., Schoonbeek, C. P., Smit, E. F., Muscaritoli, M., van Leeuwen, P. A. M., & Langius, J. A. E. (2012) · British Journal Of Nutrition · doi:10.1017/s0007114512004527 · Cited by 65
“FFM was calculated from resistance and reactance at the frequency of capacitance by using the Kyle Geneva equation (20) .”
van der Kooi, A.-L. L. F., Snijder, M. B., Peters, R. J. G., & van Valkengoed, I. G. M. (2015) · PLoS ONE · doi:10.1371/journal.pone.0137739 · Cited by 68
ESPEN diagnostic criteria for malnutrition - A validation study in hospitalized patients.
Guerra, R., Fonseca, I., Sousa, A., Jesus, A., Pichel, F., & Amaral, T. (2017) · Clinical Nutrition · doi:10.1016/j.clnu.2016.08.022 · Cited by 67
Valentini, V., Marazzi, F., Bossola, M., et al. (2012) · Journal of Human Nutrition and Dietetics · doi:10.1111/j.1365-277x.2011.01220.x · Cited by 62
Muscoloskeletal aging, sarcopenia and cancer
Colloca, G. A., Capua, B. D., Bellieni, A., Cesari, M., Marzetti, E., Valentini, V., & Calvani, R. (2018) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2018.11.007 · Cited by 65
The behavioral and clinical effects of therapeutic lifestyle change on middle-aged adults.
Aldana, S. G., Greenlaw, R. L., Diehl, H. A., Salberg, A., Merrill, R. M., Ohmine, S., & Thomas, C. (2006) · Europe PMC (PubMed Central) · Cited by 64
Metadata
- Authors
- Kyle, U. G., Genton, L., Karsegard, L., Slosman, D. O., & Pichard, C.
- Affiliations
- University Hospital of Geneva (CH)
- Venue
- Nutrition
- Publisher
- Elsevier BV
- Published
- 2001-03
- Volume
- 17
- Issue
- 3
- Pages
- 248-253
- ISSN
- 0899-9007 (ISSN-L)
- OpenAlex
- W2041793073
- Cited by
- 575
- References
- 42
- Citations by year
- 2026: 13 · 2025: 19 · 2024: 26 · 2023: 24 · 2022: 28 · 2021: 39 · 2020: 27 · 2019: 31 · 2018: 34 · 2017: 35 · 2016: 32 · 2015: 35 · 2014: 35 · 2013: 26 · 2012: 33
- FWCI
- 7.95
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Nutrition (publishedVersion)
- PubMed (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion)
- Funders
- Hôpitaux Universitaires de Genève
- Topics
- Health Sciences › Medicine › Physiology (medical) › Body Composition Measurement Techniques
- Physical Sciences › Engineering › Electrical and Electronic Engineering › Electrical and Bioimpedance Tomography
- Health Sciences › Medicine › Physiology (medical) › Nutrition and Health in Aging
- Keywords
- bioelectrical impedance analysis, fat-free mass, prediction equations, dual-energy X-ray absorptiometry, reactance, resistance, body mass index, older adults, overweight, validation, healthy adults
- MeSH terms
- Adult, Aged, Aged, 80 and over, Aging, Body Composition, Female, Humans, Male, Middle Aged, Reference Values, Regression Analysis, Reproducibility of Results, Absorptiometry, Photon, Body Mass Index, Electric Impedance
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