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FRI0258 Validation of Bioelectrical Impedance Analysis for The Assessment of Body Composition in Patients with Systemic Sclerosis
  1. M.J. Spanjer1,
  2. I.E.M. Bultink1,
  3. M.A.E. de van der Schueren2,
  4. A.E. Voskuyl1
  1. 1Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, location VU University Medical Center
  2. 2Department of Nutrition and Dietetics, VU University Medical Center, Amsterdam, Netherlands


Background Malnutrition is a frequently reported complication in patients with systemic sclerosis (SSc) [1]. Especially low fat free mass (FFM) has been identified a prognostic factor for morbidity and mortality. Different methods are available to assess body composition. Bioelectrical impedance analysis (BIA) is a bedside method that has not yet been validated in this patient group.

Objectives To validate BIA against whole body dual-energy x-ray absorptiometry (DXA), for the assessment of body composition in patients with SSc.

Methods Body composition was assessed in 72 patients with whole body DXA (Hologic, Discovery A) and BIA (Bodystat Quadscan 400). The Geneva equation [2] was used to estimate FFM. The agreement between BIA and whole body DXA was assessed with Bland-Altman analysis and intraclass correlation coefficients (ICCs). The occurrence of malnutrition was assessed and defined as fat free mass index (FFMI) ≤14.5 kg/m2 for women or ≤16.6 kg/m2 for men [3].

Results No difference was found between BIA and whole body DXA for the assessment of FFM as predicted by the Geneva equation (mean difference 0.02 ± 2.4 kg). ICC was 0.97 (95% CI: 0.95–0.98). The 95% limits of agreement, as assessed by Bland-Altman analysis were -4.6 kg and 4.6 kg. Despite normal BMIs (24.6 ± 4.3 kg/m2), malnutrition was found in 14 (19.4%) patients with SSc.

Figure 1.

Bland-Altman plot comparing fat free mass measured by whole body DXA and fat free mass measured by BIA using the Geneva equation. The solid line represents the mean and the dotted lines represent the limits of agreement.

Conclusions This study shows acceptable validity of BIA in determining FFM in patients with SSc on a group level, while on an individual level, FFM may vary by 4.6 kg. This study also demonstrated a high prevalence (19.4%) of malnutrition in patients with SSc, underlining the necessity of assessing body composition in this patient group.

  1. Harrison E, et al. Rheumatology. 2012;51:1747–56

  2. Kyle UG, et al. Nutrition. 2001;17:248–53.

  3. Schutz Y, et al. Int J Obes Relat Metab Disord. 2002;26:953–60

Disclosure of Interest None declared

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