Ecuaciones para la estimación del agua corporal total por el método de análisis de impedancia bioeléctrica a 50 kHz / Equations for the estimate of total body water by the method of bioelectric impedance at 50 kHz

Introducción: El agua mantiene un rango normal en personas aparentemente sanas, el cual se altera ante la existencia de diversas enfermedades. Objetivo: Conocer cuánto se diferencian los valores de agua corporal total estimados por las ecuaciones de agua corporal total, de Kushner, de Deurenberg y de Heitman, con respecto a los obtenidos clínicamente por el método de impedancia bioeléctrica a 50 kHz. Métodos: Se realizó un estudio descriptivo y transversal, de abril a diciembre del 2018, en 62 individuos: 31 adultos aparentemente sanos y 31 niños y adolescentes con diferentes enfermedades, ingresados en el Hospital Infantil Docente Sur Dr. Antonio María Béguez César de Santiago de Cuba (24 en el Servicio de Misceláneas y 7 en el de Oncopediatría). El agua corporal total y los parámetros bioeléctricos se estimaron con el analizador de impedancia bioeléctrica Bodystat® 1500-MDD, a 50 kHz, por el método tetrapolar ipsilateral derecho. Se utilizó el criterio de Bland-Altman, para un 95 % de confianza, a fin de conocer si las ecuaciones de Kushner, de Deurenberg y de Heitman podían sustituir a la ecuación de referencia. Resultados: Las ecuaciones de agua corporal total, de Kushner y de Deurenberg no mostraron diferencias significativas respecto a la ecuación de referencia, mientras que la ecuación de Heitman sí presentó diferencias significativas en relación con el resto de las ecuaciones. El método de Bland-Altman demostró que la ecuación de Kushner posee mayor concordancia con la ecuación de referencia. Conclusiones: La ecuación de Kushner es la de mayor exactitud para la estimación del agua corporal total en personas sanas y en las afectadas por entidades clínicas.

Introduction: The water maintains a normal range in apparently healthy people, which changes with the existence of diverse diseases. Objective: To know how the values of total body water estimated by Kushner, Deurenberg and Heitman equations of total body water, differ regarding those obtained clinically by the method of bioelectric impedance at 50 kHz. Methods: A descriptive and cross-sectional study was carried out, from April to December, 2018, in 62 individuals: 31 apparently healthy adults and 31 children and adolescents with different diseases, admitted to "Dr. Antonio María Béguez César" Southern Teaching Children Hospital in Santiago de Cuba (24 in the Miscellaneous Service and 7 in Oncopediatrics Service). The total body water and the bioelectric parameters were considered with the analyzer of bioelectric impedance Bodystat® 1500-MDD, at 50 kHz, for the right ipsilateral tetrapolar method. The approach of Bland-Altman was used, for 95% of confidence in order to know if Kushner, Deurenberg and Heitman equations could substitute the reference equation. Results: Kushner and Deurenberg equations of total body water didn't show significant differences regarding the reference equation, while Heitman equation presented significant differences related to the rest of the equations. The Bland-Altman method demonstrated that the equation of Kushner has higher concordance with the reference equation. Conclusions: Kushner equation has the highest accuracy for the estimate of total body water in healthy people and in those affected by diseases.

Body mass index and body fat percentage in assessing obesity: An analytical study among the adolescents of Dibrugarh, Assam

Background: Body mass index (BMI) is one of the most commonly used indices to measure the weight status of an individual. However, it takes only height and weight of individual into account. The relative body composition can be calculated regardless of height and weight by body fat percentage (BF%). Objectives: The objectives of the study are (1) To assess the prevalence of obesity using BMI and BF% among early adolescents studying in schools of Dibrugarh. (2) To assess the relationship between BMI and BF%. Methods: A cross-sectional analytical study was conducted among 1200 school going adolescents of 10–14 years in Dibrugarh town for 1 year. Weight status was assessed using the World Health Organization-2007 reference for BMI and the McCarthy's body fat reference. Data were presented using percentages and mean with standard deviation. The correlation between the anthropometric variables was calculated using Pearson's correlation coefficient. Kappa statistics was used to analyze the agreement. Results: Total participants included in the analysis were 1096 with a response rate of 91.3%. The prevalence of overweight and obesity by BMI was 20.9% and 10.2%, respectively. According to BF%, overweight was present in 16.4% participants and 10.9% were obese. Of the 625 normal weight participants (according to their BMI), 9.0% were overweight and 1% were obese under BF% criteria. Again, of 682 participants who were normal by BF%, 15.2% were categorized as obese by BMI criteria. BMI and BF% had a significant high positive correlation (r = 0.70 and P < 0.001). The measurement of agreement by Kappa statistics was 0.621 which was significant (P < 0.001). Conclusions: BMI and BF% positively correlate with each other. BMI accompanied by BF% in the studies might give a better picture of the adiposity of an adolescent.

Nutritional status and energy metabolism characteristics in patients with nonalcoholic fatty liver disease / 中华肝脏病杂志

Objective@#To study the nutritional status and energy metabolic characteristics of patients with nonalcoholic fatty liver disease (NAFLD), and to provide evidence for clinical evaluation and intervention.@*Methods@#A total of 359 NAFLD patients diagnosed on ultrasound from June 2015 to March 2017 were selected as study subjects and divided into mild, moderate to severe fatty liver disease group and 50 healthy subjects as control group. The changes of ICW, ECW, body fat, skeletal muscle, protein and visceral fat area (VFA) of patients and controls were analyzed by using body composition analyzer. The energy metabolism index was measured by the oxidation rate of resting energy expenditure(REE), respiratory quotient (RQ), and the oxidation rates of the three nutrients (CHO %, FAT %, and PRO %). According to different types of data, non-parametric tests like Kruskal-Wallis or χ2 were used for this analysis.@*Results@#Compared with the mild fatty liver group and the control group, the moderate and severe fatty liver group the BMI, waist circumference, waist-hip ratio were significantly elevated (P-value < 0.001), and their serum alanine aminotransferase, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, FBS levels were significantly increased (P value < 0.05). The Body composition analysis showed that there was no significant difference in skeletal muscle content between the three groups (P = 0.067). The ICW, ECW, protein, body fat content of moderate and severe fatty liver group were significantly higher than those of mild fatty liver group and control group (P < 0.01), but there was no significant difference between the mild fatty liver group and the control group. There was significant difference in the VFA between the three groups, while VFA in the moderate and severe fatty liver group was significantly increased. Metabolic results showed that the RQ of patients with moderate-severe fatty liver and mild fatty liver were 0.72 ± 0.08 and 0.78 ± 0.06, respectively, which were lower than those of the control group (0.80 ± 0.02), P = 0.004. Resting energy expenditure (REE) was not significantly different between moderate and severe fatty liver group and mild fatty liver group (P = 0.207), but both were significantly higher than those of the control group (P < 0.001). The percentages of CHO, FAT and PRO in moderate and severe fatty liver group were 19.49% ± 9.71%, 66.23% ± 12.54% and 14.22% ± 6.11% respectively. Compared with the control group, CHO % decreased, and FAT % increased.@*Conclusion@#NAFLD patients have different extent of nutritional imbalance and energy metabolism disorders, the use of Body Composition analyzer and metabolic cart can comprehensively assess and monitor NAFLD patient’s nutrition and energy metabolism status, to provide a basis for clinical intervention.

Marcadores do estado nutricional associados ao prognóstico de pacientes portadores de miocardiopatia dilatada internados em unidade de terapia intensiva de hospital referenciado: um estudo piloto / Markers of nutritional status associated with the prognosis of patients with dilated cardiomyopathy hospitalized in a referral hospital intensive therapy unit: a pilot study

Introdução: A avaliação nutricional de pacientes com insuficiência cardíaca (IC) é um desafio na prática clínica. A presença de caquexia cardíaca está relacionada com piores resultados e redução da sobrevida, enquanto excesso de peso e colesterol elevado são fatores protetores de mortalidade nos pacientes com IC. Nesse contexto, o objetivo do trabalho é estudar marcadores do estado nutricional de pacientes portadores de miocardiopatia dilatada com IC grau III e IV internados em unidade de terapia intensiva de hospital referenciado do estado de São Paulo. Método: Pesquisa prospectiva e observacional, com avaliação subjetiva global (ASG), antropometria (índice de massa corporal -IMC, prega cutânea tricipital -PCT, circunferência do braço ­CB, e circunferência muscular do braço -CMB), bioquímica (proteínas totais, albumina, linfócitos, hemoglobina (Hb), lipídeos e BNP), impedância bioelétrica (IB) e análise dos desfechos obtidos. Para estatística, foram aplicados testes t de Student, correlação de Pearson e Análise de Variância, adotando-se como significante p≤0,01. Resultados: 24 pacientes com idade média de 48,25±18,05, sendo 62,5% (n=15) homens e 37,5% (n=9) idosos. Pela ASG, 60,8% estavam denutridos, pelo IMC, 33,3% baixo peso e 41,7% eutróficos; por meio das medidas de CB, CMB e PCT, estavam desnutridos 75%, 66,7% e 50% da amostra, respectivamente. Em relação às dosagens bioquímicas, 83,3% apresentavam depleção pela contagem total de linfócitos, 75% anemia, 79,2% hipoalbuminemia, 41,6% deficiência de ferro e 75% valores reduzidos de colesterol total (<160 md/dL). O valor médio do ângulo de fase encontrado foi 5,22º±1,66º, sendo para adultos 5,05º±1,49 e para idosos 5,52º±1,80. Foi verificada correlação negativa significativa entre albumina e ângulo de fase. Conclusão: Avaliação nutricional periódica no IC grave é essencial para prevenir maus resultados, uma vez que existem diferenças significativas conforme fases da doença e estados de desnutrição, bem como valores baixos de colesterol podem auxiliar precedendo maus resultados.

Uso de indicadores antropométricos para avaliação da adiposidade corporal em idosos no sul do Brasil / Using of the anthropometrics indicators to evaluate of body adiposity in the elderly in Southern Brazil

Introdução: A composição corporal e sua distribuição sofrem mudanças conforme a idade. Por isso, avaliar o uso de indicadores antropométricos para avaliação da adiposidade corporal em idosos é de extrema importância. Método: Trata-se de um estudo transversal, realizado com 108 idosos cadastrados em 11 unidades básicas de saúde do município de Pelotas-RS integrantes da Estratégia Saúde da Família. Para a avaliação nutricional, foram aferidos: altura, peso, circunferência da cintura e circunferência do quadril. O percentual de gordura corporal (%GC) foi verificado por bioimpedância (BIA) e pelo índice de Adiposidade Corporal (IAC) calculado conforme proposto por Bergman et al. Resultados: Os idosos apresentaram médias %GC, verificado pelos dois indicadores BIA e IAC, acima do recomendado (38,5 e 35,6, respectivamente). Conclusão: São necessárias mudanças no estilo de vida destes idosos, incentivando o consumo alimentar saudável e a pratica de atividade física.

Perfil da composição corporal de mulheres com obesidade grau III pelo método de bioimpedância multipolar / Profile of body composition in women with class III obesity by multipolar bioimpedance method / Perfil de composición corporal en mujeres con obesidad grado III por el método de bioimpedancia multipolar

RESUMO Objetivo O objetivo do estudo foi analisar um perfil da composição corporal de mulheres com obesidade grau III, através do método de bioimpedância multipolar. Métodos Foram avaliadas 13 mulheres com idades entre 20 e 40 anos e sedentárias. Resultados Os resultados demonstraram que as pacientes possuíam um % de 51,9±1,50 % e massa livre de gordura de 48,1±1,50 %. Em relação à massa gorda e massa magra por regiões do corpo, observou-se que no tronco havia 26,3±3,62 kg e 26,2±2,91 kg, seguido dos membros inferiores com 9,1±0,06 kg e 8,4±0,14 kg e dos membros superiores 3,3±0,02 kg e 7,6±0,01 kg, respectivamente. Os pacientes demonstraram certa simetria entre o lado direito e esquerdo tanto para os membros superiores e inferiores, além disto, à massa muscular foi 32,1±5,08 kg, com um índice de massa muscular de 12,7±1,05 kg/m2. Conclusão Houve um maior acumulo de gordura na região do tronco seguido de membros inferiores e superiores e a massa muscular total estava aparentemente preservada, não sendo verificada a obesidade sarcopênica. Como é um grupo de pessoas que ainda é pouco estudado há a necessidade de uma maior investigação sobre o perfil genético, físico e do gasto calórico em repouso e em exercício.(AU)

ABSTRACT Objective To analyze a body composition profile in women with class III obesity using the multipolar bioimpedance method. Methods Thirteen sedentary women aged between 20 and 40 years were evaluated. Results The results show that the patients had a fat percentage of 51.9±1.50 % and lean mass of 48.1±1.50 %. Regarding fat mass and lean mass per body region, figures of 26.3±3.62kg and 26.2±2.91kg in the upper body, 9.1±0.06kg and 8.4±0.14kg in the lower limbs, and 3.3±0.02kg and 7.6±0.01kg in the upper limbs were obtained. Patients had a good symmetry between the left and right sides in both upper and lower limbs, besides of a muscular mass of 32.1±5.08kg, with a muscular mass index of 12.7±1.05kg/m2. Conclusion Higher fat accumulation was observed in the upper body region, followed by lower and upper limbs. Total muscular mass was apparently preserved, although sarcopenic obesity was not verified. Since this is a group of people that is still understudied, there is a need for further research on genetic and physical profile and caloric expenditure during exercise and rest.

RESUMEN Objetivo Analizar un perfil de la composición corporal de mujeres con obesidad grado III, a través del método de bioim-pedancia multipolar. Métodos Se evaluaron 13 mujeres de entre 20 y 40 años y sedentarias. Resultados Los resultados demostraron que las pacientes poseían un %G de 51,9 ± 1,50 % y una masa libre de grasa de 48,1 ± 1,50 %. En cuanto a la masa grasa y masa magra por regiones del cuerpo, se observó que en el tronco había 26,3 ± 3,62 kg y 26,2 ± 2,91 kg, seguido de los miembros inferiores con 9,1 ± 0,06 kg y 8 , 4 ± 0,14 kg y de los miembros superiores 3,3 ± 0,02kg y 7,6 ± 0,01 kg, respectivamente. Los pacientes demostraron cierta simetría entre el lado derecho e izquierdo tanto para los miembros superiores e inferiores, además, a la masa muscular fue 32,1 ± 5,08 kg, con un índice de masa muscular de 12,7 ± 1,05 kg/m2. Conclusión Hubo un mayor acúmulo de grasa en la región del tronco seguido de miembros inferiores, superiores y la masa muscular total estaba aparentemente preservada, no siendo verificada la obesidad sarcopénica. Como es un grupo de personas que todavía es poco estudiado hay la necesidad de una mayor investigación sobre el perfil genético, físico y del gasto calórico en reposo y en ejercicio.(AU)

Relationship between body composition and bone mass abnormal in Tibet Tibetans / 解剖学报

Objective: To investigate the distribution of bone strength index of adult Tibetans in Tibet and analyze the correlation between of their body composition and incidence of bone mass abnormal. Methods: The bone strength of right calcaneus, T score and body composition of 560 Tibetans in Shigatse, Tibet by using an ultrasonic bone mineral density meter and bioelectric impedance technique. Binary Logistic Regression was used to test the relationship of incidence of bone mass abnormal and body composition. Results: The bone mass index of the male and female participants reached the maximum at their 18-30 years old, and then declined with aging. The incidence of osteoporosis among male and female participants ≥50 years old were 7. 6% and 11. 7% respectively. Age(B =0. 046,OR = 1. 047,P <0. 01)and visceral fat mass (B = 0. 452, OR = 1. 572, P < 0. 05) were risk factors of incidence of bone mass abnormal whereas the subcutaneous fat mass (B = - 0. 181, OR = 0. 835, P < 0. 01) and muscle mass (B = - 0. 055, OR = 0. 947, P < 0. 05) were protective factors. Conclusion: The incidence of osteoporosis among Tibet Tibetans ≥50 years old are lower than other nationalities of China in the same age. The participants with high visceral fat mass while low subcutaneous fat mass and muscle mass are more likely to suffer from osteoporosis.

Utility of anthropometric parameters and body composition analysis for the screening and prediction of metabolic syndrome in the elderly / 中华健康管理学杂志

Objective To investigate effectiveness of anthropometric parameters and body composition analysis for the screening and prediction of metabolic syndrome and explore the best indicator for predicting metabolic syndrome in the elderly. Method A cross-sectional study of 763 (406 men and 357 women) elderly people who participated in the annual health check-up was conducted. Clinical data of all participants were obtained including anthropometric parameters, body composition, lipid profiles, fasting blood glucose, and high sensitivity C-reactive protein. Receiver operating characteristic (ROC) curve was used to determine the optimal cutoff points for waist circumference, waist-to-hip ratio, waist-to-height ratio, percent body fat and fat mass index in relation to the area under the curve (AUC), sensitivity and specificity in the screening and prediction of metabolic syndrome. Result In total subjects, compared with non-metabolic syndrome group,the ROC curve analysis showed that parameters including waist circumference, waist-to-height ratio, waist-to-hip ratio, percent body fat and fat mass index had a significant potential for predicting metabolic syndrome (P<0.001). It was determined that waist circumference of 87.5 cm and 77.5 cm, waist-to-hip ratio of 0.89 and 0.87, waist-to-height ratio of 0.51 and 0.52, percent body fat of 24.1%and 31.7%and fat mass index of 5.00 kg/m2 and 7.80 kg/m2 were the optimal cutoff points for screening and predicting the presence of metabolic syndrome among men and women with a sensitivity of 81.3%,78.8%,87.5%, 51.3%and 83.8%(in men) and 85.1%,79.8%,71.3%, 70.2%and 80.9%(in women) and a specificity of 57.7%,62.6%,50.0%, 75.5%and 51.8%(in men) and 38.0%,53.2%,55.1%, 50.6%and 52.5% (in women),respectively. The area under the ROC curve (AUC) was 0.728, 0.755, 0.716, 0.671 and 0.725 in men and 0.652, 0.707, 0.658, 0.619 and 0.675 in women,respectively. Waist-to-hip ratio showed the highest AUC in all the parameters in men and women. Conclusion Anthropometric parameters and body composition analysis play important roles in the screening and prediction of metabolic syndrome, and waist-to-hip ratio seems to be the best parameter in the screening and prediction of metabolic syndrome in the elderly.

Gordura corporal de pacientes em hemodiálise / Body fat of hemodialysis patients

Objetivo. Avaliar a gordura corpórea de pacientes em hemodiálise por bioimpedância elétrica e dobras cutâneas, a correlação entre os dois métodos e destes com o índice de massa corpórea. Métodos. Estudo transversal com 38 pacientes adultos em hemodiálise no Hospital das Clínicas da Universidade Federal de Goiás. Calculou-se o índice de massa corpórea: peso (kg)/altura (m2). Utilizaram-se bioimpedância elétrica e dobras cutâneas - triciptal, biciptal, subescapular e suprailíaca - para estimar a gordura corporal. Utilizaram-se estatística descritiva, coeficiente de correlação de Pearson e teste t de Student, sendo consideradas significativas diferenças no nível de p < 0,05. Resultados. A média do índice de massa corpórea indicou eutrofia nos dois sexos. As mulheres apresentaram percentual de gordura de 35,4% pelas dobras cutâneas e 39,3% pela bioimpedância elétrica. Nos homens, o percentual de gordura pelas dobras cutâneas foi 23,1% e 26,8% pela análise de bioimpedância elétrica. A média da gordura estimada por bioimpedância elétrica e dobras cutâneas não apresentou diferença estatisticamente significante nos dois sexos, todos p > 0,05. A gordura corporal apresentou correlação positiva entre a bioimpedância elétrica e as dobras cutâneas com r = 0,81 nos homens e r = 0,96 nas mulheres. Verificou-se forte correlação entre o índice de massa corpórea e os dois métodos em ambos os sexos. Conclusão. As mulheres apresentaram excesso de gordura corporal pelos dois métodos. Apesar de os homens terem percentual de gordura ligeiramente elevado apenas pela bioimpedância elétrica, não houve diferença estatisticamente significante entre os métodos. A forte correlação entre os métodos, e destes com o índice de massa corpórea, sugere que ambos são úteis e confiáveis para a avaliação da gordura corporal e acompanhamento nutricional de pacientes em hemodiálise.

Objective. To evaluate the body fat of hemodialysis patients by electrical bioimpedance and skin folds, the correlation between the two methods and those with body mass index.Methods. Cross-sectional study with 38 adult patients on hemodialysis in the Hospital of the Federal University ofGoiás. The body mass index was calculated: weight (kg)/height (m2); electrical bioimpedance and skin folds (triciptal, biciptal, subscapular and suprailiac) were used to estimate the body fat. We used descriptive statistics, Pearson correlation coefficient (r) and Student t test, considering significant differences in the level of p < 0.05.Results. The mean body mass index for both sexes indicated normal range. Women had 35.4% fat by skin foldsand 39.3% by electrical bioimpedance. Men presented 23.1% of fat by skin folds and 26.8% by electrical bioimpedance. The average fat estimated by electrical bioimpedance and skin folds was not statistically significant among both sexes, p > 0.05. The body fat showed a positive correlation between electrical bioimpedance and skin folds, withr = 0.81 in men and r = 0.96 in women. There was strong correlation between body mass index and the two methodsamong both sexes. Conclusion. Women showed an excess of body fat by the two methods. Although men show slightly higher percentage of fat just by electrical bioimpedance, there was no statistically significant difference between the methods. The strong correlation between the methods, and those with body mass index, suggest that both are useful and reliablefor the assessment of body fat and nutritional monitoring of hemodialysis patients.

Ghrelin Levels During Puberty: Relationship with Anthropometric Measures and Other Hormones / 대한소아내분비학회지

PURPOSE: Puberty is a rapid changing periods of body composition and endocrine system. Already leptin was known to be closely related to body composition and was known to change according to Tanner stage. Ghrelin, a natural GH secretagogue, was also known to be related with weight change, fat utilization, insulin secretion, and influenced by sex steroid. But the relationship between ghrelin and other parameter according to pubertal development is not established yet. METHODS: Cross-sectional study of 101 peripubertal children (54 males and 47 females) aged 8.5 to 17.0 years. We examined body composition (free fat mass, fat mass, % body fat) by bioelectric impendence measurements. Total ghrelin, leptin, insulin was measured by radioimmunoassay (RIA). Relationship between ghrelin, leptin, insulin and body composition data was analysed according to Tanner stage controlling gender using SPSS ver 11.0. RESULTS: Ghrelin concentration is only correlated with Tanner stage (r=-0.21, P<0.05) and GIR (r=0.29, P<0.01). When we divided subjects by sex, even though there was no difference of ghrelin level between both sex, only male is correlated with Tanner stage (r=-0.28, P<0.05) and GIR (r=0.36, P<0.01). There was no difference of ghrelin level between each Tanner stage and no correlation was observed with other body composition and endocrine parameter including leptin. CONCLUSION: These data suggest that Ghrelin levels decrease during puberty at least in boys as pubertal development proceeds but it is minimal. During puberty, ghrelin levels are stable. Ghrelin may have no relationship with other pubertal change. The relation of ghrelin and insulin sensitivity need to be further investigated.

Effects of hemodialysis on nutritional status and water balance in newly diagnosed ESRD patients / 中国实用内科杂志

Objective To observe the effects of hemodialysis on nutritional status and water balance in newly diagnosed end-stage renal disease(ESRD)patients.Methods Thirty newly diagnosed ESRD patients who accepted hemodialysis for the first time were included in the study;body water balance was analyzed by bioelectric impedance analysis(BIA)method and nutritional status were evaluated by BIA,anthropometry and blood biochemical indicators.Results Total body water,extracellular fluid,intracellular fluid,normalized total body water,normalized extracellular fluid,normalized intracellular fluid were decreased significantly after 3 months of hemodialysis(P

Evaluation of Ultrafiltration Adequacy by Segmental Multifrequency Bioimpddance Analysis(BIA) in Patients with Maintenance Hemodialysis(HD) / 대한신장학회잡지

OBJECTIVE: Many patients has suffered from intradialytic hypo- or hypertension. These unsatisfactory control of blood pressure(BP) may be due to inadequate ultrafiltration during HD. In this study, segmental multifrequency BIA was used to estimate dry weight(DW). Then, ultrafiltration adequacy was evaluated according to the estimated DW. METHODS: Total body water resistance(RTBW) and extracellular fluid resistance(RECF) were measured on the right lower extremity in 36 maintenance HD patients(22 men and 14 women) and in 234 control subjects(171 men, 63 women). BP was measured every 30 minutes during HD. Patients with RTBW/ RECF ratio higher and lower than the mean+/-2SD of control subjects were considered to be over- and underhydrated, respectively. RESULTS: 1)RTBW/RECF ratio of control subjects was 0.3402+/-0.0062. 2)RTBW/RECF ratio of HD patients was 0.3650+/-0.0190 before and 0.3445+/-0.0150 after dialysis(P< 0.01). After dialysis, 28 out of 36(77.8%) patients were normovolemic(NV group), 7(19.4%) patients were overhydrated(OV group), and 1 patient(2.8%) was underhydrated. 3)BP changes during HD; In NV group, BP were increased significantly(P<0.05). But there was no change in OV group. In one underhydrated patient, a decrease in BP, albeit not significant, was noticed. 4)Body weight reduction rate(kg/hr) was higher in NV group(0.48+/-0.15) than in OV group(0.25+/-0.14)(P<0.01). CONCLUSION: Segmental multifrequency BIA may be useful as a method for estimating DW and evaluating ultrafiltration adequacy in maintenance HD patients.

A Comparison of Techniques in Assessment of Postdialysis Dry Weight: The Relationship Between Biochemical Markers(ANP and cGMP) and Multifrequency Bioelectric Impedance / 대한신장학회잡지

OBJECTIVE: The accurate evaluation of dry weight followed by hemodialysis is very important. So far, dry weight has been clinically estimated by using diagnostic parameters such as weight changes during dialysis, blood pressure, extremity edema, pulmonary edema, and chest X-rays. However, these methods result in frequent trials and errors because of the low accuracy. Recently, new methods have been attempted in a non-invasive way of determining dry weight. Bioelectric impedance method has been reported to be highly related to hemodynamic parameters before and after hemodialysis, and plasma atrial natriuretic peptide(ANP) and cyclic guanosine 3', 5'-monophosphate(cGMP) concentrations have been known to represent the amount of blood. In this study, we compared and analyzed the method of dry weight evaluation followed by hemodialysis by using multifrequency bioelectric impedance method(BIA method) and biochemical index(ANP method and cGMP method). METHODS: Subjects consisted of seventeen patients who had received maintenance hemodialysis. Using multifrequency bioelectric impedance method before and after hemodialysis, a RTBW/RECF ratio in the right lower extremity was measured. Plasma ANP and cGMP concentrations were measured by collecting blood in arterial port. RESULTS: 1)Changes before and after hemodialysis: Post- dialysis weight decreased by 2.1+/-0.22kg. A RTBW/ RECF ratio significantly decreased from 0.3525+/-0.004 pre-dialysis to 0.3292+/-0.002 post-dialysis(p< 0.01). Plasma cGMP concentration(pmol/mL) significantly decreased from 23.9+/-4.4 pre-dialysis to 8.8+/-3.4 post-dialysis(p<0.01), and plasma ANP concentration(pg/mL) significantly decreased from 315+/-64 pre-dialysis to 222+/-71 post-dialysis(p<0.05). The extent of weight loss was not associated with above three parameters after dialysis. 2)The relationship between RTBW/RECF ratios and biochemical parameters:No relationship was noted between two parameters before dialysis, while a significant relationship was observed with plasma cGMP concentrations or plasma ANP concentrations after dialysis(r=0.705, p<0.01; r=0.653, p<0.01, respectively). 3)The measure of agreement in estimation of dry weight after dialysis(kappa value):Although the consistencies of a BIA method and a cGMP method were good(kappa=0.64), the consistency between a BIA method and an ANP method was low(kappa=0.21), and the consistency between a cGMP method and an ANP method was almost negligible(kappa=0.09). CONCLUSION: In conclusion, RTBW/RECF ratio or plasma cGMP concentration can be used, but plasma ANP concentration is not suitable for evaluating dry weight after dialysis.

The Study of Body Fat Percent Measured by Bioelectric Impedance Analyzer in a Rural Adult Population / 예방의학회지

Obesity usually is defined as the presence of and abnormally amount of adipose tissue. In many epidemiologic study, obesity as a health risk factor has been estimated by Body Mass Index(BMI) in general. This study was conducted to review of body fat percent measured by Bioelectric impedance analyzer as a estimator of obesity in a rural adult population. The study subjects were 421 men and 664 women who reside in the area on the Juam lake. They were sampled by multistage cluster sampling. Their mean age was 59 years old. Body fat percent increased with age, but BMI decreased with age in this study. Body fat percent was more larger at female and elder on the same BMI. The correlation coefficient between with body fat percent and body mass index was low (r=0.4737). Body fat percent was explained by not only BMI but also sex and age (r(2)=0.63). The result suggested that it is inadequate for BMI only to estimate obesity about elderly person who reside in the rural community. The relation of body fat percent and body mass index of this study agreed with the preceding knowledges and studies in general.