Bioimpedance index for measurement of total body water in severely malnourished children: Assessing the effect of nutritional oedema

TY - JOUR

T1 - Bioimpedance index for measurement of total body water in severely malnourished children

T2 - Assessing the effect of nutritional oedema

AU - Girma, Tsinuel

AU - Kæstel, Pernille

AU - Workeneh, Netsanet

AU - Mølgaard, Christian

AU - Eaton, Simon

AU - Andersen, Gregers S

AU - Michaelsen, Kim F.

AU - Friis, Henrik

AU - Wells, Jonathan C K

N1 - CURIS 2016 NEXS 108

PY - 2016/6/1

Y1 - 2016/6/1

N2 - Background & objectives: Restoration of body composition indicates successful management of severe acute malnutrition (SAM). Bioimpedance (BI) index (height2/resistance) is used to predict total body water (TBW) but its performance in SAM, especially with oedema, requires further investigation. Subjects/Methods: Children with SAM (mid-arm circumference <11.0 cm or weight-for-height <70% of median of NCHS reference and/or nutritional oedema) admitted to Jimma University Hospital were included. Tetrapolar-whole-body impedance (Z), resistance (R) and reactance (Xc) were measured at 50 and 200 kHzs. Pre- and post-deuterium dose saliva samples were analysed using isotope-ratio mass spectrometry. TBW was regressed on H2/Z. Xc and R were height (H)-indexed, and Xc/H plotted against R/H. Results: Thirty five children (16 non-oedematous and 19 oedematous) with median (interquartile range) age of 42 (26-54) months were studied. Height-for-age z-score (mean ± SD) was low in both non-oedematous (-3.9 ± 2.8) and oedematous (-3.6 ± 1.7) children. Oedematous children had lower BI parameters than non-oedematous (p < 0.001) and hence higher H2/Z for a given amount of TBW. At both 50 and 200 kHz, association between H2/Z and TBW was stronger in non-oedematous children than oedematous (60% higher coefficient of determination and 20% lower standard error of estimate). Intercepts and regression estimates at 50 and 200 kHz were similar, in both oedematous and non-oedematous children. Conclusions: In children with oedematous SAM, BI index was weak in predicting TBW. Moreover, predicted TBWs at 200 kHz and 50 kHz did not differ and hence BI measurement at 50 kHz is still practical for TBW estimation.

AB - Background & objectives: Restoration of body composition indicates successful management of severe acute malnutrition (SAM). Bioimpedance (BI) index (height2/resistance) is used to predict total body water (TBW) but its performance in SAM, especially with oedema, requires further investigation. Subjects/Methods: Children with SAM (mid-arm circumference <11.0 cm or weight-for-height <70% of median of NCHS reference and/or nutritional oedema) admitted to Jimma University Hospital were included. Tetrapolar-whole-body impedance (Z), resistance (R) and reactance (Xc) were measured at 50 and 200 kHzs. Pre- and post-deuterium dose saliva samples were analysed using isotope-ratio mass spectrometry. TBW was regressed on H2/Z. Xc and R were height (H)-indexed, and Xc/H plotted against R/H. Results: Thirty five children (16 non-oedematous and 19 oedematous) with median (interquartile range) age of 42 (26-54) months were studied. Height-for-age z-score (mean ± SD) was low in both non-oedematous (-3.9 ± 2.8) and oedematous (-3.6 ± 1.7) children. Oedematous children had lower BI parameters than non-oedematous (p < 0.001) and hence higher H2/Z for a given amount of TBW. At both 50 and 200 kHz, association between H2/Z and TBW was stronger in non-oedematous children than oedematous (60% higher coefficient of determination and 20% lower standard error of estimate). Intercepts and regression estimates at 50 and 200 kHz were similar, in both oedematous and non-oedematous children. Conclusions: In children with oedematous SAM, BI index was weak in predicting TBW. Moreover, predicted TBWs at 200 kHz and 50 kHz did not differ and hence BI measurement at 50 kHz is still practical for TBW estimation.

U2 - 10.1016/j.clnu.2015.05.002

DO - 10.1016/j.clnu.2015.05.002

M3 - Journal article

C2 - 26189699

SN - 0261-5614

VL - 35

SP - 713

EP - 717

JO - Clinical Nutrition

JF - Clinical Nutrition

IS - 3

ER -