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Validity of Bioelectrical Impedance Analysis for Older Amputees with Leprosy
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Jihyun Lee, Seorin Doo, Yeonhee Lee, Jaeyoung Ahn, Yookyoung Park, Hyun Joo Shin, Jae-myeong Lee
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Surg Metab Nutr 2021;12(1):7-15. Published online June 30, 2021
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DOI: https://doi.org/10.18858/smn.2021.12.1.7
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 Abstract
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- Purpose: Bioelectrical impedance analysis (BIA) evaluates body composition and electrical resistance according to weight and height but assumes all limbs are intact. This study evaluated the validity and accuracy of BIA in older amputees with leprosy.
Materials and Methods: We evaluated BIA’s effectiveness for determining body composition by measuring muscle mass, water percentage, and physical resistance, including phase angle, in older amputees with leprosy. BIA was performed on 42 individuals with leprosy aged ≥65 years. Comparative analyses were performed by amputation types (left lower limbs, right lower limbs, bilateral lower limbs, and non-amputees). Twenty people without leprosy or amputations of similar age, height, and weight were considered controls.
Results: Between the controls, amputee, and the controls without leprosy, BIA showed significant mean differences in skeletal muscle mass (22.5±5.6 kg, 19.6±5.6 kg, 18.2±3.9 kg, respectively; P=0.037); whole-body extracellular water (ECW) ratios (0.410±0.011, 0.401±0.007, 0.393±0.009, respectively; P<0.001) and phase angle (4.2±1.2, 4.4±0.7, 5.0±0.8, respectively; P=0.029). The bilateral lower limb amputation group (median, 0.415; range, 0.407–0.426) showed significantly higher whole-body ECW values than the non-amputee group (median, 0.401, range: 0.391–0.415) (P=0.013). Right leg lean mass was highest in the right lower limb amputation group, followed by bilateral lower limb amputation, non-amputee, and left lower limb amputation groups (median: 9.86, 6.04, 5.02, 3.95, respectively, P=0.001). As the length of the amputated lower limb was shortened, the lower limb's impedance decreased. However, BIA was evaluated without reflecting the shortened length, resulting in an error in the skeletal muscle mass readings.
Conclusion: Phase angle, ECW ratio, and bioelectrical impedance vector analysis obtained by BIA appeared accurate, but the skeletal muscle mass showed significant errors for amputated areas.
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