The Need for a New Cut-off Value to Increase Diagnostic Performance of Bioelectrical Impedance Analysis Compared with Dual-Energy X-ray Absorptiometry to Measure Muscle Mass in Indonesian Elderly

Authors

  • Purwita W Laksmi Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Fragma Ady Sukma University of Indonesia
  • Bambang Setyohadi Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • P Nugroho Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • A Ariane Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia
  • Gunawan Tirtarahardja Department of Internal Medicine, Faculty of Medicine Universitas Indonesia - Cipto Mangunkusumo Hospital, Jakarta, Indonesia

Keywords:

BIA Tanita MC-780MA, elderly, Indonesia, muscle mass, sarcopenia

Abstract

Background: the use of bioelectrical impedance analysis (BIA) is affected by the population setting, the type of BIA, and the cut-off point being used. The aim of this study was to determine the diagnostic performance of BIA to measure muscle mass in Indonesian elderly outpatients aged 60 years or more. Methods: a cross-sectional study was conducted at the Geriatric Clinic of Cipto Mangunkusumo Hospital from April to June 2018. The muscle mass was measured using BIA Tanita MC-780MA (Tokyo, Japan) with dual-energy x-ray absorptiometry (DXA) as the reference test. Analysis on the cut-off point was performed based on the Asian Working Group of Sarcopenia (AWGS) criteria and the new cut-off point. Results: from 120 subjects, 74 were female (61.7%). The diagnostic performance of BIA based on AWGS criteria only showed sensitivity and specificity of 79.2% and 66.7%. The diagnostic performance of BIA based on the new cut-off point showed sensitivity and specificity of 75% and 92.7%. The new cut-off point using BIA was found to be <6.9 kg/m2 in males (sensitivity 70.6%; specificity 82.8%) and <5 kg/m2 in females (sensitivity 85.7%; specificity 97%). Conclusion: the diagnostic performance of BIA Tanita MC-780MA (Tokyo, Japan) was good to measure muscle mass in Indonesian elderly outpatients using a new cut-off point of <6.9 kg/m2 for males and <5 kg/m2 for females.

Author Biography

Fragma Ady Sukma, University of Indonesia

Department of Internal Medicine - Resident

References

Newgard CB, Sharpless NE. Review series introduction coming of age: molecular drivers of aging and therapeutic opportunities. J Clin Invest. 2013;123(3):946–50.

Badan Pusat Statistik. Proyeksi penduduk Indonesia (Indonesia population project) 2015–2045. Jakarta: Badan Pusat Statistik, 2018.

Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis. Age Ageing. 2010;39(4):412–23.

Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian working group for sarcopenia. J Am Med Dir Assoc [Internet]. 2014;15(2):95–101. Available from: http://dx.doi.org/10.1016/j.jamda.2013.11.025

Beaudart C, McCloskey E, Bruyère O, et al. Sarcopenia in daily practice: assessment and management. BMC Geriatr [Internet]. 2016;16(1):170. Available from: http://dx.doi.org/10.1186/s12877-016-0349-4

Buckinx F, Landi F, Cesari M, et al. Pitfalls in the measurement of muscle mass: a need for a reference standard. J Cachexia Sarcopenia Muscle. 2018;(October 2017):269–78.

Bera TK. Bioelectrical impedance methods for noninvasive health monitoring: a review. J Med Eng. 2014;2014:381251.

Yu SCY, Powell A, Khow KSF, Visvanathan R. The performance of five bioelectrical impedance analysis prediction equations against dual X-ray absorptiometry in estimating appendicular skeletal muscle mass in an adult Australian population. Nutrients. 2016;8(4):189.

Wang H, Hai S, Cao L, Zhou J, Liu P, Dong B. Estimation of prevalence of sarcopenia by using a new bioelectrical impedance analysis in Chinese community-dwelling elderly people. BMC Geriatr [Internet]. 2016;16:216. Available from: http://dx.doi.org/10.1186/s12877-016-0386-z.

Beeson WL, Batech M, Schultz E, et al. Comparison of body composition by bioelectrical impedance analysis and dual-energy X-ray absorptiometry in Hispanic diabetics. Int J Body Compos Res. 2010;8(2):45–50.

Reiss J, Iglseder B, Kreutzer M, et al. Case finding for sarcopenia in geriatric inpatients: performance of bioimpedance analysis in comparison to dual X-ray absorptiometry. BMC Geriatr [Internet]. 2016;16:52. Available from: http://dx.doi.org/10.1186/s12877-016-0228-z.

Yamada M, Nishiguchi S, Fukutani N, et al. Prevalence of sarcopenia in community-dwelling Japanese older adults. J Am Med Dir Assoc [Internet]. 2013;14(12):911–5. Available from: http://dx.doi.org/10.1016/j.jamda.2013.08.015.

Yamada Y, Nishizawa M, Uchiyama T, et al. Developing and validating an age-independent equation using multi-frequency bioelectrical impedance analysis for estimation of appendicular skeletal muscle mass and establishing a cutoff for sarcopenia. Int J Environ Res Public Health. 2017;14:289.

Yoshida D, Shimada H, Park H, et al. Development of an equation for estimating appendicular skeletal muscle mass in Japanese older adults using bioelectrical impedance analysis. Geriatr Gerontol Int. 2014;14(4):851–7.

Janssen I, Baumgartner RN, Ross R, Rosenberg IH, Roubenoff R. Skeletal muscle cutpoints associated with elevated physical disability risk in older men and women. Am J Epidemiol. 2004;159(4):413–21.

Landi F, Liperoti R, Fusco D, et al. Sarcopenia and mortality among older nursing home residents. J Am Med Dir Assoc [Internet]. 2012;13(2):121–6. Available from: http://dx.doi.org/10.1016/j.jamda.2011.07.004.

Downloads

Published

2019-08-05

How to Cite

Laksmi, P. W., Sukma, F. A., Setyohadi, B., Nugroho, P., Ariane, A., & Tirtarahardja, G. (2019). The Need for a New Cut-off Value to Increase Diagnostic Performance of Bioelectrical Impedance Analysis Compared with Dual-Energy X-ray Absorptiometry to Measure Muscle Mass in Indonesian Elderly. Acta Medica Indonesiana, 51(2), 95. Retrieved from https://www.actamedindones.org/index.php/ijim/article/view/977

Issue

Vol. 51 No. 2 (2019): Acta Medica Indonesiana

Section

ORIGINAL ARTICLE

License

Copyright

The authors who publish this journal agree to the following requirements:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
  2. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  3. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work. (See The Effect of Open Access)
Privacy Statement

The names and email addresses entered in this journal site will be used exclusively for the stated purposes of this journal and will not be made available for any other purpose or to any other party.