Abstract
Objectives
This study aimed to develop an equation model combining physical fitness and anthropometric
parameters and compare its results with those of bioelectrical impedance analysis
(BIA)-measured lean mass (LM) using dual-energy X-ray absorptiometry (DXA)-measured
appendicular muscle mass (AMM) as reference.
Design
Observational analysis.
Setting and Participants
Healthy community-dwelling older subjects.
Methods
A total of 1020 participants were randomly allocated to the development group (development
group, n = 510) or the cross-validation group (validation group, n = 510). Body composition
was measured using both DXA and BIA, and physical fitness parameters, including grip
strength, timed stepping test, sit-to-stand test, flexibility, and walking speed were
also assessed. A prediction equation model of AMM by stepwise linear regression analysis
that included or excluded 1 independent variable at each step, based on the P value of significance (P < .05), was developed.
Results
Using weight, sex, height, and handgrip strength as independent variables, the equation
AMM = −9.833 + 0.397 × weight (kg) + 4.433 × sex + 0.121 × height (cm) + 0.061 × handgrip
strength (kg) best predicts DXA-measured AMM (adjusted R2 = 0.914, SEE = 2.062, P < .001). The predicted AMM was more highly correlated with DXA-measured AMM than
the commonly used BIA-measured LM (= 0.9158 and 0.8427, respectively, both P < .001). Using DXA-measured AMM as reference, the Bland-Altman plot showed mean differences
of −0.03 kg and −0.12 kg, with limits of agreement of −3.98 to 3.92 kg and −5.97 to
5.73 kg for the predicted AMM and BIA-measured AMM, respectively.
Conclusions and Implications
The proposed equation offers a practical alternative method for estimating AMM that
is less facility-dependent and more easy to use and affordable than instrumental studies.
Keywords
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References
- Frailty.Med Clin North Am. 2006; 90: 837-847
- Defining sarcopenia: The impact of different diagnostic criteria on the prevalence of sarcopenia in a large middle aged cohort.Age (Dordr). 2013; 35: 871-881
- Sarcopenia: European consensus on definition and diagnosis: Report of the European Working Group on Sarcopenia in Older People.Age Ageing. 2010; 39: 412-423
- Sarcopenia: Revised European consensus on definition and diagnosis.Age Ageing. 2019; 48: 16-31
- Sarcopenia in Asia: Consensus report of the Asian Working Group for Sarcopenia.J Am Med Dir Assoc. 2014; 15: 95-101
- Frailty in older adults: Evidence for a phenotype.. 2001; 56: M146-M156
- The role of sarcopenia in the risk of osteoporotic hip fracture.Clin Rheumatol. 2015; 34: 1673-1680
- Association between fat mass, lean mass, and bone loss: the Dubbo Osteoporosis Epidemiology Study.Osteoporos Int. 2015; 26: 1381-1386
- Lean body mass and risk of incident atrial fibrillation in post-menopausal women.Eur Heart J. 2016; 37: 1606-1613
- Lean body mass is the predominant anthropometric risk factor for atrial fibrillation.J Am Coll Cardiol. 2017; 69: 2488-2497
- Association of lean body mass with cardiometabolic risk factors in healthy postmenopausal women.Obesity (Silver Spring). 2014; 22: 828-835
- Comparison of three bioelectrical impedance methods with DXA in overweight and obese men.Obesity. 2006; 14: 2064-2070
- The official positions of the International Society for Clinical Densitometry: Acquisition of dual-energy X-ray absorptiometry body composition and considerations regarding analysis and repeatability of measures.J Clin Densitom. 2013; 16: 520-536
- Human Body Composition.Human Kinetics, Champaign1996
- Derivation and validation of simple equations to predict total muscle mass from simple anthropometric and demographic data.Am J Clin Nutr. 2014; 100: 1041-1051
- Development and validation of anthropometric prediction equations for estimation of lean body mass and appendicular lean soft tissue in Indian men and women.J Appl Physiol (1985). 2013; 115: 1156-1162
- Development and validation of anthropometric prediction equations for lean body mass, fat mass and percent fat in adults using the National Health and Nutrition Examination Survey (NHANES) 1999–2006.Br J Nutr. 2017; 118: 858-866
- Total-body skeletal muscle mass: Development and cross-validation of anthropometric prediction models.Am J Clin Nutr. 2000; 72: 796-803
- Reduced flexibility associated with metabolic syndrome in community-dwelling elders.PLoS One. 2015; 10: e0117167
- Normative data for grip strength of elderly men and women.Am J Occup Ther. 1995; 49: 637-644
- Test-retest strength reliability: Hand-held dynamometry in community-dwelling elderly fallers.Arch Phys Med Rehabil. 2002; 83: 811-815
- Senior Fitness Test Manual.2nd ed. Human Kinetics, Champaign, IL2013
- Decreased functional capacity and muscle strength in elderly women with metabolic syndrome.Clin Interv Aging. 2013; 8: 1377-1386
- Reliability and validity of 4-metre gait speed in COPD.Eur Respir J. 2013; 42: 333-340
- Measurement error and minimum detectable change in 4-meter gait speed in older adults.Aging Clin Exp Res. 2011; 23: 406-412
- Skeletal muscle mass adjusted by height correlated better with muscular functions than that adjusted by body weight in defining sarcopenia.Sci Rep. 2016; 6: 19457
- Accuracy of segmental multi-frequency bioelectrical impedance analysis for assessing whole-body and appendicular fat mass and lean soft tissue mass in frail women aged 75 years and older.Eur J Clin Nutr. 2013; 67: 395-400
- Concordance between muscle mass assessed by bioelectrical impedance analysis and by dual energy X-ray absorptiometry: A cross-sectional study.BMC Musculoskelet Disord. 2015; 16: 60
- Assessment of the composition of major body regions by dual-energy X-ray absorptiometry (DEXA), with special reference to limb muscle mass.Clin Physiol. 1992; 12: 253-266
- Segmental body composition transitions in stroke patients: Trunks are different from extremities and strokes are as important as hemiparesis.Clin Nutr. 2020; 39: 1968-1973
- A general framework for comparative Bayesian meta-analysis of diagnostic studies.BMC Med Res Methodol. 2015; 15: 70
- The relationship between grip strength and muscle mass (MM), inflammatory biomarkers and physical performance in community-dwelling very old persons.Arch Gerontol Geriatr. 2013; 57: 345-351
- Measurement of muscle strength in haemodialysis patients by pinch and hand grip strength and comparison to lean body mass measured by multifrequency bio-electrical impedance.Ann Nutr Metab. 2016; 68: 268-275
- Sarcopenia: An undiagnosed condition in older adults. Current consensus definition: Prevalence, etiology, and consequences. International Working Group on Sarcopenia.J Am Med Dir Assoc. 2011; 12: 249-256
- The FNIH Sarcopenia Project: Rationale, study description, conference recommendations, and final estimates.J Gerontol A Biol Sci Med Sci. 2014; 69: 547-558
- The association of flexibility, balance, and lumbar strength with balance ability: risk of falls in older adults.J Sports Sci Med. 2014; 13: 349-357
- Measures of static postural control moderate the association of strength and power with functional dynamic balance.Aging Clin Exp Res. 2014; 26: 645-653
- Association between handgrip strength, balance, and knee flexion/extension strength in older adults.PLoS One. 2018; 13: e0198185
Article info
Publication history
Published online: September 15, 2020
Footnotes
The authors declare no conflicts of interest.
This work was supported by the Community and Geriatric Medicine Research Center, National Taiwan University Hospital, Bei-Hu Branch, Taipei, Taiwan, and the Ministry of Science and Technology, Taipei, Taiwan (grant 106–2314-B-002–165, 107–2314-B-002–047-MY3, and 108–2321-B-001–028-MY2).
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© 2020 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
