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JIMD Reports, Volume 42 pp 37–45Cite as

The Validity of Bioelectrical Impedance Analysis to Measure Body Composition in Phenylketonuria

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Part of the book series: JIMD Reports ((JIMD,volume 42))

Abstract

Aim: To compare the measurement of total body water (TBW) and fat-free mass (FFM) using the criterion method of deuterium dilution space (2H2O) with bioelectrical impedance analysis (BIA) using a portable QuadScan 4000, Bodystat® in children and adolescents with phenylketonuria (PKU).

Methods: Sixteen patients with PKU, median age is 12.5 (range 5–20.6) years, were recruited into this cross-sectional study. TBW was measured by both deuterium dilution and BIA on the same occasion as per a standard protocol. FFM was estimated from predictive equations.

Results: There was no significant difference between TBWDeut and TBWBIA (p = 0.344) or FFMDeut and FFMBIA (p = 0.111). TBWDeut and TBWBIA were highly correlated (r = 0.990, p < 0.0001), as were FFMDeut and FFMBIA (r = 0.984, p < 0.0001). Bland-Altman plots demonstrated that there was no proportional bias between the criterion method, TBWDeut, and the test method TBWBIA, in estimating TBW (β = −0.056, adjusted r 2 = 0.069, p = 0.169) or FFM (β = −0.089, adjusted r 2 = 0.142, p = 0.083).

Conclusion: Our results suggest that when compared with the criterion method, the QuadScan 4000, Bodystat® can reliably be used to predict TBW and FFM in patients with PKU. We suggest that due to the portability and non-invasive approach, this method can reliably be used to monitor body composition in the outpatient clinic setting, to further improve the monitoring and assessment of nutritional status in PKU.

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References

  • Albersen M, Bonthuis M, de Roos N et al (2010) Whole body composition analysis by the BodPod air-displacement plethysmography method in children with phenylketonuria shows a higher body fat percentage. J Inherit Metab Dis 33:283–288

    Article  Google Scholar 

  • Aldámiz-Echevarría L, Bueno MA, Couce ML et al (2014) Anthropometric characteristics and nutrition in a cohort of PAH-deficient patients. Clin Nutr 33:702–717

    Article  Google Scholar 

  • Allen JR, Baur LA, Waters DL et al (1996) Body protein in prepubertal children with phenylketonuria. Eur J Clin Nutr 50:178–186

    CAS  PubMed  Google Scholar 

  • Battezzati A, Bertoli S, Testolin C, Testolin G (2003) Body composition assessment: an indispensable tool for disease management. Acta Diabetol 40:S151–S153

    Article  Google Scholar 

  • Böhm A, Heitmann BL (2013) The use of bioelectrical impedance analysis for body composition in epidemiological studies. Eur J Clin Nutr 67:S79–S85

    Article  Google Scholar 

  • Burrage LC, McConnell J, Haesler R et al (2012) High prevalence of overweight and obesity in females with phenylketonuria. Mol Genet Metab 107:43–48

    Article  CAS  Google Scholar 

  • Cleary J, Daniells S, Okely AD, Batterham M, Nicholls J (2008) Predictive validity of four bioelectrical impedance equations in determining percent fat mass in overweight and obese children. J Am Diet Assoc 108:136–139

    Article  Google Scholar 

  • Cordain L, Whicker RE, Johnson JE (1988) Body composition determination in children using bioelectrical impedance. Growth Dev Aging 52:37–40

    CAS  PubMed  Google Scholar 

  • Dobbelaere D, Michaud L, Debrabander A et al (2003) Evaluation of nutritional status and pathophysiology of growth retardation in patients with phenylketonuria. J Inherit Metab Dis 26:1–11

    Article  CAS  Google Scholar 

  • Eckerson JM, Evetovich TK, Stout JR et al (1997) Validity of bioelectrical impedence equations for estimating fat-free weight in high school female gymnasts. Med Sci Sports Exerc 29:962–968

    Article  CAS  Google Scholar 

  • Ellis KJ, Shypailo RJ, Wong WW (1999) Measurement of body water by multifrequency bioelectrical impedance spectroscopy in a multiethnic pediatric population. [Erratum appears in Am J Clin Nutr 2000 Jun;71(6):1618]. Am J Clin Nutr 70:847–853

    Article  CAS  Google Scholar 

  • Houtkooper LB, Going SB, Lohman TG, Roche AF, Van Loan M (1992) Bioelectrical impedance estimation of fat-free body mass in children and youth: a cross-validation study. J Appl Physiol 72:366–373

    Article  CAS  Google Scholar 

  • Huemer M, Huemer C, Moslinger D, Huter D, Stockler-Ipsiroglu S (2007) Growth and body composition in children with classical phenylketonuria: results in 34 patients and review of the literature. J Inherit Metab Dis 30:694–699

    Article  CAS  Google Scholar 

  • International Atomic Energy Agency (2010) Introduction to body composition assessment using the deuterium dilution technique with analysis of urine samples by isoptope ratio mass spectrometry. International Atomic Energy Agency, Division of Human Health, Vienna

    Google Scholar 

  • Jackson AA, Johnson M, Durkin K, Wootton S (2013) Body composition assessment in nutrition research: value of BIA technology. Eur J Clin Nutr 67:S71–S78

    Article  Google Scholar 

  • Kupka R, Manji K, Wroe E et al (2011) Comparison of isotope dilution with bioelectrical impedance analysis among HIV-infected and HIV-uninfected pregnant women in Tanzania. Int J Body Compos Res 9:1–10

    CAS  PubMed  PubMed Central  Google Scholar 

  • Lohman T (1993) Advances in body composition assessment. Human Kinetics Publishers, Champaign

    Google Scholar 

  • MacDonald A, Rocha JC, Rijn M, Feillet F (2011) Nutrition in phenylketonuria. Mol Genet Metab 104:S10–S18

    Article  CAS  Google Scholar 

  • Martin Bland J, Altman D (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 327:307–310

    Article  Google Scholar 

  • Montagnese C, Williams JE, Haroun D, Siervo M, Fewtrell MS, Wells JCK (2013) Is a single bioelectrical impedance equation valid for children of wide ranges of age, pubertal status and nutritional status? Evidence from the 4-component model. Eur J Clin Nutr 67:S34–S39

    Article  Google Scholar 

  • Mulasi U, Kuchnia AJ, Cole AJ, Earthman CP (2015) Bioimpedance at the bedside. Nutr Clin Pract 30:180–193

    Article  Google Scholar 

  • Pietrobelli A, Andreoli A, Cervelli V, Carbonelli MG, Peroni DG, Lorenzo A (2003) Predicting fat-free mass in children using bioimpedance analysis. Acta Diabetol 40:s212–s215

    Article  Google Scholar 

  • Rocha JC, MacDonald A, Trefz F (2013a) Is overweight an issue in phenylketonuria? Mol Genet Metab 110:S18–S24

    Article  CAS  Google Scholar 

  • Rocha JC, Spronsen FJ, Almeida MF, Ramos E, Guimaraes JT, Borges N (2013b) Early dietary treated patients with phenylketonuria can achieve normal growth and body composition. Mol Genet Metab 110:S40–S43

    Article  CAS  Google Scholar 

  • Rocha JC, van Rijn M, van Dam E et al (2016) Weight management in phenylketonuria: what should be monitored. Ann Nutr Metab 68:60–65

    Article  CAS  Google Scholar 

  • Scaglioni S, Verduci E, Fiori L et al (2004) Body mass index rebound and overweight at 8 years of age in hyperphenylalaninaemic children. Acta Paediatr 93:1596–1600

    Article  CAS  Google Scholar 

  • Singh RH, Cunningham AC, Mofidi S et al (2016) Updated, web-based nutrition management guideline for PKU: an evidence and consensus based approach. Mol Genet Metab 118:72–83

    Article  CAS  Google Scholar 

  • Sun SS, Chumlea WC, Heymsfield SB et al (2003) Development of bioelectrical impedance analysis prediction equations for body composition with the use of a multicomponent model for use in epidemiologic surveys. Am J Clin Nutr 77:331–340

    Article  CAS  Google Scholar 

  • van Spronsen FJ, van Wegberg AMJ, Ahring K et al (2017) Key European guidelines for the diagnosis and management of patients with phenylketonuria. Lancet Diabetes Endocrinol. https://doi.org/10.1016/S2213-8587(16)30320-5

    Article  Google Scholar 

  • Wells JCK, Fewtrell MS (2006) Measuring body composition. Arch Dis Child 91:612–617

    Article  CAS  Google Scholar 

Download references

Acknowledgments

Analysis was undertaken at the Stable Isotope Geochemistry Laboratory, School of Earth and Environmental Sciences, and the University of Queensland, and we thank Kim Baublys and Wei Zhou for their assistance.

Author information

Authors and Affiliations

  1. Department of Metabolic Medicine, Royal Children’s Hospital, Melbourne, VIC, Australia

    Maureen Evans & Avihu Boneh

  2. Department of Nutrition and Food Services, Royal Children’s Hospital, Melbourne, VIC, Australia

    Maureen Evans

  3. Department of Nutrition, Dietetics and Food, Monash University, Melbourne, VIC, Australia

    Maureen Evans, Kay Nguo, Avihu Boneh & Helen Truby

  4. Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia

    Avihu Boneh

Authors
  1. Maureen Evans
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  2. Kay Nguo
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  3. Avihu Boneh
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  4. Helen Truby
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Corresponding author

Correspondence to Maureen Evans .

Editor information

Editors and Affiliations

  1. Tulane University Medical School, New Orleans, LA, USA

    Eva Morava

  2. Division of Metabolism & Children’s Research Centre, University Children’s Hospital Zürich, Zürich, Switzerland

    Matthias Baumgartner

  3. Division of Child and Adolescent Neurology, Mayo Clinic, Rochester, MN, USA

    Marc Patterson

  4. Clinical and Molecular Genetics Unit, UCL Institute of Child Health, London, UK

    Shamima Rahman

  5. Division of Human Genetics, Medical University Innsbruck, Innsbruck, Austria

    Johannes Zschocke

  6. Center for Child and Adolescent Medicine, Heidelberg University Hospital, Heidelberg, Germany

    Verena Peters

Additional information

Communicated by: Francois Feillet, MD, PhD

Appendices

Synopsis

No predictive bias existed when measuring total body water or fat-free mass by deuterium dilution and bioelectrical impedance analysis (BIA) using the QuadScan 4000, Bodystat®; we therefore suggest that this instrument could be used as a method to monitor body composition in the outpatient clinic setting in patients with phenylketonuria.

Contributions of Individual Authors

All authors contribute to the submitted paper: contributing content development, drafting and revising the manuscript and providing final approval of the version to be submitted:

  1. 1.

    Maureen Evans has been responsible for conception and design of the project, data and sample collection, statistical analysis, researching and drafting of the manuscript through its various stages of development and completed the final version for submission.

  2. 2.

    Kay Nguo was responsible for the analysis and interpretation of the deuterium dilution samples and revising the manuscript critically for content and format.

  3. 3.

    Avihu Boneh was responsible for the interpretation of data and for revising the manuscript critically for content and format.

  4. 4.

    Helen Truby was responsible for supervising the project, conception and design and revising the manuscript critically for content and format.

Corresponding Author

Maureen Evans, Department of Metabolic Medicine, Royal Children’s Hospital, Melbourne, Australia. Tel.: +61383416376. Email address: maureen.evans@rch.org.au.

Competing Interest Statement

No person was provided with an honorarium, grant, or other form of payment to conduct the study or produce the manuscript. Maureen Evans, Kay Nguo, Avihu Boneh and Helen Truby declare that they have no conflict of interest.

Details of Funding

This research did not receive any specific grant or sponsorship from funding agencies in the public, commercial or not-for-profit sectors.

Details of Ethics Approval

This study was approved by the RCH Human Research Ethics Committee: HREC #32056D.

Patient Consent Statement

This manuscript does not contain any personal information about patients. Informed consent was obtained for all study participants as a requirement of the RCH Human Research Ethics Committee process.

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© 2017 Society for the Study of Inborn Errors of Metabolism (SSIEM)

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Evans, M., Nguo, K., Boneh, A., Truby, H. (2017). The Validity of Bioelectrical Impedance Analysis to Measure Body Composition in Phenylketonuria. In: Morava, E., Baumgartner, M., Patterson, M., Rahman, S., Zschocke, J., Peters, V. (eds) JIMD Reports, Volume 42. JIMD Reports, vol 42. Springer, Berlin, Heidelberg. https://doi.org/10.1007/8904_2017_75

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  • DOI: https://doi.org/10.1007/8904_2017_75

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  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-662-58364-7

  • Online ISBN: 978-3-662-58365-4

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