ESPEN 2022 Late Breaking Abstracts

Topic: Nutritional assessment

Abstract Submission Identifier: ESPEN22-LB-2240

COMPARISON OF BODY COMPOSITION ASSESSMENT BY DXA AND BIA IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE ON BIOLOGICAL THERAPY: PRELIMINARY RESULTS

M. Kollerová^*, ¹, I. Pražanová ¹, N. Friedová ^{1, 2}, J. Běhounek ³, P. Kohout ^{1, 2}

¹Nutrition and Dietetics Center , ²Clinic of Internal Medicine 3rd Faculty of Medicine Charles University and Thomayer University Hospital, ³Clinic of Rheumatology and Physiotherapy 3rd Faculty of Medicine Charles University and Thomayer University Hospital, Thomayer University Hospital, Prague, Czech Republic

Rationale: Patients with IBD are at increased risk of malnutrition and sarcopenia, including those who are overweight or obese, who may be missed by traditional BMI assessment. The standard method of body composition assessment, dual-energy X-ray absorptiometry (DXA), is rarely feasible in routine clinical practice contrary to Bioelectrical Impedance Analysis (BIA) method. We aimed to compare body composition assessment by DXA and BIA in patients with IBD on biological therapy. In addition to availability and affordability, the BIA method allows the comparison of measured values for IBD patients with general population.

Methods: A total of 135 IBD patients are examined by DXA and BIA. Body composition is measured under standardized conditions in the morning, after a fasting period of 12 hours, by DXA (GE Lunar iDXA) and BIA (mBCA Seca 515). Pearson correlations were performed. Bland-Altman analysis was applied to find the mean bias and the limits of agreement between reference standard (DXA) and doubly indirect method (BIA) for Fat Free Mass (FFM) and Fat Mass (FM) values. 

Results: Values of FFM obtained by DXA and BIA were strongly correlated (r = 0.98, p<0.001, Pearson correlation). Similar correlation was observed for FM (r = 0.96, p<0.001). Bland-Altman plot showed the mean bias ± SD between DXA and BIA for FFM as 1.53 ± 2.31 kg, the limits of agreement were +6.05 and -2.99. However, limits of agreement were large for both FFM and FM values. According to the preliminary results, an altered body composition was identified in a significant proportion of IBD patients enrolled in the study compared to healthy population, characterized by: reduced SMM (63%), increased visceral fat (VAT) (58% of women, 57% of men), and reduced BCM (71%).

Conclusion: Preliminary results suggest that DXA and BIA methods show comparable bias in body composition assessment within IBD patient group as reported in large cohort studies. On average, BIA overestimated FFM by 1.53 kg compared to DXA.

References: Bryant, R. V., Trott, M. J., Bartholomeusz, F. D., & Andrews, J. M. (2013). Systematic review: body composition in adults with inflammatory bowel disease [Online]. Alimentary Pharmacology & Therapeutics, 38(3), 213-225.; Achamrah N, Colange G, Delay J, Rimbert A, Folope V, et al. (2018) Comparison of body composition assessment by DXA and BIA according to the body mass index: A retrospective study on 3655 measures. PLOS ONE 13(7): e0200465.; Adams, D. W., Gurwara, S., Silver, H. J., Horst, S. N., Beaulieu, D. B., Schwartz, D. A., & Seidner, D. L. (2017). Sarcopenia Is Common in Overweight Patients with Inflammatory Bowel Disease and May Predict Need for Surgery. Inflammatory bowel diseases, 23(7), 1182–1186. 

Disclosure of Interest: None Declared

Keywords: BIA, body composition assessment, DXA, IBD