摘要
背景生物电阻抗法(BIA)测量儿童青少年身体成分的准确性存在争议,且缺乏不依赖于BIA仪器型号的校正公式。目的评价BIA与双能X线吸收法(DXA)测量6~19岁儿童青少年身体成分的一致性。设计横断面调查。方法研究对象来自2013至2023年中国生命周期体成分研究,选取使用同一型号BIA和DXA仪器检测的6~19岁儿童青少年。采用组内相关系数(ICC)、相对误差频率(RE)、Bland-Altman分析评价BIA和DXA方法间测量脂肪质量(FM)、非脂肪组织质量(FFM)、四肢骨骼肌质量(ASM)的一致性。以DXA测量值为因变量,电阻指数(RI)为自变量,建立BIA校正预测模型。主要结局指标ICC、RE、Bland-Altman分析。结果1841名6~19岁儿童青少年纳入本研究分析。在不同性别中,相较于DXA,BIA低估男、女生FM(均方根误差分别为2.60、2.27 kg,P<0.05),低估男、女生ASM(均方根误差分别为1.02、0.91 kg,P<0.05),高估男、女生FFM(均方根误差分别为3.07、2.66 kg,P<0.05),且男、女生的FM、FFM、ASM均ICC>0.90(P<0.05)。随年龄增加,FM的ICC及RE绝对值<15%的占比呈逐渐增大的趋势,ASM的ICC及RE绝对值<15%的占比先增大后减小。随BMI增加,FM的ICC及RE绝对值<15%占比逐渐增大。BIA校正预测模型为:FM=2.336+0.871×RI_(50)-1.739×RI_(500)+0.517×性别-0.478×年龄+0.753×体重(R^(2)=0.940);FFM=2.795-1.406×RI_(50)+2.177×RI_(500)-0.329×性别+0.471×年龄+0.243×体重(R^(2)=0.985);ASM=-1.937-0.697×RI_(50)+1.132×RI_(500)-0.389×性别+0.119×年龄+0.095×体重(R^(2)=0.976)。结论BIA测量学龄儿童青少年ASM、FFM与DXA一致性良好,所测FM与DXA一致性差。BIA测量FM、FFM和ASM的校正模型拟合效果好,可适用于不同型号多频BIA仪器评估学龄儿童青少年身体成分。
Background The accuracy of bioelectrical impedance analysis(BIA)in measuring body composition of children and adolescents is controversial,and there is a lack of correction formulas that do not rely on the brand and model of BIA instrument.Objective To evaluate the consistency of BIA and dual-energy X-ray absorptiometry(DXA)in measuring body composition in children and adolescents aged 6-19 years.Design Cross-sectional survey.Methods The subjects were selected from the 2013-2023 China Life Cycle Body Composition Study,and 1,841 school-age children and adolescents were tested using the same BIA and DXA instruments.Intra-group correlation coefficient(ICC),relative error frequency(RE),and Bland-Altman analysis were used to evaluate the consistency of measurements of fat mass(FM),non-fat tissue mass(FFM),and limb skeletal muscle mass(ASM).With DXA as the dependent variable and resistance index(RI)as the independent variable,a prediction model for BIA correction was established.Main outcome measures ICC,RE,and Bland-Altman analysis.Results In different sexes,compared with DXA,BIA underestimated FM(RMSE=2.60,2.27 kg,P<0.05),underestimated ASM(RMSE=1.02,0.91 kg,P<0.05),and overestimated FFM(RMSE=3.07,2.66 kg,P<0.05)for male and female students.The ICC of FM,FFM and ASM of male and female students were all>0.90(P<0.05).With the increase of age,the proportion of ICC and RE with absolute value<15%in FM increased gradually,while the proportion of ICC and RE with absolute value<15%in ASM first increased and then decreased.With the increase of BMI,the proportion of ICC and RE with absolute value<15%of FM increased gradually.The BIA corrected prediction model is:FM=2.336+0.871×RI_(50)-1.739×RI_(500)+0.517×Sex M1F2-0.478×Age+0.753×Weight(R^(2)=0.940);FFM=2.795-1.406×RI_(50)+2.177×RI_(500)-0.329×Sex M1F2+0.471×Age+0.243×Weight(R^(2)=0.985);ASM=-1.937-0.697×RI_(50)+1.132×RI_(500)-0.389×Sex M1F2+0.119×Age+0.095×Weight(R^(2)=0.976).Conclusion BIA measured ASM,FFM and DXA in school-age children and adolescents with go
作者
颉相君
王霞
熊静帆
董虹孛
程红
肖培
米杰
XIE Xiangjun;WANG Xia;XIONG Jingfan;DONG Hongbo;CHENG Hong;XIAO Pei;MI Jie(Center for Noncommunicable Disease Management,Beijing Children's Hospital,Capital Medical University,National Center for Children's Health,Beijing 100045,China;Child and Adolescent Chronic Diseases Prevention and Control Department,Shenzhen Center for Chronic Disease Control,Shenzhen 518020,China;Department of Epidemiology,Capital Institute of Pediatrics,Beijing 100020,China)
出处
《中国循证儿科杂志》
CSCD
北大核心
2024年第5期348-354,共7页
Chinese Journal of Evidence Based Pediatrics
基金
国家自然科学基金:82373589
深圳市“医疗卫生三名工程”项目:SZSM 202311020。
关键词
生物电阻抗法
双能X线吸收法
脂肪质量
四肢骨骼肌质量
一致性评价
Bioelectrical impedance analysis
Dual-energy X-ray absorptiometry
Fat mass appendicular
Skeletal muscle mass
Consistency analysis