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中国循证儿科杂志

中国循证儿科杂志 ›› 2024, Vol. 19 ›› Issue (5): 348-354.DOI: 10.3969/j.issn.1673-5501.2024.05.006

• 论著 • 上一篇    下一篇

基于双能X线吸收法评估生物电阻抗法测量儿童青少年身体成分准确性研究

颉相君1，王霞1，熊静帆2，董虹孛1，程红3，肖培1，米杰1   

  1. 1 国家儿童医学中心，首都医科大学附属北京儿童医院，儿童慢病管理中心北京，100045；2深圳市慢性病防治中心，儿童青少年慢性病防控科深圳，518020；3 首都儿科研究所，流行病学研究室北京，100020

  • 收稿日期:2024-12-23 修回日期:2024-12-23 出版日期:2024-10-25 发布日期:2024-10-25
  • 通讯作者: 米杰

Assessment of the accuracy of bioelectrical impedance analysis measurement of body composition in children and adolescents based on dual-energy X-ray absorptiometry: A cross-sectional survey

XIE Xiangjun1, WANG Xia1, XIONG Jingfan2, DONG Hongbo1, CHENG Hong3,  XIAO Pei1, MI Jie1#br#

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  1. 1 Center for Noncommunicable Disease Management, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing 100045, China; 2 Child and Adolescent Chronic Diseases Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen 518020, China; 3 Department of Epidemiology, Capital Institute of Pediatrics, Beijing 100020, China

  • Received:2024-12-23 Revised:2024-12-23 Online:2024-10-25 Published:2024-10-25
  • Contact: MI Jie, email: jiemi12@vip.sina.com

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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：1 841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×RI50-1.739×RI500+0.517×性别-0.478×年龄+0.753×体重 (R2=0.940)； FFM=2.795-1.406×RI50+2.177×RI500-0.329×性别+0.471×年龄+0.243×体重 （R2=0.985）；ASM=-1.937-0.697×RI50+1.132×RI500-0.389×性别+0.119×年龄+0.095×体重(R2=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。

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

Abstract: 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×RI50-1.739×RI500+0.517×SexM1F2-0.478×Age+0.753×Weight (R2=0.940)；FFM=2.795-1.406×RI50+2.177×RI500-0.329×SexM1F2+0.471×Age+0.243×Weight (R2=0.985); ASM=-1.937-0.697×RI50+1.132×RI500-0.389×SexM1F2+0.119×Age+0.095×Weight (R2=0.976). Conclusion：BIA measured ASM, FFM and DXA in schoolage children and adolescents with good agreement, FM and DXA with poor agreement. The corrected model of FM, FFM and ASM measured by BIA has good fitting effect, and can be used to evaluate the body composition of schoolage children and adolescents with different types of multifrequency BIA instruments.

Key words: Bioelectrical impedance analysis, Dualenergy Xray absorptiometry, Fat mass appendicular, Skeletal muscle mass, Consistency analysis