Bioelectrical impedance analysis for comparison of the body composition in type 1 diabetes patients, obese patients and healthy volunteers


Authors: L. Baxová ;  M. Žourek ;  V. Frantová ;  K. Kovářová ;  Z. Rušavý
Authors‘ workplace: Diabetologické centrum I. interní kliniky Lékařské fakulty UK a FN Plzeň, přednosta doc. MUDr. Martin Matějovič, Ph. D.
Published in: Vnitř Lék 2009; 55(5): 462-467
Category: Original Contributions

Overview

Background:
Effects of glycaemic control and insulin treatment on body composition in type 1 diabetes patients have not been clearly proven yet.

Aim:
Comparison of the body composition in type 1 diabetes patients, obese patients and healthy volunteers using multifrequency bioelectrical impedance analysis.

Methods:
Multifrequency bioelectrical impedance measurements were performed on 153 type 1 diabetes patients, 176 obese patients and on 159 healthy controls of the same age and gender. HbA1c level, duration of disease and daily dose of insulin were measured in diabetes patients.

Results:
Significant differences were observed in body composition between obese patients and both type 1 diabetes patients and healthy controls. Higher fat mass (FM) and body cell mass (BCM) and lower lean body mass (LBM) were observed in obese patients. Only a higher reactance by the healthy controls (56.75 Ω ± 11.22 vs 53.27 Ω ± 7.97, p < 0.05) was observed between type 1 diabetes patients and healthy controls. No significant differences were observed in other para­meters of body composition between these two groups. HbA1c level negatively correlated with LBM in the diabetes patients. The duration of disease negatively correlated with BCM. And a negative correlation was also found between daily dose of insulin (IU/kg) and weight and LBM.

Conclusions:
The treated type 1 diabetes does not influence the body composition. We found a negative correlation between HbA1c level and LBM, between duration of disease and BCM and between daily dose of insulin and weight and LBM. Higher FM and BCM was observed in obese patients, lower LBM is due to the abnormally high level in diabetes patients and healthy controls.

Key words:
body composition – bioelectrical impedance analysis – type 1 diabetes – obesity – insulin – HbA1c


Sources

1. Všetulová E, Bunc V. Využití bioimpedanční metody pro stanovení procenta tělesného tuku obézních žen. Čas Lék Čes 2004; 8: 528–532.

2. Deurenberg-Yap M, Deurenberg P. Is a re‑evaluation of WHO body mass index cut‑off values needed? The case of Asians in Singapore. Nutr Rev 2003; 61 (5 Pt 2): S80–S87.

3. NIH Consensus statement. Bioelectrical impedance analysis in body composition measurement. National Institutes of Health Technology Assessment Conference Statement. December 12–14, 1994. Nutrition 1996; 12: 749–762.

4. Chumlea WC, Guo SS. Bioelectrical impedance and body composition: Present status and future directions. Nutr Rev 1994; 52: 123–131.

5. Kyle UG, Bosaeus I, De Lorenzo AD et al. Bioelectrical impedance analysis – part I: review of principles and methods (ESPEN Guidelines). Clin Nutr 2004; 23: 1226–1243.

6. The Diabetes Control and Complications Trial Research Group Influence of intensive diabetes treatment on body weight and composition of adults with type 1 diabetes in the Diabetes Control and Complications Trial. Diabetes Care 2001; 24: 1711–1721.

7. Jacob AN, Salinas K, Adams-Huet B et al. Potential causes of weight gain in type 1 diabetes mellitus. Diabetes Obes Metab 2006; 8: 404–411.

8. Rigalleau V, Delafaye C, Baillet L. Composition of insulin‑induced body weight gain in diabetic patients: a bio-impedance study. Diabetes Metab 1999; 25: 321–328.

9. Leiter LA. Use of bioelectrical impedance analysis measurements in patients with diabetes. The Diabetes Control and Complications Trial Research Group. Am J Clin Nutr 1996; 64 (Suppl 3): 515S–518S.

10. Kyle UG, Bosaeus I, De Lorenzo AD et al. Bioelectrical impedance analysis – part II: utilization in clinical practice (ESPEN Guidelines). Clin Nutr 2004; 23: 1430–1453.

11. Dörhöfer RP, Pirlich M. Das BIA Kompendium. Darmstadt: Data Input GmbH 2007.

12. Nutri 4 – Multi‑Frequency Software for the Determination of Body Water, Body Composition and Nutritional Status, Instructions for Use. Hofheim: Data Input GmbH 1997.

13. Kushner RG, Schoeller DA. Estimation of total body water by bioelectrical impedance analysis. Am J Clin Nutr 1986; 11: 417–424.

14. Deurenberg P, van der Kooij K, Evers P et al. Assessment of body composition by bioelectrical impedance in a population aged > 60 y. Am J Clin Nutr 1990; 51: 3–6.

15. Kushner RF, Gudivaka R, Schoeller DA. Clinical characteristics influencing bioelectrical impedance analysis measurements. Am J Clin Nutr 1996; 64 (Suppl 3): 423S–427S.

16. Bunc V, Dlouhá R. Inovace predikčních rovnic pro stanovení složení těla bioimpedanční metodou a měřením tloušťky kožních řas. Dílčí zpráva GA UK 316/97/C, 1997.

17. Lee IT, Lin SY, Sheu WH. Serial body composition by bioimpedance analysis in a diabetic subject with rapid insulin‑induced weight gain – a case report. Kaohsiung J Med Sci 2002; 18: 45–48.

18. Rosenfalck AM, Almdal T, Hilsted J et al. Body composition in adults with type 1 diabetes at onset and during the first year of insulin therapy. Diabet Med 2002; 19: 417–423.

19. Sallé A, Guilloteau G, Ryan M et al. Effect of insulin treatment on the body composition of type 2 diabetic patients. Diabet Med 2004; 21: 1298–1303.

20. Ingberg CM, Palmér M, Åman J et al. Body composition and bone mineral density in long‑standing type 1 diabetes. J Intern Med 2004; 255: 392–398.

21. Rosenfalck AM, Almdal T, Viggers L et al. A low-fat diet improves peripheral insulin sensitivity in patients with type 1 diabetes. Diabet Med 2006; 23: 384–392.

22. Librenti MC, Vedani P, Micossi P et al. Evaluation of an impedance measurement method for determining body composition in diabetic subjects and normal controls. Minerva Endocrinol 1991; 16: 27–30.

23. Gómez JM, Maravall FJ, Soler J et al. Body composition assessment in type 1 diabetes mellitus patients over 15 years. Horm Metab Res 2001; 33: 670–673.

24. Ingberg CM, Särnblad S, Palmér M et al. Body composition in adolescent girl with type 1 diabetes. Diabet Med 2003; 20: 1005–1011.

25. Särnblad S, Ingberg CM, Aman J et al. Body composition in young female adults with type 1 diabetes mellitus. A prospective case-control study. Diabet Med 2007; 24: 728–734.

26. Bartz J, Sulzbach U, Heinze E et al. Body composition in type 1 diabetes mellitus. Bioimpedance measurements in 274 diabetic children, adolescents and young adults. Dtsch Med Wochenschr 1997; 25: 815–819.

27. Karagüzel G, Ozdem S, Boz A et al. Leptin levels and body composition in children and adolescents with type 1 diabetes. Clin Biochem 2006; 39: 788–793.

28. Neovius M, Hemmingsson E, Frey­schuss B et al. Bioelectrical impedance underestimates total and truncal fatness in abdominally obese women. Obesity (Silver Spring) 2006; 14: 1731–1738.

29. De Lorenzo A, Andreoli A, Serrano P et al. Body cell mass measured by total body potassium in normal-weight and obese men and women. J Am Coll Nutr 2003; 22: 546–549.

30. Sun G, French CR, Martin GR et al. Comparison of multifrequency bioelectrical impedance analysis with dual-energy X‑ray absorptiometry for assessment of percentage body fat in a large, healthy population. Am J Clin Nutr 2005; 81: 74–78.

31. Kyle UG, Genton L, Slosman DO et al. Fat‑free and fat mass percentiles in 5225 healthy subjects aged 15 to 98 years. Nutrition 2001; 17: 534–541.

32. Dittmar M. Reliability and variability of bioimpedance measures in normal adults: effects of age, gender and body mass. Am J Phys Anthropol 2003; 122: 361–370.

33. Butte NF, Puyau MR, Vohra FA et al. Body size, body composition and metabolic profile explain higher energy expenditure in overweight children. J Nutr 2007; 137: 2660–2667.

34. Kyle UG, Genton L, Karsegard L et al. Single prediction equation for bioelec­trical impedance analysis in adults aged 20–94 years. Nutrition 2001; 17: 248–253.

35. Rybka J. Fyzická aktivita (zátěž) – jeden z pilířů prevence a terapie diabetes mellitus. Interní Med 2005; 3: 135–138.

36. American Diabetes Association Physical activity/exercise and diabetes mellitus. Position statement. Diabetes Care 2003; 26 (Suppl 1): S73–S77.

37. Wasserman DH, Zinman B. Exercise in individuals with IDDM. Diabetes Care 1994; 17: 924–937.

38. Rybka J. Vývoj názorů na pohybovou aktivitu u diabetika. Vnitř Lék 2007; 53: 537–539.

Labels
Diabetology Endocrinology Internal medicine

Article was published in

Internal Medicine

Issue 5

2009 Issue 5

Most read in this issue

This topic is also in:


Login
Forgotten password

Don‘t have an account?  Create new account

Forgotten password

Enter the email address that you registered with. We will send you instructions on how to set a new password.

Login

Don‘t have an account?  Create new account