Journal of Multidisciplinary Healthcare (Apr 2023)
Validation of HF-Bioelectrical Impedance Analysis versus Body Mass Index in Classifying Overweight and Obese Pakistani Adults
Abstract
Rabia Anwer,1 Lubna Ansari Baig,2 Mehjabeen Musharraf3 1Registered Dietitian Nutritionist, PNS Shifa Hospital, Karachi, 75270, Pakistan; 2Chairperson, APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, 75510, Pakistan; 3Senior Lecturer, APPNA Institute of Public Health, Jinnah Sindh Medical University Karachi, Karachi, 75510, PakistanCorrespondence: Rabia Anwer, THB Global, 59 C Khyaban-e-Seher DHA Phase 6, Karachi, 75500, Pakistan, Tel + 92 333-5289010, Email [email protected] Lubna Ansari Baig, APPNA Institute of Public Health, Jinnah Sindh Medical University, Karachi, 75510, Pakistan, Tel +92300-8239680, Email [email protected]: To determine the validity of hand-to-foot bioelectrical impedance analysis (HF-BIA) versus body mass index (BMI) to assess overweight and obesity status in adults against a reference method, dual-energy x-ray absorptiometry (DXA).Patients and Methods: It is a validation study conducted on 206 Pakistani adults ≥ 20 years recruited through convenience sampling technique at PNS Shifa Hospital and Jinnah Post Medical Centre, Karachi, Pakistan.Results: HF-BIA showed better sensitivity of 90.1% and 100% specificity with no false positive, but 9% false negative as compared to BMI which indicated 80.3% sensitivity and 100% specificity with a false-negative rate of 19.6%.HF-BIA also showed better sensitivity 80.9– 97.1% with 100% specificity and PPV across all age groups. The correlation coefficient between BMI and DXA bf% (r=0.67) was moderate and less than the correlation coefficient between HF-BIA and DXA bf % (r=0.87). Kappa agreement showed weak to a fair agreement between BMI and DXA bf % (0.1 overall; 0.22 men; 0.14 women) compared to HF-BIA, which had a better agreement between BIA bf% and DXA bf% (0.43 overall; 0.46 men; 0.34 women). HF-BIA bf % demonstrated a better discriminatory power than BMI (AUC of ≥ 0.91) and was better predictor of body fat than BMI.Conclusion: HF-BIA is a more accurate method than BMI and may be used consistently throughout the country in primary care and research to identify the fat-based overweight and obese in the Pakistani population.Keywords: body fat, area under the curve, correlation, sensitivity, specificity
