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Graybeal AJ, Tinsley GM, Brandner CF, Aultman R. Raw bioelectrical impedance measurements are not different between White and Black adults when matched for sex, age, BMI, and other physical characteristics. Nutr Res 2023; 112:1-10. [PMID: 36933277 PMCID: PMC10079621 DOI: 10.1016/j.nutres.2023.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 03/18/2023]
Abstract
Raw bioelectrical impedance measurements are often used as a prognosticator of health status because of their association with disease states and malnutrition. Although studies consistently show the effect of physical characteristics on bioelectrical impedance, few investigations describe the effect of race, particularly for Black adults, and many bioelectrical impedance standards were produced from primarily White adults almost 2 decades ago. Therefore, this study sought to evaluate the racial differences in bioelectrical impedance measurements using bioimpedance spectroscopy between non-Hispanic White and non-Hispanic Black adults matched for age, sex, and body mass index. We hypothesized that Black adults would have a lower phase angle from higher resistance and lower reactance compared with White adults. One hundred non-Hispanic White (n = 50) and non-Hispanic Black (n = 50) males (n = 34) and females (n = 66) matched for sex, age, and body mass index completed this cross-sectional study. Participants underwent several anthropometric assessments, including height, weight, waist circumference, hip circumference, bioimpedance spectroscopy, and dual-energy X-ray absorptiometry. Bioelectrical impedance measures of resistance, reactance, phase angle, and impedance were all collected at frequencies of 5, 50, and 250 kHz and bioelectrical impedance vector analysis was performed using 50-kHz data. There were no significant differences for any anthropometric variable between Black and White participants in the total sample or by sex groups. In addition, there were no significant racial differences for any bioelectrical impedance assessment, including bioelectrical impedance vector analysis. Differences in bioelectrical impedance are likely not a function of race between Black and White adults and concerns regarding its utility should not be based on this characteristic.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS 39406, USA.
| | - Grant M Tinsley
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA
| | - Caleb F Brandner
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Ryan Aultman
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS 39406, USA
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Ó Breasail M, Janha R, Zengin A, Pearse C, Jarjou L, Prentice A, Ward KA. Cross-Calibration of iDXA and pQCT Scanners at Rural and Urban Research Sites in The Gambia, West Africa. Calcif Tissue Int 2023; 112:573-583. [PMID: 36859609 PMCID: PMC9977475 DOI: 10.1007/s00223-023-01071-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 02/07/2023] [Indexed: 03/03/2023]
Abstract
Between-scanner differences in measures of bone and body composition can obscure or exaggerate physiological differences in multi-site studies or the magnitude of changes in longitudinal studies. We conducted a cross-calibration study at two bone imaging centres in The Gambia, West Africa where DXA (dual-energy X-ray absorptiometry) and pQCT (peripheral Quantitative-Computed Tomography) are routinely used. Repeat scans were obtained from 64 Gambian adults (58% Male) aged Mean(SD) 30.9 (13.5) years with Mean(SD) body mass index (BMI) 21.7 (4.0) kg/m2, using DXA (GE Lunar iDXA, whole body [WB], total hip [TH], lumbar spine [LS]) and pQCT (Stratec XCT2000L/XCT2000, tibia 4%, 50% sites). Between-scanner differences were tested using paired t tests (p < 0.05). Between-scanner correlation was explored with linear regression, and cross-calibration equations derived. Bland-Altman analysis investigated machine trend/bias. When differences were detected (p < 0.05), cross-calibration equations were applied to urban values, with t tests and Bland Altman analysis repeated. Between-scanner differences exceeded the predefined level of statistical significance (p < 0.05) for WB aBMD and BA; all pQCT measures vBMD, BMC, cortical cross-sectional area (CSA) and stress-strain index (SSI). Between-scanner correlation was high (R2:0.92-0.99), except pQCT Mu.Den (R2 = 0.51). Bland Altman plots indicated bias increased with increasing BMD. Cross-calibration equations attenuated all between-scanner differences and systematic bias. Cross-calibration, particularly of pQCT scanners, is an important consideration in multi-site studies particularly where between population comparisons are intended. Our experiences and findings may be generalisable to other resource-limited settings where the logistics of sourcing parts and in-country repair may result in lengthy scanner downtime.
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Affiliation(s)
- Mícheál Ó Breasail
- Population Health Sciences, Bristol Medical School, University of Bristol, 1-5 Whiteladies Road, Bristol, BS8 1NU, UK.
- MRC Nutrition and Bone Health Research Group, Clifford Allbutt Building, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 OAH, UK.
| | - Ramatoulie Janha
- MRC Unit The Gambia at London, School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Monash Medical Centre, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Camille Pearse
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
| | - Landing Jarjou
- MRC Unit The Gambia at London, School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Ann Prentice
- MRC Nutrition and Bone Health Research Group, Clifford Allbutt Building, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 OAH, UK
- MRC Unit The Gambia at London, School of Hygiene and Tropical Medicine, Banjul, Gambia
- MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Kate A Ward
- MRC Nutrition and Bone Health Research Group, Clifford Allbutt Building, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 OAH, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, SO16 6YD, UK
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Body Composition in Asians and Caucasians: Comparative Analyses and Influences on Cardiometabolic Outcomes. ADVANCES IN FOOD AND NUTRITION RESEARCH 2015; 75:97-154. [PMID: 26319906 DOI: 10.1016/bs.afnr.2015.07.001] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Within the last four decades Asia has witnessed major transformation in its population demographics, which gave rise to changes in food availability, food habits and lifestyle. A significant consequence of these changes has been the continuing rise in overweight and obesity across Asia. In parallel, there has been a significant rise in Asians in the incidence of the major chronic diseases, particularly in cardiometabolic disorders such as metabolic syndrome, type 2 diabetes, hypertension, and other cardiovascular diseases. Given that the majority of the evidence, to date, investigating the associations between adiposity and cardiometabolic disorder risk have been obtained from studies undertaken either in European or in North American Caucasians, in this chapter, we have reviewed differences in body fat content and distribution between East Asians, South Asians, and Caucasians. The evidence is consistent that the content and distribution of body fat are markedly different between the various ethnic groups. We found that Asians have a greater predisposition towards adiposity at higher BMI than in Caucasians. Moreover, at any given level of adiposity, Asians have a much greater predisposition to risk of cardiometabolic disorders than Caucasians. We therefore strongly endorse the need for different adiposity cutoffs in Asians as compared to the Caucasians. We have also reviewed the predictive abilities of the various body composition/adiposity measures in determining risk of cardiometabolic disorders in Asians.
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Udayaraj UP, Ben-Shlomo Y, Roderick P, Steenkamp R, Ansell D, Tomson CRV, Caskey FJ. Ethnicity, socioeconomic status, and attainment of clinical practice guideline standards in dialysis patients in the United kingdom. Clin J Am Soc Nephrol 2009; 4:979-87. [PMID: 19357243 DOI: 10.2215/cjn.06311208] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND AND OBJECTIVES The role of socioeconomic status (SES) and its contribution to ethnic differences in standards attainment among dialysis patients is not known. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We examined associations between area- level SES (Townsend index) and ethnicity (white, black, South Asian) and standards attainment in 14,117 incident dialysis patients (1997-2004) in the UK. RESULTS Deprived patients were less likely to achieve hemoglobin (Hb) > or = 10 g/dl (trend P < 0.001) but not after controlling for patient and center characteristics (trend P = 0.1). There was no association with hemodialysis dose and parathyroid hormone (PTH) standard but deprived patients had better attainment of phosphate (PO4) <5.6 mg/dl, calcium (Ca) and Calcium-phosphate (CaPO4) standard (e.g., most deprived versus least deprived adjusted odds ratio [OR] 1.25, 95% confidence intervals [CI] 1.12, 1.38). There was no association with SES using a lower limit for PO4 (3.5 - 5.5 mg/dl). Compared with Whites, Blacks had lower attainment of Hb (adjusted OR 0.57, 95% CI 0.45, 0.71) and PTH standards (adjusted OR 0.27, 95% CI 0.22, 0.33) but better attainment of PO4 and CaPO4, while South Asians experienced better or comparable outcomes for most standards except Ca and PTH. CONCLUSIONS There was no evidence of socioeconomic inequity in standards attainment or a consistent pattern of inequity by ethnic group. The lower attainment of some standards in ethnic minorities may reflect biologic differences rather than ethnicity-related inequity of care.
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Affiliation(s)
- Udaya P Udayaraj
- UK Renal Registry, Southmead Hospital, Southmead Road, Bristol, BS10 5NB, UK.
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