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. 2025 Apr;20(3):709-722.
doi: 10.1007/s11739-025-03857-y. Epub 2025 Jan 15.

Raw bioelectrical impedance parameters and vector analysis in the screening of low muscle mass and low muscle mass associated with obesity in adult healthy subjects

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Raw bioelectrical impedance parameters and vector analysis in the screening of low muscle mass and low muscle mass associated with obesity in adult healthy subjects

Salam Bennouar et al. Intern Emerg Med. 2025 Apr.

Abstract

The aim was to estimate the prevalence of low muscle mass (LMM) and low muscle mass associated with obesity (LMM-O) in healthy adult, and to verify the performance of raw bioelectrical impedance parameters (BIA) and vector analysis (BIVA) in the screening of this tow conditions. This is a cross-sectional study including 1025 healthy adults. Body composition was assessed by the BIA technique. The appendicular skeletal muscle mass index (ASMMI) and body fat percentage (BF%) were used for the screening of LMM and LMM-O. The raw BIA parameters were: resistance (R), reactance (Xc), phase angle (PhA), and impedance (Z). The vectors, R and Xc, were adjusted for height and projected on the RXc graph. Associations were checked by the correlation test, binary logistic regression, adjusted for age and body water, and ROC curve. LMM was found in 30.8% of the subjects, and 20.9 and 21.4% of the men and women were with LMM-O. PhA and R/H were the most powerful discriminators of LMM with a sensitivity of 62-100% and a specificity of 71-90%. Cutoff values of PhA ranged between 4.95° and 5.75° for women and men. The RXc graph was able to identify LMM subjects, with clustering on the right side: area of low cellularity, high R/H and low-phase angle. Traditional anthropometric indices were the least effective in identifying LMM-O. The BIVA approach, PhA, R and R/H are effective in the screening of LMM and LMM-O, irrespective of age, gender, intra- and extracellular hydration status.

Keywords: RX c graph; Anthropometry; BIVA; Bioelectrical impedance; Low muscle mass; Low muscle mass–obesity.

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Conflict of interest statement

Declarations. Conflict of interest: The authors have no conflict of interest to declare. Human and animal rights: In this study, including human participants, all procedures were carried out in accordance with the 1964 Helsinki Declaration and were approved by the research ethics committee of Frantz Fanon University Hospital, Blida, Algeria. This study does not include animals. Informed consent: All participants were informed and their consent was obtained.

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