비만 여성에서 생체전기저항측정법과 이중에너지방사선흡수계측법의 비교 = Comparison of Bioelectrical Impedance Analysis with Dual Energy X-ray Absorptiometry in Obese Women

다국어 초록 (Multilingual Abstract)

Background: Bioelectrical impedance analysis (BIA) is simple, inexpensive, portable, safe and relatively accurate means of assessing body composition. However, there were many reports in that the error of BIA was increased in extremely obese subjects. This study was conducted to assess the accuracy of BIA in obese women and to investigate factors that influence the error of BIA in obese women.
Methods: 173 healthy obese women (ages 21 to 49 years; BMI ≥ 25 kg/m2) underwent BIA and dual energy X-ray absorptiometry (DEXA). The accuracy of BIA was assessed by Pearson correlation and Bland-Altman analysis. Factors that influence the error of BIA were investigated by Pearson correlation, one-way ANOVA, and multiple regression analysis.
Results: In obese women, the correlations between estimates of BIA and DEXA were highly significant (r = 0.838~0.910). Compared with DEXA, BIA was highly accurate for fat mass [ΔFM (BIA-DEXA): 0.5 kg (95% confidence interval: -3.8~4.8)], but BIA overestimated fat free mass [ΔFM (BIA-DEXA): 2.8 kg (-1.9~7.5; 95% confidence interval)]. As adiposity was increasing, BIA overestimated fat free mass and underestimated fat mass.
Increasing of waist circumference decreased the error of BIA occurred by increasing of adiposity.
Conclusion: In obese women, the correlations and agreements between estimates of BIA and DEXA were highly significant. However, the amount and distribution of body fat had influence on the error of BIA.

국문 초록 (Abstract)

연구배경: 생체전기저항측정법 (bioelectrical impedance analysis, 이하 BIA)은 비교적 정확하면서도 검사방법이간단하고, 비싸지 않으며, 운반이 간편하고, 안전하여 임상에서 손쉽게 사용될 수 있는 체성분 평가 방법이다. 그러나 비만한 사람에서는 BIA 검사의 오차가 증가된다는 많은 보고가 있다. 본 연구는 비만 여성을 대상으로 BIA의정확도를 검증하고, BIA의 오차에 영향을 주는 요인들에 대해 알아보고자 하였다.
방법: 2006년에 서울 소재 일개 연구소의 임상시험에 참여한 다른 건강상의 문제가 없는 21~49세의 체질량지수25 kg/m2 이상의 비만 여성 173명을 연구 대상으로 하였다. BIA와 이중에너지방사선흡수계측법 (dual energy X-ray absorptiometry, 이하 DEXA) 측정치의 일치도를 평가하기 위하여 상관분석과 Bland-Altman 분석을 시행하였으며, BIA의 오차에 영향을 주는 요인을 분석하기 위하여 BIA와 DEXA의 측정차와 관련 변수 간의 상관분석과일원분산분석 및 다중회귀분석을 시행하였다.
결과: 비만 여성에서 BIA 측정치와 DEXA 측정치는 높은 상관관계를 보이고 있었으며 [r = 0.910 (FM), 0.838 (FFM)], BIA는 DEXA와 비교하였을 때, 체지방량에 대해서는 일치도가 매우 높았으나 [ΔFM (BIA-DEXA): 0.5 kg (-3.8~4.8; 95% 신뢰구간)], 제지방량은 평균 2.8 kg (-1.9~7.5; 95% 신뢰구간)을 과대 측정하였다. 체지방이증가함에 따라 BIA 검사는 제지방량을 과대 측정하고, 체지방량을 과소 측정하는 경향을 보였다. 허리둘레는 상관분석에서는 BIA 측정의 오차와 유의한 관계를 보이지 않았으나, 체지방률에 따라 층화하거나, 체지방률을 보정하면, 허리둘레 또한 BIA 측정의 오차와 유의한 관련이 나타났으며, 관련성은 체지방률과 반대 방향이었다.
결론: 비만 여성에서 BIA와 DEXA 측정치의 상관관계와 일치도는 높았다. 그러나 체지방의 양과 분포에 따라BIA 검사의 오차가 증감될 수 있으므로, 비만 여성에서 BIA 검사 결과를 해석할 때, 체지방의 양과 분포에 대한고려가 필요할 것이다.

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