Abstract
BACKGROUND: Few studies have validated bioelectrical impedance analysis (BIA) following bariatric surgery. METHODS: We examined agreement of BIA (Tanita 310) measures of total body water (TBW) and percent body fat (%fat) before (T0) and 12 months (T12) after bariatric surgery, and change between T0 and T12 with reference measures: deuterium oxide dilution for TBW and three-compartment model (3C) for %fat in a subset of participants (n = 50) of the Longitudinal Assessment of Bariatric Surgery-2. RESULTS: T0 to T12 median (IQR) change in deuterium TBW and 3C %fat was -6.4 L (6.4 L) and -14.8% (13.4%), respectively. There were no statistically significant differences between deuterium and BIA determined TBW [median (IQR) difference: T0 -0.1 L (7.1 L), p = 0.75; T12 0.2 L (5.7 L), p = 0.35; Δ 0.35 L(6.3 L), p = 1.0]. Compared with 3C, BIA underestimated %fat at T0 and T12 [T0 -3.3 (5.6), p < 0.001; T12 -1.7 (5.2), p = 0.04] but not change [0.7 (8.2), p = 0.38]. Except for %fat change, Bland-Altman plots indicated no proportional bias. However, 95% limits of agreement were wide (TBW 15-22 L, %fat 19-20%). CONCLUSIONS: BIA may be appropriate for evaluating group level response among severely obese adults. However, clinically meaningful differences in the accuracy of BIA between individuals exist.