Concordância entre métodos de avaliação da composição corporal em mulheres obesas submetidas à cirurgia bariátrica
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Data
2018-01-25
Autores
Beato, Gabriel Cunha
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Universidade Estadual Paulista (Unesp)
Resumo
Objetivo: O presente estudo teve como objetivo avaliar a concordância entre um equipamento de bioimpedância multifrequencial tetrapolar segmentar direta (DSM-BIA) e a água duplamente marcada (ADM) como método de referência na predição da composição corporal de mulheres submetidas à cirurgia bariátrica. Materiais e Métodos: Participaram do estudo 20 mulheres obesas mórbidas (idade: 29,3±5,1 anos; índice de massa corporal: 44,8±2,4 kg/m²) submetidas a cirurgia de derivação gástrica em Y-de-Roux. A composição corporal (massa de gordura [MG], massa livre de gordura [MLG] e água corporal total [ACT]) foi avaliada pelo equipamento InBody 230 e ADM nos períodos: pré, 6 e 12 meses após cirurgia. A acurácia entre os métodos foi avaliada pelo viés e pela raiz do erro quadrático médio enquanto a concordância entre os métodos foi avaliada pelo coeficiente de correlação de concordância (CCC) e método Bland Altman. A correlação de Pearson foi calculada para avaliar a correlação entre os métodos. Resultados: Foi observada correlação significativa (p<0,001) e boa/excelente CCC entre ambos métodos para avaliação da MG (r=0,84-0,92 CCC=0,84-0,95) MGL (r=0,73-0,90 e CCC=0,68-0,80) e ACT (r=0,76-0,91 e CCC=0,72-0,81) nos períodos pré e pós-cirurgia. Em adição, não foi observado viés significativo entre BIA e ADM para MG (erro médio [EM] = -1,40-0,60 kg), MLG (EM= 0,91-1,86 kg) e ACT (EM= 0,71-1,24 kg). Conclusão: A BIA, nas condições deste estudo, foi capaz de estimar a composição corporal de mulheres obesas e emagrecidas pela cirurgia bariátrica com valores concordantes com o método da ADM.
Objective: This study aimed to evaluate the agreement between a direct segmental multifrequency bioelectrical impedance analysis (DSM-BIA) and doubly labeled water (DLW) as the reference method to predict the body composition of women submitted to bariatric surgery. Materials and Methods: Twenty morbidly obese women (age: 29.3 ± 5.1 years; body mass index: 44.8 ± 2.4 kg/m²) underwent Roux-en-Y gastric bypass surgery. Body composition (fat mass [FM], fat free mass [FFM] and total body water [TBW]) was evaluated by the InBody 230 equipment and DLW in the periods: before, 6 and 12 months after surgery. The accuracy between methods was assessed by bias and root mean square error while agreement between the methods was evaluated by the concordance correlation coefficient (CCC) and Bland Altman method. Pearson's correlation was calculated to evaluate the correlation between the methods. Results: Correlations were significant (p<0.001) and CCC was good/excellent between both methods for the evaluation of FM (r = 0.84-0.92, CCC = 0.84-0.95) FFM (r = 0.73 -0.90, CCC = 0.68-0.80) and TBW (r = 0.76-0.91, CCC = 0.72-0.81) in the pre- and post-surgery periods. In addition, no significant bias was observed between BIA and DLW for FM, (mean error [ME] = -1.40-0.06 kg), FFM (ME= 0.91-1.86 kg) and TBW (ME= 0.71-1.24 kg) measurements. Conclusion: The BIA, under the conditions of this study, was able to estimate the body composition of morbidly obese women submitted to bariatric surgery with values consistent with the DLW method.
Objective: This study aimed to evaluate the agreement between a direct segmental multifrequency bioelectrical impedance analysis (DSM-BIA) and doubly labeled water (DLW) as the reference method to predict the body composition of women submitted to bariatric surgery. Materials and Methods: Twenty morbidly obese women (age: 29.3 ± 5.1 years; body mass index: 44.8 ± 2.4 kg/m²) underwent Roux-en-Y gastric bypass surgery. Body composition (fat mass [FM], fat free mass [FFM] and total body water [TBW]) was evaluated by the InBody 230 equipment and DLW in the periods: before, 6 and 12 months after surgery. The accuracy between methods was assessed by bias and root mean square error while agreement between the methods was evaluated by the concordance correlation coefficient (CCC) and Bland Altman method. Pearson's correlation was calculated to evaluate the correlation between the methods. Results: Correlations were significant (p<0.001) and CCC was good/excellent between both methods for the evaluation of FM (r = 0.84-0.92, CCC = 0.84-0.95) FFM (r = 0.73 -0.90, CCC = 0.68-0.80) and TBW (r = 0.76-0.91, CCC = 0.72-0.81) in the pre- and post-surgery periods. In addition, no significant bias was observed between BIA and DLW for FM, (mean error [ME] = -1.40-0.06 kg), FFM (ME= 0.91-1.86 kg) and TBW (ME= 0.71-1.24 kg) measurements. Conclusion: The BIA, under the conditions of this study, was able to estimate the body composition of morbidly obese women submitted to bariatric surgery with values consistent with the DLW method.
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Palavras-chave
Concordância, Bioimpedância elétrica, Composição corporal, Obesidade, Cirurgia bariátrica, Agreement, Bioelectrical impedance analysis, Body composition, Obesity, Bariatric surgery