AUTHOR=Matusik Edyta 

TITLE=Usefulness of bioelectrical impedance analysis in multiple sclerosis patients—the interrelationship to the body mass index

JOURNAL=Frontiers in Neurology

VOLUME=Volume 15 - 2024

YEAR=2024

URL=https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2024.1409038

DOI=10.3389/fneur.2024.1409038

ISSN=1664-2295

ABSTRACT=This study aimed to assess the interrelationship between nutritional status assessment by both body mass index (BMI) and body composition using bioelectrical impedance analysis (BIA) and the consistency of diagnosis for underweight/underfat, normal weight/healthy, overweight/overfat, and obesity/obese pwMS. Anthropometric (BMI and waist-to-height ratio (WHtR)) and body composition (BIA) data were evaluated in 176 pwMS. Patients were categorized into four nutritional status subgroups (underweight, normal weight, overweight, obese according to BMI, and underfat, healthy, overfatoverweight, and obese according to fat mass% by BIA). The median EDSS was 4.5. Patients were then divided according to EDSS score as mild (1.0-4.0) or moderate (4.5-6.5) disability subgroups. Based on BIA there was a significantly higher prevalence of overfat than of overweight based on BMI (n = 50 (28.41%) vs. n = 38 (21.59%)); p < 0.05). However, the prevalence of obesity did not differ significantly regardless of the mode of diagnosis and was not significantly lower when assessed using BIA (n = 26 (14.77%) vs. n = 30 (17.05%), respectively). The overall compatibility rates (CR) of diagnoses made using both BMI and BIA were 75.6%, 77.0%, and 70.1% for all patients with MS and the mild and moderate subgroups, respectively. The lowest CR was observed in the overweight group. Adiposity significantly underestimated BMI in all subgroups. In the moderate MS subgroup, BMI significantly overcategorized pwMS as having a normal weight (p<0.05). Stratification for abdominal obesity (WHtR > 0.5) showed that BMI significantly underestimated the prevalence of overweight and obese versus overfat and obese patients, as assessed using BIA (60.5% vs. 67%; p<0.05). Clinical status (EDSS and EDSS) was more closely related to the nutritional status categorized by FAT% than BMI cutoff points. However, the relationship was not statistically significant. Using the BMI cutoff point for nutritional status  assessment in pwMS is associated with a significant underestimation of excess fat mass. BIA-based FAT% have a better relationship with abdominal obesity and disability status than BMI. The highest rate of false-negative diagnoses was based on the BMI in pwMS and moderate disability. BIA appears to be a useful method for proper nutritional status assessment in pwMS.