Measurement of Adipose Tissue by L4 Computed Tomography, Air Displacement Plethysmography and Bioelectrical Impedance in Ascitic Cirrhotic Patients

Abstract

Introduction: Fat and lean body mass depletion affects about 60% of liver cirrhotic patients being associated with complications and negative prognosis. However, controversy exists regarding the best body composition (BC) assessment method for ascitic cirrhotic (AC) patients. Muscle and adipose tissue surface areas were evaluated with computed tomography (CT) at L4 vertebrae and were significantly related to whole-body muscle and fat mass. But the high cost of CT limits its clinical routine use. Air displacement plethysmography (ADP) has the same limitation. Bioelectrical impedance analysis (BIA) is a widely available BC method that is simple to use in clinical practice and has minimal risk. However BIA in ascitic cirrhotic patients may not accurately evaluate BC due to alterations in hydration. Our aim was to compare, in AC patients, adipose tissue estimated from three methods using L4 CT as the reference. Methods: In 8 AC patients (6M/2F), Child class B, age was (X ± SD) 58 ± 11 years and BMI 22.86 ± 4.08 kg/m2. Adipose tissue was measured through L4 CT, multislice CT (Toshiba Aquilion 64®) and ADP (BOD POD® BC System, Life Measurement Instruments, GerAr MED-Brazil) and BIA Bodystat Quadiscam 4000®. The data collected was statistically analyzed using Spearman’s correlation coef ficient with p<0.05. Results: The absolute value for adipose tissue was for L4 CT 273.1 cm2 ± 100,2, for ADP 34,2% ± 7,8 and for BIA 29,1% ± 5,4. The correlation was r=0.88 between L4 CT and ADP. There were no significant correlations between the other methods. Table 1. Comparison of the correlation coefficient of adipose tissue estimated through of L4 CT, ADP and BIA. L4 CT vs ADP 0.88 0.01 L4 CT vs BIA 0.77 0.07 ADP vs BIA 0.35 0.38 Conclusions: BIA cannot be used for adipose tissue estimation in patients with cirrhosis and ascites.