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Abstract

Skeletal muscle mass (SMM) is a useful variable for evaluating overall fitness and detecting conditions like sarcopenia and cachexia. While several validated laboratory and clinical devices (including magnetic resonance imaging, dual-energy X-ray absorptiometry, and laboratory-grade bioimpedance devices) are adept at SMM assessment, such measures may prove inaccessible or cost-prohibitive to the average person. Consumer-grade bioimpedance analyzers seek to bridge this gap and provide affordable, accurate body composition information. PURPOSE: The purpose of this study was to compare the validity of skeletal muscle mass (SMM) assessment by a consumer-available hand-to-foot bioimpedance analyzer between females and males, using a professional-grade device as the reference method. METHODS: Eighty-five adults (n=54 F, age: 31.5 ± 15.4 y, body mass: 63.8 ± 12.6 kg, SMM: 21.0 ± 3.7 kg; n=31 M, age: 24.9 ± 4.9 y, body mass: 79.7 ± 13.6 kg, SMM: 31.6 ± 4.2 kg) completed bioelectrical impedance analysis using a professional analyzer (SECA mCBA 554 [SECA]) and a consumer-grade analyzer (GE 510 Smart Scale [GE]) in a single laboratory visit. Both devices are standing, hand-to-foot BIA, allowing for direct comparison, and both tests were conducted using standard practices recommended by the manufacturer. The relationship between composite SECA and GE SMM estimations was quantified by linear regression, the concordance correlation coefficient (CCC), equivalence testing, and Bland-Altman analysis. These analyses were performed on the entire sample as well as on females and males individually. RESULTS: Both methods demonstrated a strong linear relationship (R2 = 0.74 F, 0.77 M); however, substantial overestimation of SMM by GE was observed in both females (27.4 ± 4.1 kg) and males (41.5 ± 4.3 kg). Poor concordance was demonstrated in both sexes (CCC = 0.364 F, 0.230 M), and equivalence testing was non-significant in both females (p=1, confidence interval [CI] = 5.95 - 6.92 kg) and males (p=1, CI = 9.32 - 10.6 kg). Bland-Altman analysis showed a similar level of agreement in both sexes (±4.13 F, ± 4.09 M), but there was a slight increase in bias as the mean SSM increased in females but not in males. CONCLUSION: These findings suggest that the GE scale is not accurate at evaluating SMM in females and males, as it significantly overestimates SMM in the typical individual. GE is a dual-frequency device, as opposed to SECA’s nine frequencies, which may explain the inaccuracy of its measurements. Based on the strong linear relationships observed, the GE device could be recalibrated to provide more accurate SMM estimates. Overall, it is important for consumers to understand that such consumer-available devices may not accurately assess SMM and should not be used for diagnosis nor detection of musculoskeletal and metabolic conditions.

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