Performance of Bioelectrical Impedance Analysis in the Estimation of Bone Mineral Content in Healthy Children Aged 6-12 Years

Background: Bioelectrical impedance analysis (BIA) is a widely available tool which provides mineral estimate. However, BIA is not currently recognized as a bone mineral measuring method. This study aimed to explore the ability of BIA to predict bone mineral content (BMC) in children, using dual-energy X-ray absorptiometry as a gold standard. Methods: Healthy children aged 6-12 years (n = 176) were recruited for BIA and dual-energy X-ray absorptiometry measurements. Predictive models were generated using basic indices (age, height, weight, waist circumference, hip circumference, etc.) and BIA parameters (minerals, fat mass, and fat free mass). Results: The root-mean-square deviation and R2 for the total BMC predictive model were 0.089 kg and 0.926, respectively using height and weight as predictors whereas 0.113 kg and 0.886, respectively using minerals by BIA. The rootmean-square deviation and R2 for the subtotal BMC predictive model were 0.080 kg and 0.935, respectively using height and weight as predictors whereas 0.098 kg and 0.906, respectively using minerals by BIA. The best predictive models included basic indices and BIA parameters as predictors, but they had only slightly better performance over simple models. Conclusions: Mineral content by BIA was good predictor of total and subtotal BMC in healthy children but with similar overall model performance compared to basic indices. More complex models combined all the predictive variables gave better prediction power, but of little improvement to these simple mod els. The BIA instrument does not appear to be useful in estimating BMC in healthy children as basic indices are more widely available measures but provide comparable performance. Future studies are needed to determine the clinical usefulness of the more complex prediction model in children with disease or children in other subgroups.