
<b><i>Background:</i></b> A high amount of adipose tissue limits the accuracy of methods for body composition analysis in obesity. <b><i>Objectives:</i></b> The aim was to quantify and explain differences in fat-free mass (FFM) (as an index of skeletal muscle mass, SMM) measured with bioelectrical impedance analysis (BIA), dual energy X-ray absorptiometry (DXA), air displacement plethysmography (ADP), and deuterium dilution in comparison to multicompartment models, and to improve the results of BIA for obese subjects. <b><i>Methods:</i></b> In 175 healthy subjects (87 men and 88 women, BMI 20–43.3 kg/m<sup>2</sup>, 18–65 years), FFM measured by these methods was compared with results from a 3- (3C) and a 4-compartment (4C) model. FFM<sub>4C</sub> was compared with SMM measured by magnetic resonance imaging. <b><i>Results:</i></b> BIA and DXA overestimated and ADP underestimated FFM in comparison to 3C and 4C models with increasing BMI (all <i>p</i> < 0.001). Differences were largest for DXA. In obesity, BIA results were improved: value<sub>corrected</sub> = value<sub>uncorrected</sub> – <i>a</i>(BMI – 30 kg/m<sup>2</sup>), <i>a</i> = 0.256 for FFM and <i>a</i> = 0.298 for SMM. SMM accounts for 45% of FFM in women and 49% in men. <b><i>Conclusions:</i></b> In obesity, the use of FFM is limited by a systematic error of reference methods. In addition, SMM accounts for about 50% of FFM only. Corrected measurement of SMM by BIA can overcome these drawbacks.
Bioelectrical impedance analysis, Adult, Male, Sarcopenia, RC620-627, Adolescent, Skeletal muscle mass, Young Adult, Absorptiometry, Photon, Electric Impedance, Humans, TX341-641, Body Weights and Measures, Obesity, Nutritional diseases. Deficiency diseases, Muscle, Skeletal, Aged, Nutrition. Foods and food supply, Reproducibility of Results, Organ Size, Middle Aged, Plethysmography, Fat-free mass, Adipose Tissue, Body Composition, Female, Four-compartment model
Bioelectrical impedance analysis, Adult, Male, Sarcopenia, RC620-627, Adolescent, Skeletal muscle mass, Young Adult, Absorptiometry, Photon, Electric Impedance, Humans, TX341-641, Body Weights and Measures, Obesity, Nutritional diseases. Deficiency diseases, Muscle, Skeletal, Aged, Nutrition. Foods and food supply, Reproducibility of Results, Organ Size, Middle Aged, Plethysmography, Fat-free mass, Adipose Tissue, Body Composition, Female, Four-compartment model
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