Bioelectrical Impedance Analysis Versus Dual X-Ray Absorptiometry for Obesity Assessment in Pediatric Populations: A Systematic Review

<b>Objectives</b>: Pediatric obesity represents a significant public health challenge, requiring accurate and accessible tools for assessing body composition in pediatric populations. This systematic review (PROSPERO CRD42024592366) compares the methodological accuracy and clinical utili...

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Main Authors: Lorena Mihaela Manole, Gabriela Ghiga, Otilia Iftinchi, Laura Otilia Boca, Mădălina Andreea Donos, Elena Țarcă, Nistor Ionuț, Ninel Revenco, Iulia Margasoiu, Laura Mihaela Trandafir
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Language:English
Published: MDPI AG 2025-06-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/12/1505
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author Lorena Mihaela Manole
Gabriela Ghiga
Otilia Iftinchi
Laura Otilia Boca
Mădălina Andreea Donos
Elena Țarcă
Nistor Ionuț
Ninel Revenco
Iulia Margasoiu
Laura Mihaela Trandafir
author_facet Lorena Mihaela Manole
Gabriela Ghiga
Otilia Iftinchi
Laura Otilia Boca
Mădălina Andreea Donos
Elena Țarcă
Nistor Ionuț
Ninel Revenco
Iulia Margasoiu
Laura Mihaela Trandafir
author_sort Lorena Mihaela Manole
collection DOAJ
description <b>Objectives</b>: Pediatric obesity represents a significant public health challenge, requiring accurate and accessible tools for assessing body composition in pediatric populations. This systematic review (PROSPERO CRD42024592366) compares the methodological accuracy and clinical utility of bioelectrical impedance analysis (BIA) and dual x-ray absorptiometry (DXA) in evaluating obesity among children and adolescents. <b>Methods</b>: Utilizing a comprehensive search across PubMed, EMBASE, and Web of Science between 1 January 2014 and 31 December 2024, we identified 28 studies meeting our inclusion criteria. The studies included involved participants aged 2–17 years with obesity and compared BIA with DXA as the reference standard. The exclusion criteria were studies focusing on adults, those that assessed BC solely using anthropometry, and those that did not report primary outcomes relevant to the comparison of BIA vs. DXA. <b>Results</b>: The findings reveal that despite recent technological advances improving BIA’s precision, it consistently underestimates body fat percentage and fat mass, particularly in overweight and obese pediatric populations. DXA it is often used as a reference method in the evaluation of whole-body composition due to its higher accuracy and reliability. BIA offers significant practical advantages in accessibility, cost-effectiveness, and portability, but enhancements are needed to improve its accuracy for individual-level assessments. <b>Conclusions</b>: While BIA shows promise as a practical tool for body composition assessment in children, its accuracy varies significantly by device type. Multi-frequency segmental analyzers, such as InBody 720, demonstrate better agreement with DXA, whereas simpler models tend to underestimate fat mass. Therefore, conclusions regarding BIA performance should be device-specific and its clinical utility should be carefully weighed based on the technology used.
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spelling doaj-art-a5a09148be5241e79612a28a9dfd09cc2025-08-20T02:24:25ZengMDPI AGDiagnostics2075-44182025-06-011512150510.3390/diagnostics15121505Bioelectrical Impedance Analysis Versus Dual X-Ray Absorptiometry for Obesity Assessment in Pediatric Populations: A Systematic ReviewLorena Mihaela Manole0Gabriela Ghiga1Otilia Iftinchi2Laura Otilia Boca3Mădălina Andreea Donos4Elena Țarcă5Nistor Ionuț6Ninel Revenco7Iulia Margasoiu8Laura Mihaela Trandafir9Department of Mother and Child, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Mother and Child, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Mother and Child, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Mother and Child, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Mother and Child, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Pediatric Surgery and Orthopedics, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Medicine, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iași, RomaniaDepartment of Pediatrics, University of Medicine and Pharmaceutics “Nicolae Testemițanu”, MD-2001 Chișinău, MoldovaDepartment of Mother and Child, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, RomaniaDepartment of Mother and Child, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania<b>Objectives</b>: Pediatric obesity represents a significant public health challenge, requiring accurate and accessible tools for assessing body composition in pediatric populations. This systematic review (PROSPERO CRD42024592366) compares the methodological accuracy and clinical utility of bioelectrical impedance analysis (BIA) and dual x-ray absorptiometry (DXA) in evaluating obesity among children and adolescents. <b>Methods</b>: Utilizing a comprehensive search across PubMed, EMBASE, and Web of Science between 1 January 2014 and 31 December 2024, we identified 28 studies meeting our inclusion criteria. The studies included involved participants aged 2–17 years with obesity and compared BIA with DXA as the reference standard. The exclusion criteria were studies focusing on adults, those that assessed BC solely using anthropometry, and those that did not report primary outcomes relevant to the comparison of BIA vs. DXA. <b>Results</b>: The findings reveal that despite recent technological advances improving BIA’s precision, it consistently underestimates body fat percentage and fat mass, particularly in overweight and obese pediatric populations. DXA it is often used as a reference method in the evaluation of whole-body composition due to its higher accuracy and reliability. BIA offers significant practical advantages in accessibility, cost-effectiveness, and portability, but enhancements are needed to improve its accuracy for individual-level assessments. <b>Conclusions</b>: While BIA shows promise as a practical tool for body composition assessment in children, its accuracy varies significantly by device type. Multi-frequency segmental analyzers, such as InBody 720, demonstrate better agreement with DXA, whereas simpler models tend to underestimate fat mass. Therefore, conclusions regarding BIA performance should be device-specific and its clinical utility should be carefully weighed based on the technology used.https://www.mdpi.com/2075-4418/15/12/1505childhood obesitybody compositionbioelectrical impedancedual X-ray absorptiometrypediatric
spellingShingle Lorena Mihaela Manole
Gabriela Ghiga
Otilia Iftinchi
Laura Otilia Boca
Mădălina Andreea Donos
Elena Țarcă
Nistor Ionuț
Ninel Revenco
Iulia Margasoiu
Laura Mihaela Trandafir
Bioelectrical Impedance Analysis Versus Dual X-Ray Absorptiometry for Obesity Assessment in Pediatric Populations: A Systematic Review
Diagnostics
childhood obesity
body composition
bioelectrical impedance
dual X-ray absorptiometry
pediatric
title Bioelectrical Impedance Analysis Versus Dual X-Ray Absorptiometry for Obesity Assessment in Pediatric Populations: A Systematic Review
title_full Bioelectrical Impedance Analysis Versus Dual X-Ray Absorptiometry for Obesity Assessment in Pediatric Populations: A Systematic Review
title_fullStr Bioelectrical Impedance Analysis Versus Dual X-Ray Absorptiometry for Obesity Assessment in Pediatric Populations: A Systematic Review
title_full_unstemmed Bioelectrical Impedance Analysis Versus Dual X-Ray Absorptiometry for Obesity Assessment in Pediatric Populations: A Systematic Review
title_short Bioelectrical Impedance Analysis Versus Dual X-Ray Absorptiometry for Obesity Assessment in Pediatric Populations: A Systematic Review
title_sort bioelectrical impedance analysis versus dual x ray absorptiometry for obesity assessment in pediatric populations a systematic review
topic childhood obesity
body composition
bioelectrical impedance
dual X-ray absorptiometry
pediatric
url https://www.mdpi.com/2075-4418/15/12/1505
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