Can a consumer-grade bioimpedance device accurately estimate sarcopenia in women with type 2 diabetes? A cross-sectional agreement study with dual-energy X-ray absorptiometry.

AIMS: To evaluate the diagnostic performance of a consumer-grade bioelectrical impedance analyzer (OMRON HBF-514C) against dual-energy X-ray absorptiometry (DXA) for detecting sarcopenia in women with type 2 diabetes (T2DM).

METHODS

In this cross‑sectional study, 103 women with T2DM underwent body composition assessment using the OMRON HBF‑514C BIA device and DXA. Sarcopenia was defined by fat‑free mass index (FFMI), skeletal muscle index (SMI), and established DXA‑based criteria. Analyses included Spearman correlation, Bland-Altman plots, Cohen's kappa, receiver operating characteristic curves, and regression‑based bias correction.

RESULTS

FFMI-BIA strongly correlated with FFMI-DXA (r = 0.881) and with SMI (r = 0.854). ROC analyses yielded AUCs of 0.878 and 0.873 with optimized FFMI-BIA cut-offs, giving sensitivity/specificity of 87.8 %/79.3 % and 85.1 %/82.8 %, respectively. The bias-correction model explained 78.3 % of the variance in FFMI-DXA and reduced mean bias to -0.0009 kg/m2 (limits of agreement -2.07 to 2.07 kg/m2). Prevalence estimates and moderate agreement supported performance (κ = 0.575).

CONCLUSIONS

The OMRON HBF‑514C shows strong correlation, accurate diagnostic performance with optimized cut‑offs, and minimal systematic bias after calibration. Its affordability, portability, and enhanced precision support its use for sarcopenia screening in resource‑limited settings when combined with functional assessments.