Body composition analyses by air displacement plethysmography in adults ranging from normal weight to extremely obese

OBJECTIVE: To compare body composition parameters estimated by air displacement plethysmography (ADP) to dual x-ray absorptiometry (DXA) in body mass index (BMI) classifications that include extremely obese (BMI≥40.0kg/m(2)), and to examine if differences between analyses were influenced by BMI. DESIGN AND METHODS: Fat free mass (FFM,kg), fat mass (FM,kg) and body fat (BF,%) were analyzed with both technologies. RESULTS: All outcome measures of ADP and DXA were highly correlated (r≥0.95,P<0.001 for FFM, FM and BF), but Bland-Altman analyses revealed significant bias (P<0.01 for all). ADP estimated greater FFM and lower FM and BF (P<0.01 for all). BMI explained 27% of the variance in differences between FFM measurements (P<0.001), and 37% and 33% of the variances in differences between FM and BF measurements, respectively (P<0.001 for both). Within normal weight and overweight classifications, ADP estimated greater FFM and lower FM and BF (P<0.001 for all), but the opposite occurred within the extremely obese classification; ADP estimated lower FFM and greater FM and BF (P<0.05 for all). CONCLUSIONS: Body composition analyses by the two technologies were strongly congruent, but systematically different and influenced by BMI. Caution should be taken when utilizing ADP to estimate body composition parameters over a wide range of BMI classifications that include extremely obese.