Validez del uso de la bioimpedancia en la evaluación de la composición corporal infantil y adolescente: revisión sistemática
e202610081
DOI:
https://doi.org/10.67113/resp.v100i1.1736Palabras clave:
Impedancia bioeléctrica, Composición corporal, Niño, Adolescente, Obesidad, Absorciometría de rayos X de energía dual, Revisión sistemáticaResumen
FUNDAMENTOS // El análisis de la impedancia bioeléctrica (BIA) es una técnica no invasiva que permite estimar diferentes compartimentos corporales, como la masa grasa, la masa libre de grasa y el agua corporal total, y podría complementar la información proporcionada por las medidas antropométricas tradicionales. El objetivo de esta revisión sistemática fue sintetizar la evidencia disponible sobre la validez del BIA para la evaluación de la composición corporal en niños, niñas y adolescentes, así como identificar los factores que condicionan su rendimiento.
MÉTODOS // Se realizó una revisión sistemática de métodos diagnósticos siguiendo las recomendaciones Preferred Reporting Items in Systematic Reviews and Meta-Analyses (PRISMA). En febrero de 2025 se realizaron búsquedas en PubMed, EMBASE y Cochrane Library de estudios publicados entre 2010 y 2024. Se incluyeron estudios de validación en participantes menores de dieciocho años que compararan el BIA con métodos de referencia, como absorciometría dual de rayos X (DXA), dilución isotópica, pletismografía por desplazamiento de aire o modelos multicompartimentales. Dos revisores realizaron de forma independiente el cribado de los estudios y la extracción de la información relevante. El riesgo de sesgo se evaluó mediante QUADAS-2 y los resultados se sintetizaron de forma narrativa.
RESULTADOS // Se incluyeron cincuenta y seis estudios; en cincuenta y tres con tamaño muestral cuantificable participaron aproximadamente 11.100 sujetos. Se observaron correlaciones muy variables (r=0,03–0,98), más altas cuando se emplearon ecuaciones derivadas en poblaciones similares y más bajas en obesidad, deportistas, lactantes o grupos clínicos, especialmente con ecuaciones genéricas. Los análisis de acuerdo mostraron discrepancias relevantes a nivel individual. En sobrepeso/obesidad, el BIA tendió a subestimar porcentaje de grasa/masa grasa y a sobreestimar masa libre de grasa. La fiabilidad fue alta (ICC: aproximadamente 0,93–0,98).
CONCLUSIONES // La evidencia disponible respalda que el BIA es una herramienta no invasiva, reproducible y fiable, útil para la estimación grupal, la vigilancia y, especialmente, el seguimiento longitudinal de la composición corporal en población pediátrica. No sustituye al índice de masa corporal ni a los métodos de referencia, y su desempeño depende de forma crítica del dispositivo, la ecuación empleada y el contexto clínico, por lo que en extremos de composición corporal se recomienda cautela y el uso de ecuaciones específicas. Aun así, por su factibilidad y capacidad para monitorizar cambios, el BIA puede aportar información complementaria sobre la composición corporal y contribuir a un abordaje más centrado en la salud y el riesgo cardiometabólico en la obesidad en la población infantil, siempre que los resultados se interpreten y comuniquen adecuadamente.
REGISTRO // PROSPERO CRD420261305127 (https://www.crd.york.ac.uk/PROSPERO/view/CRD420261305127).
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