Normative Interlimb Impedance Ratios: Implications for Early Diagnosis of Uni- and Bilateral, Upper and Lower Limb Lymphedema
File version
Author(s)
Janda, Monika
Vagenas, Dimitrios
Ward, Leigh C
Cornish, Bruce H
Box, Robyn
Gordon, Susan
Matthews, Melanie
Poppitt, Sally D
Plank, Lindsay D
Yip, Wilson
Rowan, Angela
Reul-Hirche, Hildegard
Obermair, Andreas
Hayes, Sandra C
Griffith University Author(s)
Primary Supervisor
Other Supervisors
Editor(s)
Date
Size
File type(s)
Location
License
Abstract
Background: Bioimpedance spectroscopy detects unilateral lymphedema if the ratio of extracellular fluid (ECF) between arms or between legs is outside three standard deviations (SDs) of the normative mean. Detection of bilateral lymphedema, common after bilateral breast or gynecological cancer, is complicated by the unavailability of an unaffected contralateral limb. The objectives of this work were to (1) present normative values for interarm, interleg, and arm-to-leg impedance ratios of ECF and ECF normalized to intracellular fluid (ECF/ICF); (2) evaluate the influence of sex, age, and body mass index on ratios; and (3) describe the normal change in ratios within healthy individuals over time. Methods: Data from five studies were combined to generate a normative data set (n = 808) from which mean and SD were calculated for interarm, interleg, and arm-to-leg ratios of ECF and ECF/ICF. The influence of sex, age, and body mass index was evaluated using multiple linear regression, and normative change was calculated for participants with repeated measures by subtracting their lowest ratio from their highest ratio. Results: Mean (SD) interarm, interleg, dominant arm-to-leg, and nondominant arm-to-leg ratios were 0.987 (0.067), 1.005 (0.072), 1.129 (0.160), and 1.165 (0.174) for ECF ratios; and 0.957 (0.188), 1.024 (0.183), 1.194 (0.453), and 1.117 (0.367) for ECF/ICF ratios, respectively. Arm-to-leg ratios were significantly affected by sex, age, and body mass index. Mean normative change ranged from 7.2% to 14.7% for ECF ratios and from 14.7% to 67.1% for ECF/ICF ratios. Conclusion: These findings provide the necessary platform for extending bioimpedance-based screening beyond unilateral lymphedema.
Journal Title
Lymphatic Research and Biology
Conference Title
Book Title
Edition
Volume
16
Issue
6
Thesis Type
Degree Program
School
Publisher link
Patent number
Funder(s)
Grant identifier(s)
Rights Statement
Rights Statement
Item Access Status
Note
Access the data
Related item(s)
Subject
Oncology and carcinogenesis not elsewhere classified
Clinical sciences not elsewhere classified
Immunology
Science & Technology
Life Sciences & Biomedicine
Medicine, Research & Experimental
Physiology
Research & Experimental Medicine
Persistent link to this record
Citation
Steele, ML; Janda, M; Vagenas, D; Ward, LC; Cornish, BH; Box, R; Gordon, S; Matthews, M; Poppitt, SD; Plank, LD; Yip, W; Rowan, A; Reul-Hirche, H; Obermair, A; Hayes, SC, Normative Interlimb Impedance Ratios: Implications for Early Diagnosis of Uni- and Bilateral, Upper and Lower Limb Lymphedema, Lymphatic Research and Biology, 2018, 16 (6), pp. 559-566