Correlation Between Changes in Extremity Volume and Bioelectrical Impedance in Arm and Leg Lymphedema

Kotaro Suehiro, Noriyasu Morikage, Koshiro Ueda, Makoto Samura, Yuriko Takeuchi, Takashi Nagase, Takahiro Mizoguchi, Kaori Nakamura, and Kimikazu Hamano. Lymphatic Research and Biology, 2017

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Correlation Between Changes in Extremity Volume and Bioelectrical Impedance in Arm and Leg Lymphedema

Kotaro Suehiro, Noriyasu Morikage,  Koshiro Ueda, Makoto Samura, Yuriko Takeuchi, Takashi Nagase, Takahiro Mizoguchi, Kaori Nakamura, and Kimikazu Hamano. Lymphatic Research and Biology, 2017 

Background: To clarify the differences in the mode of fluid accumulation between arm and leg lymphedema using bioelectrical impedance analysis (BIA).

Methods and Results: In 22 arms with lymphedema (ALE) and 65 legs with lymphedema (LLE), as well as 54 legs with venous edema (VE) for comparison, BIA was performed twice between April 2015 and March 2017. Then, the changes in BIA-derived parameters were correlated with the changes in extremity volumes. In ALE, the change in extracellular fluid resistance (Re) was negatively correlated with the change in arm volume (r=0.51), while the change in intracellular fluid resistance (Ri) was constant, irrespective of the change in arm volume (r=0.19). In LLE, the change in Re was negatively correlated with the change in leg volume (r=0.67), but the change in Ri was also negatively correlated with the change in leg volume (r=0.51). These correlations were similar to those in VE, in which the changes in Re and Ri were each negatively correlated with the change in leg volume (r=0.66 and 0.53, respectively).

Conclusion: The modes of change in BIA-derived parameters according to the change in extremity volume were different in ALE and LLE. The changes in LLE were similar to that in VE.

Main findings

  • For LLE and VE, the impedance in an affected leg was normalized to the right arm instead of the contralateral normal leg, so that bilateral cases could be assessed. Although L Dex Score (LDS) in the leg is normally calculated using the contralateral normal leg as a reference, modified LDS obtained in this way (mLDS) has been validated and correlates very well with ordinary LDS impedance ratio in the leg was also calculated using these data.
  • The modes of change in BIA-derived parameters according to the change in extremity volume were different in arm lymphoedema and lower leg lymphoedema (LLE). The changes in LLE were similar to that in venous edema.