Comparison of two methods of assessing total body water at sea level and increasing high altitude

Fluid retention is a recognized feature of acute mountain sickness. However, accurate assessment of hydration, including the quantification of body water, has traditionally relied on expensive and non-portable equipment limiting its utility in the field setting. We compared the assessment of total body water (TBW) and their relationship to total body weight using two non-invasive methods using the NICas single-frequency bioimpedance analysis (SF-BIA) system and the BodyStat QuadScan 4000 multifrequency BIA system (MF-BIA). TBW measurements were performed at rest at sea level and at high altitude (HA) at 3833 m postexercise and at rest and thereafter at rest at 4450 m and 5129 m on 47 subjects. The average age was 34.5 ± 9.3 years with an age range of 21-54 years (70.2% male). There were strong correlations between TBW assessment with both methods at sea level (r = 0.90; 95% CI 0.78-0.95: P<0.0001) and at HA (r = 0.92; 0.89-0.94: P<0.0001), however, TBW readings were 0.2 l and 1.91 l lower, respectively, with the NICaS. There was a stronger correlation between TBW and body weight with the QuadScan (r = 0.91; P<0.0001) than with the NICaS (r = 0.83; P<0.0001). The overall agreement between the two TBW methods was good, but the 95% confidence intervals around these agreements were relatively wide. We conclude that there was reasonable agreement between the two methods of BIA for TBW, but this agreement was lower at HA.