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Sales WB, Mâcedo SGGF, Gonçalves RSDSA, Andrade LELD, Ramalho CST, de Souza GF, Maciel ÁCC. Use of electrical bioimpedance in the assessment of sarcopenia in the older aldults: A scoping review. J Bodyw Mov Ther 2024; 39:373-381. [PMID: 38876654 DOI: 10.1016/j.jbmt.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 01/14/2024] [Accepted: 02/25/2024] [Indexed: 06/16/2024]
Abstract
OBJECTIVE to map and synthesize the main evidence on the use of bioelectrical impedance (BIA) and its variables in the assessment of sarcopenia in community-dwelling older adults. METHODS This is a scoping review carried out by searching for articles available in four databases: PUBMED, LILACS, Web of Science and CINAHL, with the following search strategy: Body Composition AND Sarcopenia AND ″electric impedance'' OR ″bioelectrical impedance analysis'' AND Aged. RESULTS A total of 27,660 older adults made up the sum of the samples of the included studies. Most studies included participants of both sexes (75.6%), used the variable skeletal and/or appendicular skeletal muscle mass (ASMM) (75.6%), followed by body fat (8.1%), and phase angle (8.1%) in the assessment of the body composition of subjects with sarcopenia. CONCLUSION The data from this research show that ASMM and phase angle are the main variables related to sarcopenia screening in community-dwelling older adults. Whereas total extracellular water/body water is still considered a confounding variable in the screening of sarcopenia in the elderly, but it can be considered useful regarding the health conditions of the elderly in the community.
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Affiliation(s)
- Weslley Barbosa Sales
- Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado, Filho, 3000, Brazil.
| | | | | | - Luiz Eduardo Lima de Andrade
- Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado, Filho, 3000, Brazil.
| | - Caroline Sousa Truta Ramalho
- Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado, Filho, 3000, Brazil.
| | - Gérson Fonseca de Souza
- Department of Physical Therapy, Universidade Federal do Rio Grande do Norte, Avenida Senador Salgado, Filho, 3000, Brazil.
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Härter J, Orlandi SP, Bielemann RM, Dos Santos LP, Gonzalez MC. Standardized phase angle: relationship with functionality, muscle mass and postoperative outcomes in surgical cancer patients. Med Oncol 2024; 41:139. [PMID: 38709365 DOI: 10.1007/s12032-024-02367-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Accepted: 03/20/2024] [Indexed: 05/07/2024]
Abstract
To evaluate the association of standardized phase angle (SPA) with nutritional status, functional parameters, and postoperative outcomes in surgical cancer patients. This prospective study includes 59 cancer patients from Pelotas (Brazil) admitted for elective cancer surgery. We obtained the phase angle through Bioelectrical Impedance Analysis (BIA) and standardized it according to the population's reference values. We estimated the muscle mass using BIA for later calculation of the Skeletal Muscle Index (SMI) and performed handgrip strength (HGS) and gait speed (GS) tests. We used the Patient-Generated Subjective Global Assessment (PG-SGA) to assess the nutritional status. Postoperative complications and duration of hospital stay were evaluated as the outcomes. The prevalence of malnutrition in the sample was 28.8%, according to ASG-PPP. SPA was statistically lower in patients with malnutrition, with lower HGS and reduced GS. For postoperative outcomes, patients with severe complications and those with prolonged hospitalization also had lower SPA values. The greater the number of functional alterations in patients, the lower the SPA value, mainly when associated with reduced muscle mass assessed by BIA, suggesting that muscle mass reduction plays an important role in the association between functional alterations and phase angle in patients with cancer. According to the parameters used in this study, low SPA value was associated with impaired nutritional and functional status and negative outcomes in the analyzed sample.
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Affiliation(s)
- Jéssica Härter
- Programa de Pós-Graduação em Medicina: Ciências Médicas, Universidade Federal do Rio Grande do Sul, Rua Ramiro Barcelos, 2400, 2º andar, Porto Alegre, RS, 90035003, Brazil.
| | - Silvana Paiva Orlandi
- Departamento de Nutrição, Universidade Federal de Pelotas, Rua Gomes Carneiro, 01, Pelotas, RS, 96010-610, Brazil
| | - Renata Moraes Bielemann
- Programa de Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas, Rua Gomes Carneiro, 01, Pelotas, RS, 96010-610, Brazil
| | - Leonardo Pozza Dos Santos
- Departamento de Nutrição, Universidade Federal de Pelotas, Rua Gomes Carneiro, 01, Pelotas, RS, 96010-610, Brazil
| | - Maria Cristina Gonzalez
- Programa de Pós-Graduação em Nutrição e Alimentos, Universidade Federal de Pelotas, Rua Gomes Carneiro, 01, Pelotas, RS, 96010-610, Brazil
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Valisoltani N, Mohammadi H, Aliannejad R, Naeini F, Harsini AR, Sadeghi E, Mirzaee P, Imani H. Association of phase angle with sarcopenia and muscle function in patients with COPD: a case-control study. BMC Pulm Med 2024; 24:18. [PMID: 38184558 PMCID: PMC10771663 DOI: 10.1186/s12890-023-02814-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/13/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND AND AIMS The predictive value of phase angle for sarcopenia diagnosis has been discussed for years. The present investigation was conducted to determine the association between phase angle and sarcopenia in patients with COPD. METHODS In this case-control study, 222 smoker men were divided into healthy and COPD groups. COPD was diagnosed by a pulmonologist through spirometry. Anthropometric indices, phase angle, muscle function, sarcopenia, and dietary intake were assessed. RESULTS A significant inverse association was observed between phase angle and sarcopenia after adjustment for age and energy intake (OR: 0.31, 95% CI 0.18-0.52) and after adjustment for BMI (OR: 0.31, 95% CI 0.18-0.52). A significant decrease was detected in anthropometric indices and indicators of sarcopenia and muscle function in COPD cases compared to the healthy controls. CONCLUSIONS Although further studies are suggested, phase angle might be considered an indicator of sarcopenia and muscle function in COPD patients.
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Affiliation(s)
- Neda Valisoltani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Science, Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Science, Tehran, Iran
| | - Rasoul Aliannejad
- Department of Pulmonary and Critical Care, School of Medicine, Shariati Hospital, Tehran, Iran
| | - Fatemeh Naeini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Science, Tehran, Iran
| | - Asma Rajabi Harsini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Science, Tehran, Iran
| | - Erfan Sadeghi
- Research Consultation Center (RCC), Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pouya Mirzaee
- Department of Medicine, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Hossein Imani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Science, Tehran, Iran.
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Bieger P, Sangali TD, Ribeiro ÉCT, Schweigert Perry ID, Souza GC. Association of phase angle values and sarcopenia in older patients with heart failure. Nutr Clin Pract 2023; 38:672-685. [PMID: 36815519 DOI: 10.1002/ncp.10956] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/24/2022] [Accepted: 12/31/2022] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND Sarcopenia presents an accelerated and accentuated muscle loss in patients with heart failure (HF), leading to a worse prognosis for these patients. This study sought to assess the association of phase angle (PA) values with sarcopenia and its components, as well as to establish a PA cutoff point to predict outcomes such as hospitalization and mortality in older adult patients with HF. METHODS Sarcopenia diagnosis followed the European Working Group on Sarcopenia in Older People criteria. Anthropometric, bioelectrical impedance (PA and body composition), functional capacity and inflammatory markers were assessed. RESULTS Included patients were predominantly male (67%) and White, with a mean age of 69 ± 7 years, and a predominance of New York Heart Association I and II functional classes (82.1%) and reduced left ventricular ejection fraction (70.8%). Of the total sample, 23.6% were identified as sarcopenic. Mean PA values were lower in patients with sarcopenia (4.9 ± 0.9 and 6.0 ± 0.8°; P < 0.001). The cutoff point detected for sarcopenia in the receiver operating characteristic curve was 5.45°, which is an independent predictor for sarcopenia. PA values below this cutoff point were also associated with each of the sarcopenic components evaluated. PA proved to be an independent predictor for hospitalization (P = 0.042) in the entire sample studied. CONCLUSION PA is associated with diagnostic components of sarcopenia and the cutoff point 5.45° proved to be an independent predictor of sarcopenia and hospitalization >3 years in older adult patients with HF.
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Affiliation(s)
- Patrícia Bieger
- Graduate Program in Food, Nutrition and Health, Medical School, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Tamirys Delazeri Sangali
- Graduate Program in Food, Nutrition and Health, Medical School, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Édina Caroline Ternus Ribeiro
- Graduate Program in Health Sciences: Cardiology and Cardiovascular Sciences, Medical School, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Ingrid Dalira Schweigert Perry
- Food and Nutrition Research Center, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gabriela Corrêa Souza
- Graduate Program in Food, Nutrition and Health, Medical School, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.,Food and Nutrition Research Center, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.,Heart Failure and Transplant Group, Nutrition Department, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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Chen Y, Wu J, Ran L, Yu D, Chen X, Liu M. The combination of phase angle and age has a good diagnostic value for sarcopenia in continuous ambulatory peritoneal dialysis patients. Front Nutr 2022; 9:1036796. [DOI: 10.3389/fnut.2022.1036796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 10/25/2022] [Indexed: 11/17/2022] Open
Abstract
AimsThere are limited studies on phase angle and sarcopenia in continuous ambulatory peritoneal dialysis patients. So, we want to explore the association between phase angle and sarcopenia and find a more sensitive indicator for diagnosing sarcopenia.MethodsWe included 101 continuous ambulatory peritoneal dialysis patients from March 2022 to August 2022 and measured the phase angle and body composition by bioelectrical impedance analysis. All patients had their handgrip strength measured. Then, we divided patients into the sarcopenia (n = 30) group and non-sarcopenia (n = 71) group according to the sarcopenia diagnostic strategy formulated by the Asian Working Group for Sarcopenia. We used logistic regression to explore the risk factors of sarcopenia. We applied Receiver-operating characteristics curves to determine the diagnostic accuracy of these risk factors.ResultsAfter adjustments for sex, age, diabetes, BMI, extracellular water ratio, extra water, serum creatinine, total kt/v, and residual kt/v, phase angle correlated to handgrip strength and lowered limb muscle mass but not to skeletal muscle mass, upper arm muscle circumference, upper limb muscle mass and appendicular skeletal muscle mass index. In the multivariate logistic model, low phase angle and older age are risk factors for sarcopenia. The AUROC of phase angle for sarcopenia is 0.79 (95%CI, 0.70–0.86, P < 0.01) for both sexes, 0.70 and 0.85 for females and males. After we combined age and phase angle as diagnostic indicators of sarcopenia, the AUROC is 0.91 (95%CI, 0.83–0.96, P < 0.0001) in both sexes, 0.89 and 0.93 for females and males.ConclusionThis study illustrates that age 52 or older is an independent risk factor for sarcopenia in continuous ambulatory peritoneal dialysis patients. Phase angle can act as a predictor of sarcopenia in those patients. But the combination of age and phase angle is more valuable in diagnosing sarcopenia.
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Martins AD, Fernandes O, Oliveira R, Bilro V, Lopes G, Rego AM, Parraça JA, Raimundo AMM, Brito JP. Effects of exercise programs on phase angle in older adults: A systematic review and meta-analysis. Arch Gerontol Geriatr 2022; 103:104787. [PMID: 35961106 DOI: 10.1016/j.archger.2022.104787] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Revised: 07/31/2022] [Accepted: 08/04/2022] [Indexed: 11/02/2022]
Abstract
The purpose of this study was to calculate the effects of exercise programs on phase angle (PhA) in older people. A systematic review was undertaken in multiple electronic databases in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses statement guidelines for the purposes of selecting randomized controlled trials that measured the effects of the exercise programs on PhA in older adults on 31 March 2022. We carried out a random-effect meta-analysis for the effects of exercise programs on PhA. Additionally, we analysed the differences between subgroups in terms of weekly frequency, number of sets and repetitions, and duration of interventions. Studies were methodological assessed through the PEDro scale where one had excellent, ten had good, and three had poor methodological quality. For the purposes of the study, fourteen studies met the criteria for inclusion. However, four studies did not have enough information to be included in the quantitative analysis. The remaining ten articles revealed moderate effects on PhA in favour of intervention groups (p=0.009, SMD=0.72 [0.46-0.99], I2=54%). The meta-analysis also showed that interventions lasting twelve weeks are more successful in generating positive effects on PhA as opposed to eight weeks (SMD's=0.79 vs. 0.64, respectively). These results indicate that resistance training (RT) is an effective and safe to improve PhA in the older people, especially through RT programs lasting from eight to twelve weeks. A novel finding of this study was that RT is the most used type of exercise by authors when assessing the PhA in older adults.
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Affiliation(s)
- Alexandre Duarte Martins
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal; Sports Science School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior 2040-413, Portugal; Life Quality Research Centre, Rio Maior 2040-413, Portugal.
| | - Orlando Fernandes
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - Rafael Oliveira
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior 2040-413, Portugal; Life Quality Research Centre, Rio Maior 2040-413, Portugal; Research Centre in Sport Sciences, Health Sciences and Human Development, Vila Real 5001-801, Portugal
| | - Vitor Bilro
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - Gabriel Lopes
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - António Maia Rego
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - José A Parraça
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - Armando Manuel Mendonça Raimundo
- Comprehensive Health Research Centre (CHRC), Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Largo dos Colegiais 2, 7004-516, Évora 7000-727, Portugal
| | - João Paulo Brito
- Sports Science School of Rio Maior, Polytechnic Institute of Santarém, Rio Maior 2040-413, Portugal; Life Quality Research Centre, Rio Maior 2040-413, Portugal; Research Centre in Sport Sciences, Health Sciences and Human Development, Vila Real 5001-801, Portugal
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SANTIAGO LB, RORIZ AKC, OLIVEIRA CCD, OLIVEIRA TMD, CONCEIÇÃO-MACHADO MEPD, RAMOS LB. Phase angle as a screening method for sarcopenia in community-dwelling older adults. REV NUTR 2022. [DOI: 10.1590/1678-9865202235200243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
ABSTRACT Objective We investigated the utility of the phase angle as a screening tool for sarcopenia. Methods We performed a cross-sectional study that included 169 active community-dwelling elderly women. The phase angle was determined using tetrapolar bioelectrical impedance, and sarcopenia was diagnosed based on skeletal muscle mass, muscle strength, and physical performance using bioelectrical impedance analysis, a handheld dynamometer, and the gait speed test, respectively. Receiver operating characteristic curve analysis was performed to investigate the role of the phase angle as a predictor of sarcopenia. Results The prevalence of sarcopenia was 12.4%. The median phase angle was 5.30°; elderly women with sarcopenia had lower phase angles than those without sarcopenia (p=0.006). The phase angle cutoff for the detection of sarcopenia was ?5.15°, with an area under the curve of 0.685, sensitivity 81.0%, specificity 60.8%, and accuracy 63.31%. Elderly women with a low phase angle show a high risk of presenting with reduced muscle mass. Conclusions The phase angle was shown to be a useful screening tool in elderly women with sarcopenia.
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Ding Y, Chang L, Zhang H, Wang S. Predictive value of phase angle in sarcopenia in patients on maintenance hemodialysis. Nutrition 2021; 94:111527. [PMID: 34896667 DOI: 10.1016/j.nut.2021.111527] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 10/19/2021] [Accepted: 10/22/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVES The aim of this study was to analyze the factors influencing sarcopenia in patients on maintenance hemodialysis (MHD) in mainland China and to explore the role of phase angle (PhA) in sarcopenia. METHODS We enrolled 346 patients on MHD with regular dialysis and collected relevant data. According to the diagnostic criteria of the Asian Sarcopenia Working Group, the patients were placed into one of two groups: sarcopenia and non-sarcopenia. The differences between groups were compared and the statistically significant factors were included in binary logistic regression analysis to screen for independent factors influencing sarcopenia. Receiver operating characteristic curve and area under the curve were used to evaluate the predictive value of PhA in sarcopenia. RESULTS The prevalence of sarcopenia was 32.66% in patients on MHD. Logistic regression analysis showed that sarcopenia was significantly associated with age (odds ratio [OR], 1.12; 95% confidence interval [CI], 1.08-1.15; P < 0.001), body mass index (OR, 0.66; 95% CI, 0.58-0.76; P < 0.001), and PhA (OR, 0.24; 95% CI, 0.15-0.40; P < 0.001). The best cutoff value of PhA on sarcopenia was 4.67° for both sexes, 4.67° and 4.60° for men and women, respectively (P < 0.001). CONCLUSION The present study showed that PhA was an important influencing factor of sarcopenia adjusted by age and body mass index in Asian patients on MHD. PhA may have an optimistic predictive value to identify sarcopenia in these population, and it is convenient and accessible in clinical practice than the diagnostic criteria of sarcopenia.
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Affiliation(s)
- Yan Ding
- Department of Blood Purification Centre, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Liyang Chang
- Department of Blood Purification Centre, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
| | - Hongmei Zhang
- Department of Blood Purification Centre, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Shaoling Wang
- School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
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Custódio Martins P, de Lima TR, Silva AM, Santos Silva DA. Association of phase angle with muscle strength and aerobic fitness in different populations: A systematic review. Nutrition 2021; 93:111489. [PMID: 34688022 DOI: 10.1016/j.nut.2021.111489] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/30/2021] [Accepted: 09/03/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim of this study was to summarize the evidence on the association of phase angle (PhA) with muscle strength and aerobic fitness in different populations. METHODS A systematic search on this topic was performed in nine electronic databases (CINAHL, LILACS, PubMed, SciELO, Scopus, SPORTDiscus, ScienceDirect, MEDLINE, and Web of Science) in January 2021. Studies with different designs that permitted extraction of information about the relationships between PhA and muscle strength and between PhA and aerobic fitness were included. A total of 4446 studies were initially identified; 34 were included after reading of the title, abstract, full text, and references. Four of the studies included had a longitudinal design, with samples consisting of participants ages 6 to 92 years. Thirty-two of the 34 studies evaluated the relationship between PhA and muscle strength, two cross-sectional studies investigated only PhA and aerobic fitness, and three cross-sectional studies evaluated both components (muscle strength and aerobic fitness). RESULTS PhA was directly associated with muscle strength in 30 cross-sectional studies and two longitudinal studies; the two studies that did not find a direct relationship had a cross-sectional design. For aerobic fitness, the five studies identified reported a direct relationship with PhA. CONCLUSIONS PhA is directly associated with muscle strength and aerobic fitness in different age groups (children, adolescents, adults, and older adults) and in people with different health conditions (human immunodeficiency virus, Crohn's disease, chronic obstructive pulmonary disease, bariatric surgery, kidney transplant, cancer, hemodialysis, and sarcopenia).
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Affiliation(s)
- Priscila Custódio Martins
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianópolis, Brazil.
| | - Tiago Rodrigues de Lima
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianópolis, Brazil.
| | - Analiza Mónica Silva
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Cruz-Quebrada, Portugal.
| | - Diego Augusto Santos Silva
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianópolis, Brazil.
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Phase angle as a marker for muscle abnormalities and function in patients with colorectal cancer. Clin Nutr 2021; 40:4799-4806. [PMID: 34271241 DOI: 10.1016/j.clnu.2021.06.013] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Revised: 05/24/2021] [Accepted: 06/09/2021] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Considering the applicability of phase angle (PhA) as a marker of muscle mass and function, we aimed to investigate whether PhA is a predictor of muscle abnormalities and function in patients with cancer. METHODS In a sample of patients with colorectal cancer (CRC), PhA was obtained from measurements of resistance and reactance from bioelectrical impedance analysis. Computerized tomography imaging at the third lumbar vertebra was used to evaluate muscle abnormalities by quantifying skeletal muscle index (SMI) and skeletal muscle radiodensity (SMD). Muscle function was assessed by handgrip strength (HGS) and gait speed (GS). RESULTS This cross-sectional study included 190 participants (X±SD), mean age 60.5 ± 11.3 years; 57% men; 78% had cancer stages III to IV. PhA was highly correlated with SMI (r = 0.70) and moderately correlated with HGS (r = 0.54). PhA explained 48% of the SMI variability (R2 = 0.485), 21% of the SMD variability (R2 = 0.214), 26% of HGS (R2 = 0.261) and 9.8% of GS (R2 = 0.098). In the multivariate model adjusted for age, sex, body mass index, performance status, comorbidities and cancer stage, 1-degree decrease in PhA was associated with low SMI (Odds Ratio (OR) = 6.56, 95% CI: 2.90-14.86) and with low SMI and HGS combined (OR = 11.10, 95% CI: 2.61-47.25). In addition, Receiving Operating Characteristics curve analysis showed that PhA had a good diagnostic accuracy for detecting low SMI, low SMI and SMD combined, low SMD and HGS and low SMI and HGS combined (AUC = 0.81, 95% CI: 0.74-0.88; AUC = 0.88, 95% CI: 0.81-0.95; AUC = 0.80, 95% CI: 0.70-0.91; AUC = 0.82, 95% CI: 0.74-0.89; respectively). CONCLUSIONS PhA was a predictor of muscle abnormalities and function and had a good diagnostic accuracy for detecting low muscle mass, low muscle mass and radiodensity, low muscle radiodensity and strength, and low muscle mass and strength in patients with CRC.
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Rosas-Carrasco O, Ruiz-Valenzuela RE, López-Teros MT. Phase Angle Cut-Off Points and Their Association With Sarcopenia and Frailty in Adults of 50-64 Years Old and Older Adults in Mexico City. Front Med (Lausanne) 2021; 8:617126. [PMID: 33791322 PMCID: PMC8005522 DOI: 10.3389/fmed.2021.617126] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 02/12/2021] [Indexed: 12/13/2022] Open
Abstract
Background: In recent studies, the usefulness of the phase angle (PA) to assess geriatric conditions such as sarcopenia and frailty has been evaluated. However, there are no useful cut-off points for clinical research and/or practice. Objective: To analyze PA cut-off points associated with sarcopenia and frailty in adults of 50-64 years old and older adults in Mexico City. Design: Cross-sectional analysis of the FraDySMex cohort study (Frailty, Dynapenia, and Sarcopenia in Mexican Adults). Setting and Participants: 498 people were included, 78.7% women, aged 71.1 ± 9.5 years. Methods: The sarcopenia measurements were made according to the European Working Group on Sarcopenia in Older People (EWGSOP) (2019) (by dynamometer to evaluate hand grip strength and dual energy X-ray absorptiometry (DXA) for appendicular muscle mass), and the frailty through the physical frailty phenotype with cut-off points adjusted to the Mexican population. The PA was evaluated by bioelectrical impedance analysis (BIA), tetrapolar to 50 Hz, other variables such as socio-demographic, comorbidity, cognitive status, and functional dependence were evaluated. Results: The prevalence of frailty was 10.6% and sarcopenia 10.0%. The mean of the PA was 4.6° ± 0.70°. The PA cut-off point for frailty in adults 50 to 64 years was ≤4.3° [sensitivity (S) = 91.95%, specificity (Sp) 66.77%, AUROC (Area Under the Receiver Operating Characteristic) curve = 0.9273 95% CI (0.8720-0.9825)]; the PA cut-off point for sarcopenia was ≤4.3 [S = 91.95%, Sp = 66.77%, AUROC = 0.9306 95% CI (0.8508-1.000)]. The PA cut-off for frailty in adults ≥ 65 years was ≤4.1° [S = 72.37%, Sp 71.43%, AUROC = 0.7925 95%, CI (0.7280-0.8568)] for sarcopenia was ≤4.1° [S = 72.76%, Sp 73.81%, AUROC = 0.7930 95% CI (0.7272-0.8587)]. These cut-off points showed a significant association between PA with frailty (OR 4.84; 95% CI 2.61-8.99) and sarcopenia (OR 8.44; 95% CI 3.85-18.4) after adjusted by age, sex, BMI, comorbidity index and cognitive impairment. Conclusions and Implications: These cut-off points of PA could be useful for the screening of sarcopenia and frailty in Mexican adults of 50 years and older in centers that have BIA.
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Affiliation(s)
- Oscar Rosas-Carrasco
- Health Department, Ibero American University, Mexico City, Mexico
- Instituto Nacional de Geriatría, Mexico City, Mexico
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Ji W, Liu X, Zheng K, Yang H, Cui J, Li W. Correlation of phase angle with sarcopenia and its diagnostic value in elderly men with cancer. Nutrition 2020; 84:111110. [PMID: 33453619 DOI: 10.1016/j.nut.2020.111110] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 11/27/2020] [Accepted: 11/30/2020] [Indexed: 01/01/2023]
Abstract
OBJECTIVES The aims of this study was to investigate the association of phase angle (PA) with sarcopenia and its components and to evaluate the effectiveness of PA in sarcopenia diagnosis in older men (>65 y of age) with cancer. METHODS The study included older men with non-small cell lung cancer and digestive tract cancer who were hospitalized in the past 3 y. General characteristics such as age, body mass index, and tumor stage were gathered. Mid-upper arm muscle circumstance, calf circumstance, and handgrip strength (HGS) were measured. PA and appendicular skeletal muscle mass were examined by bioelectrical impedance analysis. According to the diagnostic criteria of the 2019 consensus of Asian Sarcopenia Working Group, the patients were divided into two groups: non-sarcopenia and sarcopenia. The study included 445 patients with a 22.2% prevalence of sarcopenia. RESULTS PA was different between the non-sarcopenia and sarcopenia groups (5.02° versus 4.18°; P < 0.001). Pearson correlation showed that PA was related to diagnostic and confounding factors of sarcopenia. After adjusting for all potential confounding factors, multiple linear regression analysis showed diagnostic components of sarcopenia (HGS and skeletal muscle mass index [SMI]) could predict 25.3% of PA variation and logistic regression analysis showed PA (odds ratio, 0.309; P < 0.001) were related to sarcopenia. Then receiver operating characteristic curve showed the cutoff value of 4.25° with area under the curve of 0.785 for PA. CONCLUSIONS PA is related to diagnostic components of sarcopenia, HGS and SMI. PA can be useful in the diagnosis of sarcopenia in older male patients with cancer. The cutoff value proposed in this study was 4.25°.
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Affiliation(s)
- Wei Ji
- Center of Cancer, The First Affiliated Hospital of Jilin University, Changchun, China
| | - XiangLiang Liu
- Center of Cancer, The First Affiliated Hospital of Jilin University, Changchun, China
| | - KaiWen Zheng
- Center of Cancer, The First Affiliated Hospital of Jilin University, Changchun, China
| | - HaiMei Yang
- Center of Cancer, The First Affiliated Hospital of Jilin University, Changchun, China
| | - JiuWei Cui
- Center of Cancer, The First Affiliated Hospital of Jilin University, Changchun, China.
| | - Wei Li
- Center of Cancer, The First Affiliated Hospital of Jilin University, Changchun, China.
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