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Kujawowicz K, Mirończuk-Chodakowska I, Cyuńczyk M, Witkowska AM. Identifying Malnutrition Risk in the Elderly: A Single- and Multi-Parameter Approach. Nutrients 2024; 16:2537. [PMID: 39125416 PMCID: PMC11314023 DOI: 10.3390/nu16152537] [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: 07/04/2024] [Revised: 07/23/2024] [Accepted: 07/31/2024] [Indexed: 08/12/2024] Open
Abstract
Malnutrition is a significant concern affecting the elderly, necessitating a complex assessment. This study aims to deepen the understanding of factors associated with the assessment of malnutrition in the elderly by comparing single- and multi-parameter approaches. In this cross-sectional study, 154 individuals underwent a comprehensive geriatric assessment (CGA). Malnutrition risk was determined using the mini nutritional assessment (MNA). Additional factors assessed included sarcopenia, polypharmacy, depression, appetite, handgrip strength, and gait speed. Phase angle (PA) and body composition were measured using bioelectrical impedance analysis (BIA). The MNA identified a malnutrition risk in 36.8% of individuals. The geriatric depression scale (GDS) and PA demonstrated moderate effectiveness in assessing malnutrition risk, with AUC values of 0.69 (95% CI: 0.60-0.78) and 0.62 (95% CI: 0.54-0.72), respectively. A logistic regression model incorporating handgrip strength, skeletal muscle mass, sarcopenia, osteoporosis, depression, specific antidepressant use, mobility, appetite, and smoking achieved superior performance in predicting malnutrition risk, with an AUC of 0.84 (95% CI: 0.77-0.91). In conclusion, this study demonstrates that integrating multiple parameters into a composite model provides a more accurate and comprehensive assessment of malnutrition risk in elderly adults.
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Affiliation(s)
- Karolina Kujawowicz
- Department of Food Biotechnology, Medical University of Białystok, 15-089 Białystok, Poland; (I.M.-C.); (M.C.); (A.M.W.)
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Utsumi Y, Takase K, Murakami N, Nakagawa T, Obayashi T, Ogura R, Hosokawa S. Investigation of Skeletal Muscle Indices Affecting Anaerobic Thresholds after Acute Myocardial Infarction. Phys Ther Res 2024; 27:100-107. [PMID: 39257518 PMCID: PMC11382791 DOI: 10.1298/ptr.e10286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 05/30/2024] [Indexed: 09/12/2024]
Abstract
OBJECTIVE To investigate skeletal muscle indices influencing the anaerobic threshold (AT) measured by cardiopulmonary exercise testing (CPX). METHODS This study included 125 consecutive men (median age: 66.0 years) diagnosed with acute myocardial infarction who underwent CPX before discharge. Participants were categorized into two groups based on their AT: the AT-lowering and AT-maintaining groups, comprising those with AT <11 and ≥11 ml/min/kg, respectively. Skeletal muscle indices that influenced AT, strengths of such influences, and respective cutoff values were investigated using multiple logistic regression analysis, decision-tree analysis, and the random-forest method. Skeletal muscle indices included grip strength, knee extension strength, lower-limb skeletal muscle index, phase angle (PhA), lower-limb PhA, arm circumference (AC), and calf circumference. RESULTS Lower-limb PhA, AC, age, and body mass index (BMI) influenced AT (model X2 test: p <0.05; Hosmer-Lemeshow test: p = 0.98). Among the skeletal muscle indices, Gini impurity reduction was the highest in the lower-limb PhA. The cutoff values for AT were ≥4.0° for BMI <24 kg/m2 and ≥6.4° for BMI ≥24 kg/m2. CONCLUSION Lower-limb PhA was the most influential skeletal muscle index affecting AT. PhA measured using body composition analyzers is useful to identify exercise-limiting factors and determine the effectiveness of exercise because it can be easily performed shortly.
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Affiliation(s)
- Yuya Utsumi
- Department of Rehabilitation, Tokushima Red Cross Hospital, Japan
| | - Koji Takase
- Department of Rehabilitation, Tokushima Red Cross Hospital, Japan
| | - Naoya Murakami
- Department of Rehabilitation, Tokushima Red Cross Hospital, Japan
| | - Tokiko Nakagawa
- Department of Rehabilitation, Tokushima Red Cross Hospital, Japan
| | - Takuya Obayashi
- Department of Rehabilitation, Tokushima Red Cross Hospital, Japan
| | - Riyo Ogura
- Department of Cardiology, Tokushima Red Cross Hospital, Japan
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3
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Sanson G, Doriguzzi L, Garbari P, Ruggiero MJ, Valentinuzzo I, Mettulio T, Stolfa E, Fisicaro M, Vecchiet S, Mazzaro E, Zanetti M, Fabiani A. The severity of early fluid overload assessed by bioelectrical vector impedance as an independent risk factor for longer patient care after cardiac surgery. Clin Nutr 2024; 43:803-814. [PMID: 38350288 DOI: 10.1016/j.clnu.2024.02.007] [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: 09/29/2023] [Revised: 02/03/2024] [Accepted: 02/06/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND AND AIMS Fluid overload is a common postoperative complication in patients undergoing cardiac surgery. Although this condition is notably associated with relevant adverse outcomes, assessment of hydration status in clinical practice is challenging. Bioelectrical impedance vector analysis (BIVA) has emerged as a potentially effective method to monitor hydration changes, but the available evidence in critically ill patients undergoing cardiac surgery is limited and sometimes conflicting. The aim of this study was to explore by mean of BIVA the evolution over time of hydration status and its impact on relevant outcomes. METHODS Prospective observational study enrolling 130 patients undergoing cardiac surgery. Height normalized impedance was calculated both before surgery (baseline) and in the first five postoperative days. Relevant clinical and laboratory data were collected daily close to BIVA measurements. Length of mechanical ventilation (MV), intensive care unit (ICU) and hospital stay exceeding the 75th percentile of the study population were considered as study endpoints. RESULTS Compared to baseline, a significant reduction in impedance was found at first postoperative day, demonstrating a relevant fluid overload. An adjusted impedance at first postoperative day shorter than the best respective threshold was associated to longer MV (7.4 times), ICU stay (4.7 times) and hospital stay (5.6 times). A significant change in impedance and phase angle was documented throughout the observation days (p < 0.001), without returning to the baseline value. The co-existence of low impedance and high plasma osmolarity increased significantly the risk of incurring the study outcomes. CONCLUSIONS In patients with cardiac surgery-induced fluid overload, recovery to baseline conditions occurs slowly. A relevant early fluid overload should be considered predictive for longer time of MV, ICU and total hospital stay.
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Affiliation(s)
- Gianfranco Sanson
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, Trieste, Italy.
| | - Lisa Doriguzzi
- Cardiac Surgery Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, Strada di Fiume 447, Trieste, Italy.
| | - Pierpaolo Garbari
- Cardiac Surgery Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, Strada di Fiume 447, Trieste, Italy.
| | - Maria Josè Ruggiero
- Cardiac Surgery Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, Strada di Fiume 447, Trieste, Italy.
| | - Ilaria Valentinuzzo
- Cardiac Surgery Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, Strada di Fiume 447, Trieste, Italy.
| | - Tanja Mettulio
- Cardiac Surgery Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, Strada di Fiume 447, Trieste, Italy.
| | - Elisa Stolfa
- Cardiac Surgery Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, Strada di Fiume 447, Trieste, Italy.
| | - Manuela Fisicaro
- Cardiac Surgery Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, Strada di Fiume 447, Trieste, Italy.
| | - Sara Vecchiet
- Cardiac Surgery Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, Strada di Fiume 447, Trieste, Italy.
| | - Enzo Mazzaro
- Cardiac Surgery Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, Strada di Fiume 447, Trieste, Italy.
| | - Michela Zanetti
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume 447, Trieste, Italy.
| | - Adam Fabiani
- Cardiac Surgery Unit, Azienda Sanitaria Universitaria Giuliano-Isontina, Strada di Fiume 447, Trieste, Italy.
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Quist JR, Rud CL, Brantlov S, Ward LC, Dahl Baunwall SM, Hvas CL. Bioelectrical impedance analysis as a clinical marker of health status in adult patients with benign gastrointestinal disease: A systematic review. Clin Nutr ESPEN 2024; 59:387-397. [PMID: 38220401 DOI: 10.1016/j.clnesp.2023.12.145] [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: 07/16/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Body composition reflects nutritional status, disease status and progression, and treatment responses. Mounting evidence supports the use of bioelectrical impedance analysis (BIA) as a non-invasive tool to assess body composition. Patients with benign gastrointestinal (GI) disease experience disease-related alterations in their body composition, and bioimpedance outcomes in patients with benign GI diseases have not previously been summarized. We aimed to evaluate BIA as a clinical body composition marker for benign GI diseases and describe its association with physical health status. METHODS We systematically searched PubMed, Scopus, Web of Science, Embase, and CINAHL from inception to October 2023 (PROSPERO registration: CRD42021265866). Of 971 screened studies, 26 studies were included in the final analysis, comprising a total of 2398 adult patients with benign GI disease. The main outcome was raw impedance data. RESULTS The most frequently reported BIA outcome was phase angle (PhA) (reported in 18 of 26 studies), followed by fat-free-mass (FFM) (reported in 13 of 26 studies). The consensus view of the included studies illustrates that BIA can be a useful tool for evaluating body composition in patients with benign GI diseases, and low PhA and FFM were associated with increased nutritional risk, abnormal physical characteristics, and increased mortality risk. CONCLUSION To fully utilize BIA as a clinical marker of health in patients with benign GI disease, standardized protocols specific to this population are needed and prospective studies testing cut-offs and ranges, accuracy, and other raw BIA parameters for classifying disease status.
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Affiliation(s)
| | - Charlotte Lock Rud
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark
| | - Steven Brantlov
- Department of Procurement & Clinical Engineering, Central Denmark Region, Denmark
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
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Ukai T, Yokoyama K, Watanabe M. Preoperative Body Composition Correlates with Postoperative Muscle Volume and Degeneration after Total Hip Arthroplasty. Nutrients 2024; 16:386. [PMID: 38337672 PMCID: PMC10857396 DOI: 10.3390/nu16030386] [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: 12/06/2023] [Revised: 01/26/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024] Open
Abstract
Impaired muscle recovery after total hip arthroplasty (THA) may affect gait and activities of daily living. Bioelectrical impedance analysis (BIA) can assess body composition and muscle volume, and computed tomography (CT) can assess muscle volume and the fatty degeneration of muscle. This study aimed to explore the effectiveness of BIA, and the correlation between preoperative body composition and postoperative muscle volume and degeneration after THA using BIA and CT. Thirty-eight patients who underwent THA and had BIA and CT performed pre- and postoperatively were retrospectively assessed. The BIA-derived measurements of preoperative body composition (fat mass index, fat-free mass index, and phase angle) were correlated with the CT-derived measurements (pre- and postoperative muscle volume and gluteus maximus and quadriceps Hounsfield Units of the affected hip). The preoperative fat mass index negatively correlated with the postoperative muscle volume of the gluteus maximus (p = 0.02) and quadriceps (p < 0.001) and the Hounsfield Units of the gluteus maximus (p = 0.03) and quadriceps (p = 0.03). The preoperative fat-free mass index positively correlated with the postoperative muscle volume of the quadriceps (p = 0.02). The preoperative phase angle positively correlated with the postoperative muscle volume of the quadriceps (p = 0.001) and the Hounsfield Units of the gluteus maximus (p = 0.03) and quadriceps (p = 0.001). In patients who underwent THA, preoperative body composition correlated with postoperative muscle volume and the fatty degeneration of the affected lower limb. Preoperative body composition may help predict postoperative muscle volume and fatty degeneration and thus, postoperative recovery.
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Affiliation(s)
- Taku Ukai
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Japan
| | - Katsuya Yokoyama
- Department of Orthopaedic Surgery, Tokai University School of Medicine Oiso Hospital, 21-1 Gekkyo, Oiso 259-0198, Japan
| | - Masahiko Watanabe
- Department of Orthopaedic Surgery, Surgical Science, Tokai University School of Medicine, 143 Shimokasuya, Isehara 259-1193, Japan
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Yilmaz M, Atik-Altinok Y, Seyidoglu Yüksel D, Acarer A, Bozkurt D, Savas S, Sarac ZF, Akcicek F. Evaluation of sarcopenia and phase angle in elderly patients with Parkinson's Disease. Int J Neurosci 2024:1-8. [PMID: 38275120 DOI: 10.1080/00207454.2024.2310180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 01/21/2024] [Indexed: 01/27/2024]
Abstract
PURPOSE To investigate sarcopenia and related factors and to determine the disease-specific phase angle (PhA) cut-off score in detecting sarcopenia in elderly patients with Parkinson's Disease (PD). METHODS This cross-sectional study was conducted with 89 participants. The Mini-Nutritional Assessment (MNA), the Eating Attitude Test-10 (EAT-10), the Physical Activity Scale for The Elderly (PASE) questionnaire and the Hoehn-Yahr scale have been used. Additionally, anthropometric measurements were performed. The diagnosis of sarcopenia was based on the new consensus published by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). PhA has been performed by Bioelectrical Impedance Analysis (BIA) with Tanita MC 780®. RESULTS The mean age was of the participants 68.9 ± 6.4 years, and 57.3% were male. The prevalence of sarcopenia was 12.3%. PhA, malnutrition, age, disease severity, low calf circumference (CC), low body mass index (BMI), the difference between the pre-diagnosis and current weight loss, dopaminergic treatment, and low PASE score were associated with sarcopenia. The cut-off value of the PhA in terms of the ability to identify sarcopenia was <4.5o with a sensitivity of 53.3% and a specificity of 93.2% (p = 0.001). When we grouped the PhA of the patients according to this cut-off score, it was seen that 14.6% of them were sarcopenic. Age, disease severity, PASE score and hand grip strength were significantly related to both sarcopenia and PhA. CONCLUSION It is important to be aware of sarcopenia and related factors at an early stage in Parkinson's patients. Because of disease-related symptoms, it may be more appropriate to use a disease-specific PhA cut-off score in the definition of sarcopenia.
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Affiliation(s)
- Merve Yilmaz
- Faculty of Health Science, Department of Nutrition and Dietetics, İzmir Tinaztepe University, İzmir, Turkey
| | | | | | - Ahmet Acarer
- Department of Neurology, Ege University of Medical Faculty, İzmir
| | - Devrim Bozkurt
- Department of Internal Medicine, Ege University of Medical Faculty, İzmir, Turkey
| | - Sumru Savas
- Department of Internal Medicine, Ege University of Medical Faculty, İzmir, Turkey
| | - Z Fulden Sarac
- Department of Internal Medicine, Ege University of Medical Faculty, İzmir, Turkey
| | - Fehmi Akcicek
- Department of Internal Medicine, Ege University of Medical Faculty, İzmir, Turkey
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Gulin J, Ipavic E, Mastnak DM, Brecelj E, Edhemovic I, Kozjek NR. Phase angle as a prognostic indicator of surgical outcomes in patients with gastrointestinal cancer. Radiol Oncol 2023; 57:524-529. [PMID: 38038415 PMCID: PMC10690749 DOI: 10.2478/raon-2023-0060] [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: 08/03/2023] [Accepted: 09/30/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND In patients with gastrointestinal cancer with planned elective surgery, malnutrition increases the risk of adverse outcomes in the postoperative period. The phase angle, measured by the bioelectrical impedance analysis is an indicator of the metabolic and functional status of the patient. It may be an important prognostic indicator for the clinical outcome of post-surgical treatment in patients with gastrointestinal cancer. PATIENTS AND METHODS In this prospective study, 70 patients with gastrointestinal cancer had their phase angles measured by the bioelectrical impedance analysis before the surgery. During the first month after the surgery, we documented the postoperative complications from the patient's records and classified them according to the Clavien Dindo classification of surgical complications. The time of hospitalization was also recorded. The data was statistically analysed in SPSS. RESULTS We found a statistically significant difference (p = 0.036) in the average value of phase angles between the group of patients who had postoperative complications (phase angle 5.09°) and the group without postoperative complications (5.64°). We noted a correlating trend of decreasing phase angle values and increasing hospitalization time (Pe R = -0,40, p = 0,001). The phase angle cut-off value (5.5°) was calculated using the ROC curve method, predicting a higher risk of the postoperative complications (p = 0,037) in patients with lower phase angle. CONCLUSIONS Lower phase angle values before surgery were associated with more complications during the first month after surgery and longer hospitalization time. We found that a phase angle below than 5.5° could serve as a marker that predicts a greater risk of postoperative complications.
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Affiliation(s)
- Jana Gulin
- Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | | | - Erik Brecelj
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | | | - Nada Rotovnik Kozjek
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
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8
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Silva AM, Campa F, Stagi S, Gobbo LA, Buffa R, Toselli S, Silva DAS, Gonçalves EM, Langer RD, Guerra-Júnior G, Machado DRL, Kondo E, Sagayama H, Omi N, Yamada Y, Yoshida T, Fukuda W, Gonzalez MC, Orlandi SP, Koury JC, Moro T, Paoli A, Kruger S, Schutte AE, Andreolli A, Earthman CP, Fuchs-Tarlovsky V, Irurtia A, Castizo-Olier J, Mascherini G, Petri C, Busert LK, Cortina-Borja M, Bailey J, Tausanovitch Z, Lelijveld N, Ghazzawi HA, Amawi AT, Tinsley G, Kangas ST, Salpéteur C, Vázquez-Vázquez A, Fewtrell M, Ceolin C, Sergi G, Ward LC, Heitmann BL, da Costa RF, Vicente-Rodriguez G, Cremasco MM, Moroni A, Shepherd J, Moon J, Knaan T, Müller MJ, Braun W, García-Almeida JM, Palmeira AL, Santos I, Larsen SC, Zhang X, Speakman JR, Plank LD, Swinburn BA, Ssensamba JT, Shiose K, Cyrino ES, Bosy-Westphal A, Heymsfield SB, Lukaski H, Sardinha LB, Wells JC, Marini E. The bioelectrical impedance analysis (BIA) international database: aims, scope, and call for data. Eur J Clin Nutr 2023; 77:1143-1150. [PMID: 37532867 DOI: 10.1038/s41430-023-01310-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Bioelectrical impedance analysis (BIA) is a technique widely used for estimating body composition and health-related parameters. The technology is relatively simple, quick, and non-invasive, and is currently used globally in diverse settings, including private clinicians' offices, sports and health clubs, and hospitals, and across a spectrum of age, body weight, and disease states. BIA parameters can be used to estimate body composition (fat, fat-free mass, total-body water and its compartments). Moreover, raw measurements including resistance, reactance, phase angle, and impedance vector length can also be used to track health-related markers, including hydration and malnutrition, and disease-prognostic, athletic and general health status. Body composition shows profound variability in association with age, sex, race and ethnicity, geographic ancestry, lifestyle, and health status. To advance understanding of this variability, we propose to develop a large and diverse multi-country dataset of BIA raw measures and derived body components. The aim of this paper is to describe the 'BIA International Database' project and encourage researchers to join the consortium. METHODS The Exercise and Health Laboratory of the Faculty of Human Kinetics, University of Lisbon has agreed to host the database using an online portal. At present, the database contains 277,922 measures from individuals ranging from 11 months to 102 years, along with additional data on these participants. CONCLUSION The BIA International Database represents a key resource for research on body composition.
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Affiliation(s)
- Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002, Lisbon, Portugal.
| | - Francesco Campa
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Silvia Stagi
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
| | - Luís A Gobbo
- Skeletal Muscle Assessment Laboratory, Physical Education Department, School of Technology and Science, São Paulo State University, Presidente Prudente, 19060-900, Brazil
| | - Roberto Buffa
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
| | - Stefania Toselli
- Department for Life Quality Studies, University of Bologna, 47921, Rimini, Italy
| | - Diego Augusto Santos Silva
- Research Center of Kinanthropometry and Human Performance, Sports Center, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Ezequiel M Gonçalves
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Raquel D Langer
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Gil Guerra-Júnior
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Dalmo R L Machado
- Laboratory of Kinanthropometry and Human Performance, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, 05508-030, São Paulo, Brazil
| | - Emi Kondo
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Hiroyuki Sagayama
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Naomi Omi
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, 566-0002, Japan
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, 566-0002, Japan
| | - Wataru Fukuda
- Yokohama Sports Medical Center, Yokohama Sport Association, Kanagawa, 222-0036, Japan
| | - Maria Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, 96010-610 Pelotas, Brazil
| | - Silvana P Orlandi
- Nutrition Department, Federal University of Pelotas, 96010-610, Pelotas, Brazil
| | - Josely C Koury
- Nutrition Institute, State University of Rio de Janeiro, 20550-013, Rio de Janeiro, Brazil
| | - Tatiana Moro
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Antonio Paoli
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Salome Kruger
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, 2520, South Africa
| | - Aletta E Schutte
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, NSW, Australia
| | | | | | | | - Alfredo Irurtia
- National Institute of Physical Education of Catalonia (INEFC), University of Barcelona (UB), Barcelona, Spain
| | - Jorge Castizo-Olier
- School of Health Sciences, TecnoCampus, Pompeu Fabra University, Barcelona, Spain
| | - Gabriele Mascherini
- Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Cristian Petri
- Department of Sports and Computer Science, Section of Physical Education and Sports, Universidad Pablo de Olavide, Seville, Spain
| | - Laura K Busert
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mario Cortina-Borja
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | | | | | - Hadeel Ali Ghazzawi
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Adam Tawfiq Amawi
- Department of Physical and Health Education, Faculty of Educational Sciences, Al-Ahliyya Amman University, Al-Salt, Jordan
| | - Grant Tinsley
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, 79409, USA
| | - Suvi T Kangas
- International Rescue Committee, New York, NY, 10168, USA
| | - Cécile Salpéteur
- Department of Expertise and Advocacy, Action contre la Faim, 93358, Montreuil, France
| | - Adriana Vázquez-Vázquez
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mary Fewtrell
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Chiara Ceolin
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, 35128, Italy
| | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, 35128, Italy
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Berit L Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Frederiksberg and Bispebjerg Hospital, Copenhagen, Denmark
- Section for general Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Roberto Fernandes da Costa
- Department of Physical Education, Research Group in Physical Activity and Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | - German Vicente-Rodriguez
- Faculty of Health and Sport Science FCSD, Department of Physiatry and Nursing, University of Zaragoza, 50009, Zaragoza, Spain
| | - Margherita Micheletti Cremasco
- Laboratory of Anthropology, Anthropometry and Ergonomics, Department of Life Sciences and Systems Biology, University of Torino, 10123, Torino, Italy
| | - Alessia Moroni
- Laboratory of Anthropology, Anthropometry and Ergonomics, Department of Life Sciences and Systems Biology, University of Torino, 10123, Torino, Italy
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Jordan Moon
- United States Sports Academy, Daphne, AL, 36526, USA
| | - Tzachi Knaan
- Weight Management, Metabolism & Sports Nutrition Clinic, Metabolic Lab, Tel-Aviv, Tel Aviv-Yafo, Israel
| | - Manfred J Müller
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | - Wiebke Braun
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | - José M García-Almeida
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Malaga University, 29010, Malaga, Spain
| | | | - Inês Santos
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
| | - Sofus C Larsen
- Research Unit for Dietary Studies at the Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Xueying Zhang
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - John R Speakman
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- School of Biological Sciences, University of Aberdeen, Aberdeen, UK
| | - Lindsay D Plank
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Boyd A Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jude Thaddeus Ssensamba
- Center for Innovations in Health Africa (CIHA Uganda), Kampala, Uganda
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Keisuke Shiose
- Faculty of Education, University of Miyazaki, Miyazaki, Japan
| | - Edilson S Cyrino
- Metabolism, Nutrition, and Exercise Laboratory. Physical Education and Sport Center, State University of Londrina, Rod. Celso Garcia Cid, Km 380, 86057-970, Londrina-PR, Brazil
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | | | - Henry Lukaski
- Department of Kinesiology and Public Health Education, Hyslop Sports Center, University of North Dakota Grand Forks, Grand Forks, ND, 58202, USA
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002, Lisbon, Portugal
| | - Jonathan C Wells
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Elisabetta Marini
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
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Kajiyama S, Nakanishi N, Yamamoto S, Ichikawa T, Okamura T, Hashimoto Y, Kitagawa N, Hamaguchi M, Fukui M. The Impact of Nutritional Markers and Dietary Habits on the Bioimpedance Phase Angle in Older Individuals. Nutrients 2023; 15:3599. [PMID: 37630789 PMCID: PMC10458185 DOI: 10.3390/nu15163599] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Low phase angle (PhA), as determined via bioelectrical impedance analysis, reflects unhealthy aging and mortality. In this study, we assessed whether nutritional status, including serum nutritional markers and dietary habits, is related to PhA in older individuals. We recruited 212 participants (aged ≥ 65 years) who underwent medical health checkups. PhA was measured using a multi-frequency impedance body composition analyzer. Habitual food and nutrient intake was evaluated using a brief, self-administered diet history questionnaire. Low PhA values were defined as ≤4.95 in males and ≤4.35 in females. Males with low PhA had poor exercise habits (p = 0.0429) and a lower body mass index (p = 0.0024). PhA was significantly correlated with serum cholinesterase levels, a nutritional status marker (r = 0.3313, p = 0.0004 in males; r = 0.3221, p = 0.0070 in females). The low-PhA group had significantly lower total energy and carbohydrate intake per ideal body weight (IBW) than the high-PhA group in males (total energy intake:30.2 ± 9.8 and 34.5 ± 9.3 kcal/kg/day, p = 0.0307; carbohydrate intake:15.2 ± 4.9 and 18.0 ± 5.8 kcal/kg/day, p = 0.0157). Total energy intake per IBW (adjusted odds ratio [95% confidence interval], 0.94 [0.89-1.00] per 1 kcal/kg/day increase) was independently associated with a low PhA in males. Our study revealed that lower total energy intake independently impacted low PhA in older males.
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Affiliation(s)
- Shintaro Kajiyama
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Naoko Nakanishi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Shinta Yamamoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Takahiro Ichikawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi 570-8540, Japan
| | - Noriyuki Kitagawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Kameoka Municipal Hospital, Kyoto 621-8585, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
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10
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Martins PC, Alves Junior CAS, Silva AM, Silva DAS. Phase angle and body composition: A scoping review. Clin Nutr ESPEN 2023; 56:237-250. [PMID: 37344079 DOI: 10.1016/j.clnesp.2023.05.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 05/12/2023] [Accepted: 05/22/2023] [Indexed: 06/23/2023]
Abstract
The aim of the study was to map evidence on the association between phase angle (PhA) and body composition in populations healthy and clinical populations). A systematic search for information regarding the topic was conducted in nine electronic databases (CINAHL, LILACS, PubMed, SciELO, Scopus, SPORTDiscus, Science Direct, MEDLINE and Web of Science) between October and November 2021. Studies with different designs, which allowed extracting information about the relationship between PhA and body composition (body cell mass [BCM], muscle tissue, bone mineral content, lean mass, total fat mass, visceral fat, and lean soft tissue mass [LSTM]) were included. Of the total of 11,913 initially identified studies, 59 were included after reading titles, abstracts, full texts and references. Most studies (40.67%; n = 24) presented data from Brazilian samples. With regard to the design of studies, 15 (25.42%) had longitudinal design. The age group of studies was wide, with studies involved 3-year-old children and 88-year-old adults. Body fat mass was evaluated by 31 studies (52.54%) in which 11 observed inverse relationships, nine studies showed direct relationships and 11 observed no relationship. Regarding lean mass, muscle mass, and fat-free mass components, most studies observed direct relationship with PhA (n = 37; 86.04%). It could be concluded that the phase angle was directly associated with lean mass and muscle mass in different age groups (children, adolescents, adults and older adults) and in people with different health diagnoses (HIV, cancer, hemodialysis, sarcopenia and without the diagnosis of diseases). Regarding body fat and the other investigated components, there is not enough evidence to establish the direction of associations.
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Affiliation(s)
- Priscila Custódio Martins
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianópolis, SC, 88040900, Brazil.
| | - Carlos Alencar Souza Alves Junior
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianópolis, SC, 88040900, Brazil.
| | - Analiza Mónica Silva
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Estrada da Costa, 1499-002 Cruz-Quebrada, Portugal.
| | - Diego Augusto Santos Silva
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianópolis, SC, 88040900, Brazil.
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11
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Cimmino F, Petrella L, Cavaliere G, Ambrosio K, Trinchese G, Monda V, D’Angelo M, Di Giacomo C, Sacconi A, Messina G, Mollica MP, Catapano A. A Bioelectrical Impedance Analysis in Adult Subjects: The Relationship between Phase Angle and Body Cell Mass. J Funct Morphol Kinesiol 2023; 8:107. [PMID: 37606402 PMCID: PMC10443260 DOI: 10.3390/jfmk8030107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2023] [Revised: 07/22/2023] [Accepted: 07/26/2023] [Indexed: 08/23/2023] Open
Abstract
The correct assessment of body composition is essential for an accurate diagnostic evaluation of nutritional status. The body mass index (BMI) is the most widely adopted indicator for evaluating undernutrition, overweight, and obesity, but it is unsuitable for differentiating changes in body composition. In recent times, bioelectrical impedance analyses (BIA) have been proven as a more accurate procedure for the assessment of body composition. Furthermore, the efficiency of bioelectrical impedance vector analyses, as an indicator of nutritional status and hydration, has been demonstrated. By applying a bioimpedance analysis, it is possible to detect fat mass (FM), fat free mass (FFM), phase angle, and body cell mass (BCM). It is important to point out that phase angle and BCM are strongly associated with health status. The aim of this research was to examine body composition and the association between the phase angle and BCM in 87 subjects (14 males and 73 females), aged between 23 and 54 years, with BMIs ranging from 17.0 to 32.0 kg/m2, according to sex. The BMI results revealed that the majority of the assessed subjects were within the normal range and had a normal percentage of FM. Our data indicate that a direct relation exists between phase angle and cellular health and that these values increase almost linearly. Consequently, a high phase angle may be related to increased BCM values.
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Affiliation(s)
- Fabiano Cimmino
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (L.P.); (K.A.); (G.T.); (C.D.G.); (A.S.); (M.P.M.)
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant’Angelo, 80126 Naples, Italy;
| | - Lidia Petrella
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (L.P.); (K.A.); (G.T.); (C.D.G.); (A.S.); (M.P.M.)
| | - Gina Cavaliere
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant’Angelo, 80126 Naples, Italy;
- Department of Pharmaceutical Sciences, University of Perugia, 06126 Perugia, Italy
| | - Katia Ambrosio
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (L.P.); (K.A.); (G.T.); (C.D.G.); (A.S.); (M.P.M.)
| | - Giovanna Trinchese
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (L.P.); (K.A.); (G.T.); (C.D.G.); (A.S.); (M.P.M.)
| | - Vincenzo Monda
- Department of Movement Sciences and Wellbeing, University of Naples “Parthenope”, 80133 Naples, Italy;
| | - Margherita D’Angelo
- Department of Experimental Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Cristiana Di Giacomo
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (L.P.); (K.A.); (G.T.); (C.D.G.); (A.S.); (M.P.M.)
| | - Alessandro Sacconi
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (L.P.); (K.A.); (G.T.); (C.D.G.); (A.S.); (M.P.M.)
| | - Giovanni Messina
- Department of Clinical and Experimental Medicine, University of Foggia, 71122 Foggia, Italy;
| | - Maria Pina Mollica
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (L.P.); (K.A.); (G.T.); (C.D.G.); (A.S.); (M.P.M.)
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant’Angelo, 80126 Naples, Italy;
- Task Force on Microbiome Studies, University of Naples Federico II, 80138 Naples, Italy
| | - Angela Catapano
- Department of Biology, University of Naples Federico II, 80126 Naples, Italy; (L.P.); (K.A.); (G.T.); (C.D.G.); (A.S.); (M.P.M.)
- Centro Servizi Metrologici e Tecnologici Avanzati (CeSMA), Complesso Universitario di Monte Sant’Angelo, 80126 Naples, Italy;
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da Silva BR, Rufato S, Mialich MS, Cruz LP, Gozzo T, Jordão AA. Phase angle is related to oxidative stress and antioxidant biomarkers in breast cancer patients undergoing chemotherapy. PLoS One 2023; 18:e0283235. [PMID: 37289671 PMCID: PMC10249836 DOI: 10.1371/journal.pone.0283235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 03/06/2023] [Indexed: 06/10/2023] Open
Abstract
PURPOSE The study aimed to analyze the influence of chemotherapy on health biomarkers and examine the relationship between phase angle (PhA) and oxidative stress. METHODS A prospective study was performed. Women who were starting chemotherapy were recruited. Also, this study included a control group of women without cancer. Bioelectrical impedance multiple-frequency (BIS) analysis, 24h food recall, and blood samples were collected at 2-time points: diagnosis (T0) and after one month of completion of therapy (T1) for the main study group and one-time point for the control group. T-tests or Mann-Whitney Wilcoxon Test was used to compare variables. Linear regression analysis was conducted to test if PhA is related to the dependent variables after adjusting for age and body mass index. RESULTS 119 women were included (61 with breast cancer and 58 healthy). There was no difference between the groups concerning anthropometrics, fat mass, and fat-free mass. Breast cancer patients had a worsening in PhA (p<0.001) after chemotherapy completion. PhA was positive statistically correlated with extracellular water, albumin, and the antioxidant markers at both times. The linear model showed that PhA was significantly predicted by C reactive protein, 2,2-Diphenyl-1-picrylhydrazyl (DPPH), Malondialdehyde (MDA), total body water/extracellular water, and body mass index fat mass. This model explained 58% of PhA variability (p<0.001). CONCLUSION Our findings show that PhA is an easy and affordable tool that correlates oxidative stress markers in breast cancer patients, regardless of age or body mass index.
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Affiliation(s)
- Bruna R. da Silva
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Sarah Rufato
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Mirele S. Mialich
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
| | - Loris P. Cruz
- Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Thais Gozzo
- Nursing School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alceu A. Jordão
- Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo (USP), Ribeirão Preto, São Paulo, Brazil
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de Queiroz Júnior JRA, da Costa Pereira JP, Benjamim RDAC, da Silva NOL, de Paiva Silva ME, Pinho Ramiro CPS. Relationship between sarcopenia and cachexia with prognostic markers of middle-aged and older inpatients with COVID-19: a case-control study. Eur Geriatr Med 2023:10.1007/s41999-023-00792-z. [PMID: 37162646 PMCID: PMC10171161 DOI: 10.1007/s41999-023-00792-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 04/24/2023] [Indexed: 05/11/2023]
Abstract
PURPOSE SARS-CoV-2 infection can lead to various manifestations beyond an inflammatory response, such as anorexia, hyposmia, and other symptoms that may increase the risk of nutritional disorders. Sarcopenia and cachexia are conditions that appear to influence COVID-19 evolution. Thus, this study aimed to evaluate sarcopenia and cachexia in hospitalized patients with COVID-19, verifying their clinical impacts and relationship with prognostic markers. METHODS This is a case-control study involving inpatients with and without a COVID-19 diagnosis. The occurrence of sarcopenia was evaluated according to European Working Group on Sarcopenia 2 criteria. Cachexia was evaluated according to (Evans et al. in Clin Nutr 27:793-799, 2008) criteria. Inflammatory markers and the 4C Mortality Score were evaluated. RESULTS Our study included 96 individuals, divided into two groups: COVID-19 (n = 32) and control (n = 64). The mean age of the COVID-19 group was 63.3 ± 11.8 years, and the control group had a mean age of 64.3 ± 5.5 years. No significant differences in mean age were found between the groups. The prevalence of sarcopenia and cachexia in patients with COVID-19 was 21.9% and 28.1%, respectively, while in the control group, it was 29.7% and 26.6%, respectively. Sarcopenic patients with COVID-19 had a higher risk of death (4C Mortality Score) (p = 0.038). The occurrence of sarcopenia or cachexia within the COVID-19 group was not associated with inflammatory biomarkers or a higher number of COVID-19 symptoms (p > 0.05). CONCLUSION The presence of sarcopenia among COVID-19 patients increased the risk of mortality.
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Affiliation(s)
| | - Jarson Pedro da Costa Pereira
- Federal University of Pernambuco, Prof. Moraes Rego Avenue, 1235-Cidade Universitária, Recife, Pernambuco, 50670-901, Brazil.
- , Av. Prof. Moraes Rego, 1235, Cidade Universitária, Recife, Pernambuco, 50670-901, Brazil.
| | | | - Nahara Oliveira Lima da Silva
- Federal University of Pernambuco, Prof. Moraes Rego Avenue, 1235-Cidade Universitária, Recife, Pernambuco, 50670-901, Brazil
| | | | - Cláudia Porto Sabino Pinho Ramiro
- Cardiologic Emergency Room of Pernambuco, Luiz Tavares Professor, Recife, Pernambuco, Brazil
- Hospital das Clinicas of Pernambuco, Recife, Pernambuco, Brazil
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14
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Unterberger S, Aschauer R, Zöhrer PA, Draxler A, Aschauer M, Kager B, Franzke B, Strasser EM, Wagner KH, Wessner B. Association of Bioelectrical Impedance Phase Angle with Physical Performance and Nutrient Intake of Older Adults. Nutrients 2023; 15:nu15061458. [PMID: 36986185 PMCID: PMC10057147 DOI: 10.3390/nu15061458] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
In recent years, the phase angle (PhA) as a raw bioelectrical impedance analysis variable has gained attention to assess cell integrity and its association to physical performance in either sports-related or clinical settings. However, data on healthy older adults are scarce. Therefore, data on body composition, physical performance and macronutrient intake from older adults (n = 326, 59.2% women, 75.2 ± 7.2 years) were retrospectively analyzed. Physical performance was evaluated by the Senior Fitness Test battery, gait speed, timed up and go and handgrip strength. Body composition was determined by the BIA and dual-energy X-ray absorptiometry (from a subgroup of n = 51). The PhA was negatively associated with the timed up and go test and age (r = -0.312 and -0.537, p < 0.001), and positively associated with the 6 min walk test, 30 s chair stand, handgrip strength, gait speed and physical performance score (r = 0.170-0.554, p < 0.05), but not protein intake (r = 0.050, p = 0.386). Hierarchical multiple regression analysis showed that especially age, sex, BMI, but also the PhA predicted the performance test outcomes. In conclusion, the PhA seems to be an interesting contributor to physical performance, but sex- and age-specific norm values still need to be determined.
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Affiliation(s)
- Sandra Unterberger
- Research Platform Active Ageing, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
- Institute of Sport Science, Centre for Sport Science and University Sports, University of Vienna, Auf der Schmelz 6, 1150 Vienna, Austria
- Vienna Doctoral School of Pharmaceutical, Nutritional and Sport Sciences (PhaNuSpo), University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Rudolf Aschauer
- Research Platform Active Ageing, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
- Institute of Sport Science, Centre for Sport Science and University Sports, University of Vienna, Auf der Schmelz 6, 1150 Vienna, Austria
- Vienna Doctoral School of Pharmaceutical, Nutritional and Sport Sciences (PhaNuSpo), University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Patrick A Zöhrer
- Research Platform Active Ageing, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
- Vienna Doctoral School of Pharmaceutical, Nutritional and Sport Sciences (PhaNuSpo), University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Agnes Draxler
- Vienna Doctoral School of Pharmaceutical, Nutritional and Sport Sciences (PhaNuSpo), University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Mirjam Aschauer
- Institute of Sport Science, Centre for Sport Science and University Sports, University of Vienna, Auf der Schmelz 6, 1150 Vienna, Austria
| | - Benno Kager
- Institute of Sport Science, Centre for Sport Science and University Sports, University of Vienna, Auf der Schmelz 6, 1150 Vienna, Austria
| | - Bernhard Franzke
- Research Platform Active Ageing, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Eva-Maria Strasser
- Karl Landsteiner Institute for Remobilization and Functional Health/Institute for Physical Medicine and Rehabilitation, Kaiser Franz Joseph Hospital, Social Medical Center South, 1100 Vienna, Austria
| | - Karl-Heinz Wagner
- Research Platform Active Ageing, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
- Department of Nutritional Sciences, Faculty of Life Sciences, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
| | - Barbara Wessner
- Research Platform Active Ageing, University of Vienna, Josef-Holaubek-Platz 2, 1090 Vienna, Austria
- Institute of Sport Science, Centre for Sport Science and University Sports, University of Vienna, Auf der Schmelz 6, 1150 Vienna, Austria
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15
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Muñoz-Redondo E, Morgado-Pérez A, Pérez-Sáez MJ, Faura A, Sánchez-Rodríguez D, Tejero-Sánchez M, Meza-Valderrama D, Muns MD, Pascual J, Marco E. Low Phase Angle Values Are Associated with Malnutrition according to the Global Leadership Initiative on Malnutrition Criteria in Kidney Transplant Candidates: Preliminary Assessment of Diagnostic Accuracy in the FRAILMar Study. Nutrients 2023; 15:nu15051084. [PMID: 36904084 PMCID: PMC10005429 DOI: 10.3390/nu15051084] [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: 01/22/2023] [Revised: 02/09/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Malnutrition has a negative impact on patients with chronic diseases and its early identification is a priority. The primary objective of this diagnostic accuracy study was to assess the performance of the phase angle (PhA), a bioimpedance analysis (BIA)-derived parameter, for malnutrition screening using the Global Leadership Initiative for Malnutrition (GLIM) criteria as the reference standard in patients with advanced chronic kidney disease (CKD) waiting for kidney transplantation (KT); criteria associated with low PhA in this population were also analyzed. Sensitivity, specificity, accuracy, positive and negative likelihood ratios, predictive values, and area under the receiver operating characteristic curve were calculated for PhA (index test) and compared with GLIM criteria (reference standard). Of 63 patients (62.9 years old; 76.2% men), 22 (34.9%) had malnutrition. The PhA threshold with the highest accuracy was ≤4.85° (sensitivity 72.7%, specificity 65.9%, and positive and negative likelihood ratios 2.13 and 0.41, respectively). A PhA ≤ 4.85° was associated with a 3.5-fold higher malnutrition risk (OR = 3.53 (CI95% 1.0-12.1)). Considering the GLIM criteria as the reference standard, a PhA ≤ 4.85° showed only fair validity for detecting malnutrition, and thus cannot be recommended as a stand-alone screening tool in this population.
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Affiliation(s)
- Elena Muñoz-Redondo
- Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar–Hospital de l’Esperança), 08003 Barcelona, Spain
- Rehabilitation Research Group, Hospital del Mar Medical Research Group, 08003 Barcelona, Spain
- PhD Program in Medicine, Department of Medicine, Universitat Autònoma de Barcelona, 08035 Barcelona, Spain
| | - Andrea Morgado-Pérez
- Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar–Hospital de l’Esperança), 08003 Barcelona, Spain
- Rehabilitation Research Group, Hospital del Mar Medical Research Group, 08003 Barcelona, Spain
| | - María-José Pérez-Sáez
- Nephrology Department, Hospital del Mar, 08003 Barcelona, Spain
- Kidney Disease Research Group, Hospital del Mar Medical Research Group, 08003 Barcelona, Spain
- Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Dr Aiguader Building (Mar Campus), 08003 Barcelona, Spain
| | - Anna Faura
- Nephrology Department, Hospital del Mar, 08003 Barcelona, Spain
| | - Dolores Sánchez-Rodríguez
- Geriatrics Department, Brugmann University Hospital, Université Libre de Bruxelles, 1020 Brussels, Belgium
- Geriatrics Department, Parc de Salut Mar (Centre Fòrum), 08019 Barcelona, Spain
- WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, Université of Liège, Campus Sart Tilman, Quartier Hôpital, 4000 Liège, Belgium
| | - Marta Tejero-Sánchez
- Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar–Hospital de l’Esperança), 08003 Barcelona, Spain
- Rehabilitation Research Group, Hospital del Mar Medical Research Group, 08003 Barcelona, Spain
| | - Delky Meza-Valderrama
- Rehabilitation Research Group, Hospital del Mar Medical Research Group, 08003 Barcelona, Spain
- Physical Medicine and Rehabilitation Department, National Institute of Physical Medicine and Rehabilitation (INMFRE), Diagonal a la Universidad Tecnológica de Panamá, Panama City 0819, Panama
| | - María Dolors Muns
- Department of Endocrinology and Nutrition, Hospital del Mar, 08003 Barcelona, Spain
| | - Julio Pascual
- Nephrology Department, Hospital Universitario 12 de Octubre, 28041 Madrid, Spain
| | - Ester Marco
- Physical Medicine and Rehabilitation Department, Parc de Salut Mar (Hospital del Mar–Hospital de l’Esperança), 08003 Barcelona, Spain
- Rehabilitation Research Group, Hospital del Mar Medical Research Group, 08003 Barcelona, Spain
- Faculty of Health and Life Sciences, Universitat Pompeu Fabra, Dr Aiguader Building (Mar Campus), 08003 Barcelona, Spain
- Correspondence:
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García-Almeida JM, García-García C, Ballesteros-Pomar MD, Olveira G, Lopez-Gomez JJ, Bellido V, Bretón Lesmes I, Burgos R, Sanz-Paris A, Matia-Martin P, Botella Romero F, Ocon Breton J, Zugasti Murillo A, Bellido D. Expert Consensus on Morphofunctional Assessment in Disease-Related Malnutrition. Grade Review and Delphi Study. Nutrients 2023; 15:nu15030612. [PMID: 36771319 PMCID: PMC9920608 DOI: 10.3390/nu15030612] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 01/13/2023] [Accepted: 01/18/2023] [Indexed: 01/27/2023] Open
Abstract
Disease-related malnutrition (DRM) affects approximately a third of hospitalized patients and is associated with an increased risk of morbimortality. However, DRM is often underdiagnosed and undertreated. Our aim is to evaluate the prognostic value of morphofunctional tools and tests for nutritional assessment in clinical practice. A systematic literature review was conducted to identify studies relating to the morphofunctional assessment of nutritional status and mortality or complications. Evidence was evaluated using the GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) method. Twelve GRADE recommendations were made and divided into seven topics: food intake and nutrient assimilation, anthropometry, biochemical analysis, hand grip strength, phase angle, muscle imaging, and functional status and quality of life. From these recommendations, 37 statements were developed and scored in a two-survey Delphi method by 183 experts. A consensus was reached on accepting 26/37 statements. Surveys had high internal consistency and high inter-rater reliability. In conclusion, evidence-based recommendations were made on the prognostic value of morphofunctional assessment tools and tests to assess malnutrition, most of which were found to be feasible in routine clinical practice, according to expert opinions.
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Affiliation(s)
- José Manuel García-Almeida
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario Virgen de la Victoria, 29010 Málaga, Spain
- IBIMA, Instituto de Investigación Biomédica y Plataforma en Nanomedicina, BIONAND, 29590 Málaga, Spain
- CIBEROBN, Centro de Investigación Biomédica en Red, Fisiopatología de la Obesidad y Nutrición, 28029 Madrid, Spain
- Department of Endocrinology and Nutrition, Hospital Quirónsalud, 29004 Málaga, Spain
- Facultad de Medicina, University of Málaga, 29010 Málaga, Spain
| | - Cristina García-García
- PhD Program in Biomedicine, Translational Research and New Health Technologies, Faculty of Medicine, University of Málaga, 29071 Málaga, Spain
- Medical Director, Persan Farma, 35007 Las Palmas de Gran Canaria, Spain
- Correspondence: ; Tel.: +34-670326887
| | - María D. Ballesteros-Pomar
- Department of Endocrinology and Nutrition, Complejo Asistencial Universitario de León, 24071 León, Spain
| | - Gabriel Olveira
- IBIMA, Instituto de Investigación Biomédica y Plataforma en Nanomedicina, BIONAND, 29590 Málaga, Spain
- Facultad de Medicina, University of Málaga, 29010 Málaga, Spain
- Department of Endocrinology and Nutrition, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- CIBERDEM, Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas, Instituto de Salud Carlos III, 29010 Málaga, Spain
- Department of Medicine and Dermatology, University of Málaga, 29016 Málaga, Spain
| | - Juan J. Lopez-Gomez
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Virginia Bellido
- Department of Endocrinology and Nutrition, Hospital Universitario Virgen del Rocío, 41013 Sevilla, Spain
| | - Irene Bretón Lesmes
- Department of Endocrinology and Nutrition, Hospital General Universitario Gregorio Marañón, 28007 Madrid, Spain
| | - Rosa Burgos
- Nutritional Support Unit, Vall d’Hebron Barcelona Hospital Campus, 08035 Barcelona, Spain
| | - Alejandro Sanz-Paris
- Department of Endocrinology and Nutrition, University Hospital Miguel Servet, 50009 Zaragoza, Spain
- Instituto de Investigación Sanitaria (IIS) Aragón, 50009 Zaragoza, Spain
| | - Pilar Matia-Martin
- Department of Endocrinology and Nutrition, Hospital Clínico San Carlos, 28040 Madrid, Spain
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
- Medicine Department, Universidad Complutense, 28040 Madrid, Spain
| | - Francisco Botella Romero
- Department of Endocrinology and Nutrition, Complejo Hospitalario de Albacete, 02006 Albacete, Spain
| | - Julia Ocon Breton
- Department of Endocrinology and Nutrition, Hospital Clínico Universitario Lozano Blesa, 50009 Zaragoza, Spain
| | - Ana Zugasti Murillo
- Nutrition Department, Hospital Universitario de Navarra, 31008 Pamplona, Spain
| | - Diego Bellido
- Department of Endocrinology and Nutrition, Complejo Hospitalario de Ferrol, 15405 Ferrol, Spain
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17
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Wauters L, Dermine S, de Dreuille B, Bettolo J, Hutinet C, Mohamed A, Lecoq E, Billiauws L, Nuzzo A, Corcos O, Joly F. Malnutrition with Low Muscle Mass Is Common after Weaning off Home Parenteral Nutrition for Chronic Intestinal Failure. Nutrients 2023; 15:338. [PMID: 36678209 PMCID: PMC9860702 DOI: 10.3390/nu15020338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 01/07/2023] [Accepted: 01/09/2023] [Indexed: 01/12/2023] Open
Abstract
The differences in outcomes after weaning off intravenous support (IVS) for chronic intestinal failure (IF) are unclear. Adult IF patients who are weaned off IVS at a tertiary care center (June 2019−2022) were included in this study, and nutritional and functional markers were assessed before, during, and after weaning. Short bowel syndrome (SBS) was present in 77/98 of the IF patients, with different outcomes according to the final anatomy. The body weight and the BMI increased during IVS in those with a jejunocolonic (JC) anastomosis (p < 0.001), but weight loss was significant during follow-up (p < 0.001). Malnutrition was present in >60%, with a reduced muscle mass, which was found using bioelectrical impedance analysis (BIA), in >50% of SBS-JC patients. Although reduced hand-grip strength and sarcopenia were less common, the muscle quality, or phase angle (BIA), decreased during follow-up, also correlating with serum albumin and muscle mass (p ≤ 0.01). The muscle quality and albumin were low in the patients restarting IVS, which was only the case with ≤60 cm of small bowel. Closer follow-up and earlier treatment with teduglutide (TED) should be considered in these patients, as none of the TED-treated patients were malnourished or sarcopenic. Studies on the potential benefits of nutritional and physical interventions for low muscle mass and associations with outcomes are needed in chronic IF patients.
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Affiliation(s)
- Lucas Wauters
- Department of Gastroenterology and Hepatology, University Hospitals Leuven, 3000 Leuven, Belgium
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
- Institut National de la Santé et de la Recherche Médicale (INSERM), University of Paris, UMR 1149, 75890 Paris, France
| | - Solène Dermine
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
| | - Brune de Dreuille
- Institut National de la Santé et de la Recherche Médicale (INSERM), University of Paris, UMR 1149, 75890 Paris, France
| | - Joanna Bettolo
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
| | - Coralie Hutinet
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
| | - Ashiq Mohamed
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
| | - Emilie Lecoq
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
| | - Lore Billiauws
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
| | - Alexandre Nuzzo
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
- Laboratoire de Recherche Vasculaire Translationnelle (LVTS), Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Cité, Bichat Hospital, U1148, 75018 Paris, France
| | - Olivier Corcos
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
- Laboratoire de Recherche Vasculaire Translationnelle (LVTS), Institut National de la Santé et de la Recherche Médicale (INSERM), Université Paris Cité, Bichat Hospital, U1148, 75018 Paris, France
| | - Francisca Joly
- Department of Gastroenterology and Nutrition Support, APHP Beaujon Hospital, 92110 Clichy, France
- Institut National de la Santé et de la Recherche Médicale (INSERM), University of Paris, UMR 1149, 75890 Paris, France
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18
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Smith LO, Olieman JF, Berk KA, Ligthart-Melis GC, Earthman CP. Clinical applications of body composition and functional status tools for nutrition assessment of hospitalized adults: A systematic review. JPEN J Parenter Enteral Nutr 2023; 47:11-29. [PMID: 36036239 DOI: 10.1002/jpen.2444] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 08/16/2022] [Accepted: 08/22/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND No global consensus exists on diagnostic criteria for malnutrition. Muscular deficits and functional impairments are major components of available malnutrition diagnostic frameworks because these facets of nutrition status significantly impact outcomes. The purpose of this review is to explore which body composition assessment (BCA) and functional status assessment (FSA) tools are being used for nutrition assessment (NA) and monitoring the response to nutrition interventions (RNIs) in adult inpatients. METHODS A literature search of Embase, Medline (Ovid), Web of Science, and Cochrane Central was performed to identify studies that used BCA and/or FSA tools for NA (along with an accepted NA diagnostic framework) and/or for monitoring RNI in adult inpatients. RESULTS The search yielded 3667 articles; 94 were included in the review. The number of studies using BCA and/or FSA tools for NA was 47 and also 47 for monitoring RNI. Seventy-nine percent of studies used bioimpedance for BCA, and 97% that included FSA utilized handgrip strength. When compared against sets of diagnostic criteria, many of the BCA and FSA tools showed promising associations with nutrition status. CONCLUSION Bioimpedance methods are the most widely used bedside BCA tools, and handgrip strength is the most widely used FSA tool; however, these methods are being used with a variety of protocols, algorithms, and interpretation practices in heterogeneous populations. To create a standardized nutrition status assessment process there is a need for validation studies on bedside methods and the development of globally standardized assessment protocols in clinical inpatient settings.
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Affiliation(s)
- Luke O Smith
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - Joanne F Olieman
- Division of Dietetics, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Kirsten A Berk
- Division of Dietetics, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Gerdien C Ligthart-Melis
- Division of Dietetics, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Carrie P Earthman
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
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19
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Langer RD, Ward LC, Larsen SC, Heitmann BL. Can change in phase angle predict the risk of morbidity and mortality during an 18-year follow-up period? A cohort study among adults. Front Nutr 2023; 10:1157531. [PMID: 37200946 PMCID: PMC10186468 DOI: 10.3389/fnut.2023.1157531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Accepted: 03/22/2023] [Indexed: 05/20/2023] Open
Abstract
Introduction Phase angle (PhA, degrees), measured via bioimpedance (BIA, 50 kHz), is an index that has been used as an indicator of nutritional status and mortality in several clinical situations. This study aimed to determine the relationship between 6-year changes in PhA and total mortality as well as the risk of incident morbidity and mortality from cardiovascular disease (CVD) and coronary heart disease (CHD) during 18 years of follow-up among otherwise healthy adults. Methods A random subset (n = 1,987) of 35-65 years old men and women was examined at the baseline in 1987/1988 and 6 years later in 1993/1994. Measures included weight, height, and whole-body BIA, from which PhA was calculated. Information on lifestyle was obtained through a questionnaire. The associations between 6-year PhA changes (ΔPhA) and incident CVD and CHD were assessed by Cox proportional hazard models. The median value of ΔPhA was used as the reference value. The hazard ratio (HR) model and confidence intervals (CIs) of incident CVD and CHD were used according to the 5th, 10th, 25th, 50th, 75th, 90th, and 95th percentiles of ΔPhA. Results During 18 years of follow-up, 205 women and 289 men died. A higher risk of both total mortality and incident CVD was present below the 50th percentile (Δ = -0.85°). The highest risk was observed below the 5th percentile (ΔPhA = -2.60°) in relation to total mortality (HR: 1.55; 95% CI: 1.10-2.19) and incident CVD (HR: 1.52; 95% CI: 1.16-2.00). Discussion The larger the decrease in PhA, the higher the risk of early mortality and incident CVD over the subsequent 18 years. PhA is a reliable and easy measure that may help identify those apparently healthy individuals who may be at increased risk of future CVD or dying prematurely. More studies are needed to confirm our results before it can be definitively concluded that PhA changes can improve clinical risk prediction.
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Affiliation(s)
- Raquel D. Langer
- Research Unit for Dietary Studies, Parker Institute, Copenhagen, Denmark
- Growth and Development Laboratory, Center for Investigation in Pediatrics, State University of Campinas, Campinas, Brazil
- *Correspondence: Raquel D. Langer
| | - Leigh C. Ward
- School of Chemistry and Molecular Biosciences, Faculty of Science, The University of Queensland, Brisbane, QLD, Australia
| | - Sofus C. Larsen
- Research Unit for Dietary Studies, Parker Institute, Copenhagen, Denmark
- Section for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Berit L. Heitmann
- Research Unit for Dietary Studies, Parker Institute, Copenhagen, Denmark
- Section for General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- The Boden Initiative, Charles Perkins Centre, The University of Sydney, Sydney, NSW, Australia
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20
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Shi J, Xie H, Ruan G, Ge Y, Lin S, Zhang H, Zheng X, Liu C, Song M, Liu T, Zhang X, Yang M, Liu X, Zhang Q, Deng L, Wang X, Shi H. Sex differences in the association of phase angle and lung cancer mortality. Front Nutr 2022; 9:1061996. [PMID: 36618681 PMCID: PMC9818340 DOI: 10.3389/fnut.2022.1061996] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 12/05/2022] [Indexed: 12/24/2022] Open
Abstract
Background Lung cancer is a lethal malignant tumor that is common worldwide and is associated with a high incidence of malnutrition. Phase angle (PA) is a simple, objective, and non-invasive indicator of body composition that has increasingly attracted attention as an indicator of the nutritional status and prognosis of patients with malignant tumors. This study aimed to investigate the association between the PA and overall survival in patients with lung cancer. Methods This study prospectively analyzed 804 lung cancer patients in the Investigation on Nutrition Status and its Clinical Outcome of Common Cancers (INSCOC) project from 40 hospitals in China. We used a restricted cubic spline to analyze the sex-specific association between PA and mortality in men and women with lung cancer. Cox regression analysis was used to evaluate the independent association between PA and mortality in men and women. Sensitivity analysis was performed. The Kaplan-Meier method was used to evaluate the survival of patients with high and low PA values. Results There was an L-shaped association between PA and survival in both men and women with lung cancer (p = 0.019 and p = 0.121, respectively). Kaplan-Meier survival analysis suggested that patients with a high PA showed a better survival than patients with a low PA (p = 0.007 for men and p < 0.001 for women). Multivariate-adjusted Cox regression analysis showed that PA was an independent risk factor for mortality in men (HR = 0.79, 95% CI = 0.65-0.95, p = 0.015), but not in women (HR = 0.83, 95% CI = 0.67-1.04, p = 0.105). Conclusion Phase angle is an independent risk factor for the mortality of male lung cancer patients. However, its role in predicting the mortality of female lung cancer patients seems to be limited.
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Affiliation(s)
- Jinyu Shi
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Hailun Xie
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Guotian Ruan
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Yizhong Ge
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Shiqi Lin
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Heyang Zhang
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Xin Zheng
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Chen’an Liu
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Mengmeng Song
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Tong Liu
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Xiaowei Zhang
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Ming Yang
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Xiaoyue Liu
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Qi Zhang
- Department of Colorectal Surgery, Cancer Hospital of the University of Chinese Academy of Sciences, Zhejiang Cancer Hospital, Hangzhou, China
| | - Li Deng
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Xin Wang
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
| | - Hanping Shi
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, China
- Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China
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21
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Polak-Szczybyło E, Stępień AE, Zielińska M, Dąbrowski M. Hashimoto Thyroiditis, but Not Hypothyroidism Due to Other Causes, Is Associated with Lower Phase Angle Score in Adult Women: A Pilot Cross-Sectional Study. J Clin Med 2022; 12:jcm12010056. [PMID: 36614854 PMCID: PMC9821760 DOI: 10.3390/jcm12010056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/18/2022] [Accepted: 12/19/2022] [Indexed: 12/24/2022] Open
Abstract
PURPOSE In recent years, Hashimoto's thyroiditis (HT) has become one of the commonest autoimmune diseases. Its clinical symptoms include systemic manifestations related mainly, but not solely, to thyroid hormone deficiency. The bioimpedance phase angle (PhA) is a reliable indicator of nutritional as well as cellular health status. PhA is decreased not only in malnutrition, but also in many inflammatory diseases. The aim of this study was to assess the relationship between HT and PhA score. METHODS In this cross-sectional study, we compared the anthropometric, laboratory and body composition parameters of 49 women with HT and 98 propensity-score-matched women without thyroid disease. RESULTS Females with HT had significantly lower PhA scores (5.78 ± 0.43) compared to women without a thyroid disorder (5.98 ± 0.49, p = 0.017). Regarding TSH levels, although they were within the normal range in all study participants, in women with HT, they were slightly but significantly higher. Women with HT treated with L-thyroxin had significantly higher PhA compared to their non-treated counterparts. No differences between women with non-HT hypothyroidism and the control group were found. CONCLUSIONS Decreased PhA scores in patients with HT may indicate that the inflammatory process in this autoimmune disease has an influence on cellular health and on the function of the entire body. Such an association was not found in women with non-HT hypothyroidism.
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Affiliation(s)
- Ewelina Polak-Szczybyło
- Department of Dietetics, Institute of Health Sciences, University of Rzeszow, College of Medical Sciences, 35-959 Rzeszów, Poland
| | - Agnieszka Ewa Stępień
- Department of Dietetics, Institute of Health Sciences, University of Rzeszow, College of Medical Sciences, 35-959 Rzeszów, Poland
- Correspondence:
| | - Magdalena Zielińska
- Department of Dietetics, Institute of Health Sciences, University of Rzeszow, College of Medical Sciences, 35-959 Rzeszów, Poland
| | - Mariusz Dąbrowski
- Institute of Medical Sciences, University of Rzeszow, College of Medical Sciences, 35-959 Rzeszów, Poland
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22
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Gobbi M, Brunani A, Arreghini M, Baccalaro G, Dellepiane D, La Vela V, Lucchetti E, Barbaglia M, Cova A, Fornara E, Galli S, Cimolin V, Brugliera L, Capodaglio P. Nutritional status in post SARS-Cov2 rehabilitation patients. Clin Nutr 2022; 41:3055-3060. [PMID: 34049750 PMCID: PMC8056781 DOI: 10.1016/j.clnu.2021.04.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 12/22/2020] [Accepted: 04/07/2021] [Indexed: 01/27/2023]
Abstract
BACKGROUND & AIMS After prolonged hospitalization, the assessment of nutritional status and the identification of adequate nutritional support is of paramount importance. In this observational study, we aimed at assessing the presence of a malnutrition condition in SARS-Cov2 patients after the acute phase and the effects of a multidisciplinary rehabilitation program on nutritional and functional status. METHODS We recruited 48 patients (26 males/22 females) admitted to our Rehabilitation Unit after discharge from acute Covid Hospitals in northern Italy with negative swab for SARS-Cov2. We used the Global Leadership Initiative on Malnutrition (GLIM) criteria to identify patients with different degrees of malnutrition. Patients underwent a 3 to 4-week individual multidisciplinary rehabilitation program consisting of nutritional intervention (energy intake 27to30 kcal/die/kg and protein intake 1-1.3 g/die/kg), exercise for total body conditioning and progressive aerobic exercise with cycle- and arm-ergometer (45 min, 5 days/week). At admission and discharge from our Rehabilitation Unit, body composition and phase angle (PhA) (BIA101 Akern), muscle strength (handgrip, HG) and physical performance (Timed-Up-and-Go, TUG) were assessed. RESULTS At admission in all patients the mean weight loss, as compared to the habitual weight, was -12.1 (7.6)%, mean BMI was 25.9 (7.9) kg/m2, mean Appendicular Skeletal Muscle Index (ASMI) was 6.6 (1.7) kg/m2 for males and 5.4 (1.4) kg/m2 for females, mean phase angle was 2.9 (0.9)°, mean muscle strength (HG) was 21.1 (7.8) kg for males and 16.4 (5.9) kg for females, mean TUG value was 23.7 (19.2) s. Based on GLIM criteria 29 patients (60% of the total) showed a malnutrition condition. 7 out of those 29 patients (24%) presented a mild/moderate grade and 22 patients (76%) a severe grade. After a rehabilitation program of an average duration of 25 days (range 13-46) ASMI increased, with statistically significant differences only in females (p = 0.001) and HG improved only in males (p = 0.0014). In all of the patients, body weight did not change, CRP/albumin (p < 0.05) and TUG (p < 0.001) were reduced and PhA increased (p < 0.01). CONCLUSIONS We diagnosed a malnutrition condition in 60% of our post SARS-Cov2 patients. An individualized nutritional intervention with adequate energy and protein intake combined with tailored aerobic and strengthening exercise improved nutritional and functional status.
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Affiliation(s)
- M Gobbi
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy.
| | - A Brunani
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - M Arreghini
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - G Baccalaro
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - D Dellepiane
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - V La Vela
- Department of Clinical Nutrition and Eating Disorder, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - E Lucchetti
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - M Barbaglia
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - A Cova
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - E Fornara
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - S Galli
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy
| | - V Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico of Milano, Milan, Italy
| | - L Brugliera
- Department of Rehabilitation and Functional Recovery, IRCCS San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - P Capodaglio
- Istituto Auxologico Italiano, IRCCS, Ospedale San Giuseppe, Piancavallo, Verbania, Italy; Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Turin, Turin, Italy
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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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Theilla M, Singer P, Tadmor B, Bendavid I, Hellerman M, Kagan I. Community optimized management for better eating after hospital sTay among geriatric patients of poor socio-economic status - The COMEAT study. Clin Nutr 2022; 41:1746-1751. [PMID: 35780702 DOI: 10.1016/j.clnu.2022.06.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Revised: 06/02/2022] [Accepted: 06/13/2022] [Indexed: 02/07/2023]
Abstract
INTRODUCTION In patients suffering from disease-related and socioeconomic malnutrition and being discharged from hospital, continuity of care is challenging. Lack of adequate nutrition may lead to increase in morbidity and mortality. The aim of this study was to overcome the handicap of limited nutrition access in this category of patients and to study its consequences on clinical outcome. METHODS Hospitalized patients screened to be at risk of malnutrition were approached and if diagnosed as suffering from malnutrition and from limited financial resources, they were randomized to receive a delivered daily dinner tray for 6 months and an assistance during the meal by a philanthropic association, or to regular food. At entry to the study, patients were assessed by indirect calorimetry, bioimpedance, Hospital Anxiety and Depression Scale (HADS), Functional independence measure (FIM) and SF 36 quality of life questionnaire. The latest questionnaires were reproduced after 3 and 6 months. Survival was followed at 6 months. The student t-test, the paired t-test, ANOVA were used. 180 days survival curves were expressed using the Kaplan-Meier method. RESULTS 631 patients were screened and 60 patients were randomized. There was no difference between groups. Survival at 6 months was improved significantly in the intervention group (87%) compared to the control group (65%, p<005). HADS did significantly improve at 3 months and other parameters (FIM, SF 36) were not changed significantly. CONCLUSIONS In hospitalized patients at nutritional risk, lunch home delivery, supported by a physical company after hospital discharge was associated with significantly lower mortality rates and improved depression and anxiety scores in elderly patients suffering from socioeconomic related malnutrition.
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Affiliation(s)
- Miriam Theilla
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Petah Tikva, Israel; Tel Aviv-Yaffo Academic College School for Nursing Sciences, Israel
| | - Pierre Singer
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Petah Tikva, Israel.
| | - Boaz Tadmor
- Administration Office, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Petah Tikva, Israel
| | - Itai Bendavid
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Petah Tikva, Israel
| | - Moran Hellerman
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Petah Tikva, Israel
| | - Ilya Kagan
- Department of General Intensive Care and Institute for Nutrition Research, Rabin Medical Center, Beilinson Hospital, Sackler School of Medicine, Tel Aviv University, Petah Tikva, Israel
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25
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Hirano Y, Yamada Y, Matsui Y, Ota S, Arai H. Lower limb muscle quality and phase angle contribute to the reduced walking speed among older adults. Geriatr Gerontol Int 2022; 22:603-609. [PMID: 35781752 DOI: 10.1111/ggi.14423] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 05/10/2022] [Accepted: 05/21/2022] [Indexed: 11/27/2022]
Abstract
AIM This cross-sectional study aimed to determine the predictors of a walking speed <1 m/s. Factors associated with the health of muscle cells, including the phase angle analyzed using bioimpedance analysis, answers to the mini-nutritional assessment-short form, albumin levels, leg muscle quality and vitamin D levels, were assessed. METHODS The study participants were outpatients from the Locomotor Frailty Outpatient Clinic which was established at our center in 2016 (231 women, 76.5 ± 7.6 years; 137 men, 78.0 ± 6.3 years). Participants were classified into two groups, with 1 m/s walking speed as the cutoff value. Binominal logistic regression analysis was performed with walking speed as the dependent variable, and age, leg muscle quality, mini-nutritional assessment-short form answers, albumin levels, vitamin D levels and the phase angle as explanatory variables. Leg muscle quality was defined as the mean value of both lower limbs' isometric knee extensor strength, divided by the mean value of both lower limbs' muscle mass through bioimpedance analysis. RESULTS The explanatory variables associated with decreased walking speed among women were leg muscle quality (P = 0.004, odds ratio: 0.57) and phase angle (P = 0.017, odds ratio: 0.42). Men were also more likely to have leg muscle quality (P = 0.004, odds ratio: 0.43). CONCLUSIONS Leg muscle quality and the phase angle of lower extremities were independently associated with low walking speeds (<1 m/s) among older outpatients. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Yuji Hirano
- National Center for Geriatrics and Gerontology, Obu city, Japan.,Graduate School of Mechanical System Engineering, Nagoya University, Nagoya City, Japan
| | - Yoji Yamada
- Graduate School of Mechanical System Engineering, Nagoya University, Nagoya City, Japan
| | - Yasumoto Matsui
- National Center for Geriatrics and Gerontology, Obu city, Japan
| | - Susumu Ota
- The Faculty of Rehabilitation and care, Seijoh University, Tokai City, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu city, Japan
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Park S, Kim J, Kim Y, Kim MW. Correlation of Body Composition via Bioelectrical Impedance Analysis and Motor Function and Recovery of Upper Extremity in Patients Undergoing Stroke Rehabilitation. BRAIN & NEUROREHABILITATION 2022; 15:e20. [PMID: 36743204 PMCID: PMC9833470 DOI: 10.12786/bn.2022.15.e20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/22/2022] [Accepted: 04/18/2022] [Indexed: 11/08/2022] Open
Abstract
Bioelectrical impedance analysis (BIA) has been used to investigate the body compositions and predict functional outcomes in patients with stroke, while the role of BIA to predict motor function or recovery in stroke has not been clarified. This study aimed to investigate relationship between body composition measured by BIA and upper limb motor function and recovery. Body compositions (soft tissue lean mass, phase angle, body fat mass and body water) of fifty patients who are admitted to the stroke rehabilitation unit were segmentally analyzed via BIA. The motor recovery of upper extremity (UE) was evaluated via Fugl-Meyer Assessment (UE-FMA) at the time of transfer and discharge. Correlations between body composition and UE-FMA at discharge were analyzed using Spearman correlation coefficient. Multiple regression analysis was used to determine the regression between body composition and motor function and recovery. The Δ Phase angle, the difference of both sides was significantly linearly inversely correlated with UE-FMA at discharge. However, in multiple regression analysis, body compositions including phase angle did not significantly predict motor function at discharge or motor recovery. The Δ Phase angle is related to the severity of upper limb motor function at discharge in subacute stroke patients, and further studies are needed to determine its value as a predictor for motor recovery.
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Affiliation(s)
- Sunha Park
- Department of Rehabilitation Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Jaewon Kim
- Department of Rehabilitation Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Youngmin Kim
- Department of Rehabilitation Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Min-Wook Kim
- Department of Rehabilitation Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
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Cioce M, Botti S, Lohmeyer FM, Galli E, Magini M, Giraldi A, Garau P, Celli D, Zega M, Sica S, Bacigalupo A, De Stefano V, Borrelli I, Moscato U. Nutritional status and quality of life in adults undergoing allogeneic hematopoietic stem cell transplantation. Int J Hematol 2022; 116:266-275. [PMID: 35532878 PMCID: PMC9314297 DOI: 10.1007/s12185-022-03351-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/05/2022] [Accepted: 04/05/2022] [Indexed: 01/07/2023]
Abstract
Although the effects of malnutrition on morbidity and mortality in adult patients undergoing allogeneic hematopoietic stem cell transplantation are clear, the relationship with quality of life (QOL) is less clear. The purpose of this study was to assess the relationship between malnutrition and QOL. A prospective observational study was conducted in 36 adult patients undergoing allogeneic hematopoietic stem cell transplantation. Adapted criteria of the Global Leadership Initiative on malnutrition have been used for the diagnosis of malnutrition in clinical settings. A cancer linear analog scale was used to assess QOL. Overall QOL at 14 days after allogeneic hematopoietic stem cell transplantation was 37.1 (95% CI 2.9–45.39) in patients without severe malnutrition, versus 16.0 (95% CI − 6.6 to 38.6) in patients with severe malnutrition (p = 0.05). At discharge, it was 48.0 (95% CI 38.4–57.6) versus 34.0 (95% CI 4.1–63.9) (p = 0.27). The results of our study suggest that patients with severe malnutrition at discharge tend to have worse QOL. A larger cohort of patients is required to confirm this hypothesis.
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Affiliation(s)
- Marco Cioce
- Department UOC SITRA, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Stefano Botti
- Haematology Unit, Oncology and Advanced Technology Department, Azienda USL-IRCCS Reggio Emilia, Reggio Emilia, Italy
| | | | - Eugenio Galli
- Department of Hematology, Fondazione Policlinico Universitario Gemelli IRCCS, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Marinella Magini
- UOC Clinical Nutrition, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Alessandra Giraldi
- UOC Clinical Nutrition, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
| | - Paola Garau
- Department UOC SITRA, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Danilo Celli
- Faculty of Medicine and Psychology, Università "La Sapienza", Rome, Italy
| | - Maurizio Zega
- Department UOC SITRA, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy
| | - Simona Sica
- Department of Hematology, Fondazione Policlinico Universitario Gemelli IRCCS, Universita' Cattolica del Sacro Cuore, Rome, Italy.
| | - Andrea Bacigalupo
- Department of Hematology, Fondazione Policlinico Universitario Gemelli IRCCS, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Valerio De Stefano
- Department of Hematology, Fondazione Policlinico Universitario Gemelli IRCCS, Universita' Cattolica del Sacro Cuore, Rome, Italy
| | - Ivan Borrelli
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Umberto Moscato
- Department of Health Science of Woman and Child and Public Health-Occupational Health and Hygiene, Area-Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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Phase Angle Is a Stronger Predictor of Hospital Outcome than Subjective Global Assessment-Results from the Prospective Dessau Hospital Malnutrition Study. Nutrients 2022; 14:nu14091780. [PMID: 35565747 PMCID: PMC9100773 DOI: 10.3390/nu14091780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 04/21/2022] [Accepted: 04/22/2022] [Indexed: 02/06/2023] Open
Abstract
This prospective cohort study of 16,943 consecutive patients compared phase angle (PhA, foot-to-hand at 50 kHz) and subjective global assessment (SGA) to predict outcomes length of hospital stay (LOS) and in-hospital mortality in patients at risk of malnutrition (NRS-2002 ≥ 3). In 1505 patients, the independent effects on LOS were determined by competing risk analysis and on mortality by logistic regression. In model I, including influence factors age, sex, BMI, and diagnoses, malnourished (SGA B and C) patients had a lower chance for a regular discharge (HR 0.74; 95%CI 0.69−0.79) and an increased risk of mortality (OR 2.87; 95%CI 1.38−5.94). The association of SGA and outcomes regular discharge and mortality was completely abrogated when PhA was added (model II). Low PhA reduced the chance of a regular discharge by 53% in patients with a PhA ≤ 3° (HR 0.47; 95%CI 0.39−0.56) as compared to PhA > 5°. Mortality was reduced by 56% for each 1° of PhA (OR 0.44; 95%CI 0.32−0.61). Even when CRP was added in model III, PhA ≤ 3° was associated with a 41% lower chance for a regular discharge (HR 0.59; 95%CI 0.48−0.72). In patients at risk of malnutrition, the objective measure PhA was a stronger predictor of LOS and mortality than SGA.
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Nakahara H, Hashizume N, Yoshida M, Fukahori S, Ishii S, Saikusa N, Koga Y, Higashidate N, Sakamoto S, Tsuruhisa S, Tanaka Y, Yamashita Y, Yagi M. Creatinine-to-cystatin C ratio estimates muscle mass correlating the markers of the patients with severe motor and intellectual disabilities. Brain Dev 2022; 44:196-202. [PMID: 34782198 DOI: 10.1016/j.braindev.2021.10.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 09/30/2021] [Accepted: 10/20/2021] [Indexed: 12/31/2022]
Abstract
AIM The creatinine-to-cystatin C ratio (CCR) has been acknowledged as a potential marker of muscle mass. The purpose of the present study was to evaluate the relationship between CCR and nutritional status in a bioelectrical impedance analysis (BIA) of patients with severe motor and intellectual disabilities (SMID). METHODS This study included 39 patients with SMID (17 males, 22 females) over 16 years of age were included retrospectively. CCR was calculated as serum creatinine (mg/dL)/cystatin C (mg/L) × 10. The BIA parameters such as the phase angle (PhA), fat free mass (FFM), appendicular skeletal muscle mass (ASM) and appendicular skeletal muscle mass index (ASMI) values were measured using BIA. Correlation analyses between CCR and the BIA parameters were conducted. RESULTS The mean CCR is 4.47 ± 1.34. Significant positive relationships between CCR and FFM, PhA, ASM, ASMI were identified (r = 0.3373, p = 0.0357. r = 0.4273, p = 0.0093. r = 0.5008, p = 0.0012. r = 0.4706, p = 0.0025 and r = 0.4751, p = 0.0022, respectively). CONCLUSIONS The study indicated that CCR in the patients with SMID is a useful parameter that allows for the muscle mass to be estimated easily and accurately. This means that evaluating CCR could be used as a simple and important screening tool for PhA, FFM and muscle mass.
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Affiliation(s)
- Hirotomo Nakahara
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Naoki Hashizume
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
| | - Motomu Yoshida
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Suguru Fukahori
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shinji Ishii
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Nobuyuki Saikusa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yoshinori Koga
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Naruki Higashidate
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Saki Sakamoto
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Shiori Tsuruhisa
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yoshiaki Tanaka
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan; Division of Medical Safety Management, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yushiro Yamashita
- Department of Pediatrics and Child Health, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Minoru Yagi
- Department of Pediatric Surgery, Kurume University School of Medicine, Kurume, Fukuoka, Japan
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Langer RD, Guimarães RF, Guerra-Júnior G, Gonçalves EM. Can Phase Angle Be Associated With Muscle Strength in Healthy Male Army Cadets? Mil Med 2022; 188:usac007. [PMID: 35078246 DOI: 10.1093/milmed/usac007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 01/06/2022] [Accepted: 01/10/2022] [Indexed: 11/12/2022] Open
Abstract
INTRODUCTION Phase angle (PhA) determined by bioelectrical impedance (BIA) is related to body fluid balance and cell membrane integrity. Handgrip strength (HGS) is used to assess muscle strength and as an indicator of health. We aimed to determine the relationship between PhA and HGS in healthy young males and to verify whether this relationship is dependent on body components. MATERIALS AND METHODS Hundred and sixty-three healthy male army cadets (18.8 ± 0.6 years old) participated in the study. PhA was determined by BIA, HGS was assessed by a hydraulic dynamometer, and dual-energy X-ray absorptiometry determined: fat mass (FM), bone mineral content (BMC), and lean soft tissue (LST). Participants were divided according to the PhA tertile (first tertile: PhA < 7.14°, second tertile: 7.14° ≤ PhA < 7.83°, and third tertile: PhA ≥ 7.83°). RESULTS Youth from the first tertile of PhA had lower BMC (2.8 kg vs. 3.0 kg and vs. 3.1 kg) and LST (51.7 vs. 53.8 kg and vs. 57.6 kg) compared to youth from the second and third tertile of PhA (P < .001), respectively. Additionally, lower HGS (83.0 kg vs. 93.1 kg) was found in the first tertile compared to the third tertile of PhA (P < .001). PhA explained 3% of the HGS variation (R2 = 0.029), while LST and BMC explained 39% (R2 = 0.385) and 22% (R2 = 0.221), respectively. Furthermore, the correlation between PhA and HGS was dependent on LST (P = .567) and BMC (P = .182). CONCLUSION In this sample, PhA showed a small relationship with HGS, remaining dependent on BMC and LST values. These results reinforce the importance of maintaining a physically active lifestyle with great lean mass and muscle strength values.
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31
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Fu L, Ren Z, Liu X, Wu N, Zhao K, Luo G, Yang H, Zhang Y, Yan T, Liu Y, Zhang T. Reference Data of Phase Angle Using Bioelectrical Impedance Analysis in Overweight and Obese Chinese. Front Endocrinol (Lausanne) 2022; 13:924199. [PMID: 35903275 PMCID: PMC9319044 DOI: 10.3389/fendo.2022.924199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/17/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Phase angle (PhA) is a ratio of reactance and resistance {arctangent (reactance (Xc)/resistance (R)) × (180°/π)}, which can be obtained by bioelectrical impedance analysis (BIA). PhA indicates cellular health and integrity, and it is also considered as a prognostic tool in medical disorders and an indicator of nutritional status (especially of muscle quality) in patients with obesity. However, PhA has limited usefulness in clinical practice because of a lackness of reference values for Chinese overweight and obese populations. The main aim of this study was to show PhA reference data in different age and BMI groups by sex. In addition, we also study the association of age, sex, and BMI on PhA. METHODS A total of 1729 overweight and obese participants were included in this study. PhA and body composition were measured using segmental multifrequency BIA. Differences in mean values for variables were tested by one-way analysis of variance. Multiple regression analysis was used to assess the associations of PhA with age, sex and BMI. RESULTS Multiple regression analysis showed that age, sex and BMI were significant (P < 0.05) independent influence factors of PhA in Chinese overweight and obese adults when age and BMI were continues variables. The mean PhA value for all participants was 5.5°. Mean BMI, age, weight, height and 50kHz-PhA were significantly higher (P < 0.001) in male participants than female ones. In age groups and BMI groups, mean 50kHz-PhA was significantly higher (P < 0.005) in male participants than female ones. When age groups and BMI groups were categorical variables, multiple regression analysis showed that different age groups (46-55 years and ≥ 56 years) had a significantly lower (P < 0.005) PhA as compared with the baseline group (18-25 years) and different BMI groups (≥ 28 kg/m2) had a significantly higher (P < 0.05) PhA as compared with the baseline group (24-27.9 kg/m2). CONCLUSION PhA differed according to age, sex and BMI. Reference data in this study can be taken into consideration when deriving the reference values for overweight and obese Chinese populations.
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Affiliation(s)
- Luo Fu
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Zhengyun Ren
- College of Medicine, Southwest Jiaotong University, Chengdu, China
| | - Xiaoxiao Liu
- College of Medicine, Southwest Jiaotong University, Chengdu, China
| | - Nianwei Wu
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
- Medical Research Center, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Kang Zhao
- College of Medicine, Southwest Jiaotong University, Chengdu, China
| | - Guangping Luo
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
- Medical Research Center, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Huawu Yang
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Yuanchuan Zhang
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Tong Yan
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Yanjun Liu
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Tongtong Zhang
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
- Medical Research Center, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
- *Correspondence: Tongtong Zhang,
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Gobbi M, Bezzoli E, Ismelli F, Trotti G, Cortellezzi S, Meneguzzo F, Arreghini M, Seitanidis I, Brunani A, Aspesi V, Cimolin V, Fanari P, Capodaglio P. Skeletal Muscle Mass, Sarcopenia and Rehabilitation Outcomes in Post-Acute COVID-19 Patients. J Clin Med 2021; 10:jcm10235623. [PMID: 34884325 PMCID: PMC8658326 DOI: 10.3390/jcm10235623] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 11/23/2021] [Accepted: 11/25/2021] [Indexed: 12/28/2022] Open
Abstract
The relationship between skeletal muscle mass at the beginning of the post-acute rehabilitation phase and rehabilitation outcomes has been scarcely investigated. The aim of this study was to investigate the impact of the existence of sarcopenia upon admission to a post-acute COVID-19 patient rehabilitation unit on body composition and functional and respiratory capacity at discharge. Thirty-four post-acute COVID-19 patients were referred to our Rehabilitation Unit from different COVID Hospitals in northern Italy. Body weight loss, body composition, handgrip strength, functional parameters, oxygen saturation and related perception of dyspnea in several positions were measured before and after a 28-day multidisciplinary rehabilitation program. Spirometry was performed only upon admission. The intervention included psychiatric support, cognitive behavioral therapy, nutritional therapy and physiotherapy, including aerobic and resistance training. Training volume was 45 min/session, 6 sessions/week. Upon admission, the prevalence of sarcopenia among our patients was 58%. In all of the 34 patients, we observed a trend of improvement in all of the respiratory, body composition, muscle strength and functional parameters considered. Monitoring muscle mass and strength in post-acute COVID-19 patients appears to be a key predictor of rehabilitation outcomes. Early diagnosis of sarcopenia therefore appears to be of paramount importance in the management of post-acute COVID-19 patients.
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Affiliation(s)
- Michele Gobbi
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo, Italy; (F.I.); (G.T.); (S.C.); (F.M.); (M.A.); (I.S.); (A.B.); (V.A.); (P.C.)
- Correspondence:
| | - Emanuela Bezzoli
- Respiratory Rehabilitation, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo, Italy; (E.B.); (P.F.)
| | - Francesco Ismelli
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo, Italy; (F.I.); (G.T.); (S.C.); (F.M.); (M.A.); (I.S.); (A.B.); (V.A.); (P.C.)
| | - Giulia Trotti
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo, Italy; (F.I.); (G.T.); (S.C.); (F.M.); (M.A.); (I.S.); (A.B.); (V.A.); (P.C.)
| | - Stefano Cortellezzi
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo, Italy; (F.I.); (G.T.); (S.C.); (F.M.); (M.A.); (I.S.); (A.B.); (V.A.); (P.C.)
| | - Francesca Meneguzzo
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo, Italy; (F.I.); (G.T.); (S.C.); (F.M.); (M.A.); (I.S.); (A.B.); (V.A.); (P.C.)
| | - Marco Arreghini
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo, Italy; (F.I.); (G.T.); (S.C.); (F.M.); (M.A.); (I.S.); (A.B.); (V.A.); (P.C.)
| | - Ionathan Seitanidis
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo, Italy; (F.I.); (G.T.); (S.C.); (F.M.); (M.A.); (I.S.); (A.B.); (V.A.); (P.C.)
| | - Amelia Brunani
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo, Italy; (F.I.); (G.T.); (S.C.); (F.M.); (M.A.); (I.S.); (A.B.); (V.A.); (P.C.)
| | - Valentina Aspesi
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo, Italy; (F.I.); (G.T.); (S.C.); (F.M.); (M.A.); (I.S.); (A.B.); (V.A.); (P.C.)
| | - Veronica Cimolin
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, 20133 Milano, Italy;
| | - Paolo Fanari
- Respiratory Rehabilitation, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo, Italy; (E.B.); (P.F.)
| | - Paolo Capodaglio
- Orthopaedic Rehabilitation Unit and Research Laboratory in Biomechanics and Rehabilitation, Istituto Auxologico Italiano, IRCCS, 28824 Piancavallo, Italy; (F.I.); (G.T.); (S.C.); (F.M.); (M.A.); (I.S.); (A.B.); (V.A.); (P.C.)
- Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Torino, 10126 Torino, Italy
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Hosseini SAT, Rahimi F, Esmaeili M, Khalili M. Phase Angle determinants in patients with cardiovascular disease using machine learning methods. HEALTH AND TECHNOLOGY 2021. [DOI: 10.1007/s12553-021-00622-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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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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Han SR, Bae JH, Lee CS, Al-Sawat A, Park SJ, Lee HJ, Yoon MR, Jin HY, Lee YS, Lee DS, Lee IK. Serial measurements of body composition using bioelectrical impedance and clinical usefulness of phase angle in colorectal cancer. Nutr Clin Pract 2021; 37:153-166. [PMID: 34609767 DOI: 10.1002/ncp.10754] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Although body composition (BC) can be measured easily using bioelectrical impedance analysis (BIA), there are few studies of serial BC measurements in colorectal cancer (CRC). The purpose of the present study was to observe the serial change of BC in patients with CRC surgery from the initiation to the end of chemotherapy and to evaluate its clinical usefulness. METHODS From July 2018 to November 2019, patients undergoing elective CRC surgery were enrolled. All clinical data were reviewed retrospectively. BIA data were collected prospectively at four time points (initial, discharge day, first chemotherapy, and 6 months later). BC was measured using a commercial BIA device. RESULTS A total of 160 patients were enrolled, and 110 (68.8%) patients were followed. Most BC measurements, such as weight, body mass index, skeletal muscle mass, skeletal muscle index, and fat mass index, were lowest at the first chemotherapy and rebounded after 6 months. Phase angle (PhA) and the ratio of extracellular water to total body water (ECW/TBW) were "V" shaped and inverted "V" shaped, respectively, and the peaks were on discharge days. This pattern of BC showed significant difference according to sarcopenia, old age (>70 years), and advanced stage (III or IV). The change of PhA and ECW/TBW sensitively pattern differences according to clinical aspect. CONCLUSIONS Using BIA, serial BC measurements were taken to establish a pattern based on clinical characteristics. PhA showed the most sensitive change according to the patient's clinical aspect.
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Affiliation(s)
- Seung-Rim Han
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jung Hoon Bae
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Chul Seung Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Abdullah Al-Sawat
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.,Department of Surgery, College of Medicine, Taif University, Taif, Saudi Arabia
| | - Soo Ji Park
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyo Jin Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Mi Ran Yoon
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyeong Yong Jin
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoon Suk Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Do Sang Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - In Kyu Lee
- Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Exploring the potential role of phase angle as a marker of oxidative stress: A narrative review. Nutrition 2021; 93:111493. [PMID: 34655952 DOI: 10.1016/j.nut.2021.111493] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 08/30/2021] [Accepted: 09/08/2021] [Indexed: 12/18/2022]
Abstract
Chronic conditions including non-communicable diseases have become increasingly prevalent in the past decade. Proinflammatory cytokines are associated with the development of several pathologies, their prognoses, and their associated mortality. Chronic inflammation is also associated with oxidative stress whereby reactive oxygen species (ROS) induce cellular injury and, thus, by doing so, initiate inflammatory signaling. Phase angle (PhA) is a measurable body composition parameter obtained using bioelectrical impedance analysis (BIA). PhA is considered an indicator of cellular health and integrity and is also related to inflammatory markers and inflammation. Given the association among oxidative stress, cell damage, and inflammation that may in turn be associated with low PhA values, it is expected that PhA could mirror oxidative stress. In this hypothesis-generating, narrative review we summarize the current knowledge regarding the potential relationship between PhA and oxidative stress and their interrelationship in chronic conditions.
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Osuna-Padilla IA, Salazar Arenas MDLA, Rodríguez-Moguel NC, Aguilar-Vargas A, Montano Rivas JA, Ávila-Ríos S. Phase angle as predictor of malnutrition in people living with HIV/AIDS. Nutr Clin Pract 2021; 37:146-152. [PMID: 34270135 DOI: 10.1002/ncp.10744] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Accepted: 06/06/2021] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Phase angle (PhA), measured by bioelectrical impedance analysis (BIA) has been studied as an indicator of survival in people living with HIV (PLWH). However, it remains unclear whether PhA is associated with malnutrition or low CD4+ T-cell counts. OBJECTIVE In this study, we assessed the discriminative capacity of PhA for malnutrition detection using Global Leadership Initiative on Malnutrition (GLIM) criteria in PLWH, aiming to propose cutoff points for this population. METHODS This retrospective observational study included 427 adult PLWH (13% female). Participants were classified according to malnutrition status by using GLIM criteria. Body composition was assessed by using BIA. CD4+ T-cell counts were determined by flow cytometry. RESULTS According to GLIM criteria, 30% of the participants were malnourished. Multivariate regression analysis showed that PhA (adjusted odds ratio [OR], 0.10; 95% CI, 0.05-0.18; P < 0.001), fat-mass percentage (adjusted OR, 0.86; 95% CI, 0.82-0.90; P < 0.001), and male sex (adjusted OR, 0.26; 95% CI, 0.09-0.76; P = 0.013) were independently associated with malnutrition. A PhA cutoff of 5.45° in men and 4.95° in women may predict malnutrition with sensitivity and specificity >70%. CONCLUSION PhA could be a valid, useful, and simple predictor of malnutrition in PLWH.
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Affiliation(s)
- Iván Armando Osuna-Padilla
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | | | | | - Adriana Aguilar-Vargas
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
| | | | - Santiago Ávila-Ríos
- Centro de Investigación en Enfermedades Infecciosas, Instituto Nacional de Enfermedades Respiratorias, Mexico City, Mexico
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Więch P, Chmiel Z, Bazaliński D, Sobolewski M, Sałacińska I. Body Composition and Selected Nutritional Indicators in Healthy Adults-A Cross-Sectional Study. Glob Adv Health Med 2021; 10:21649561211021794. [PMID: 34158999 PMCID: PMC8182172 DOI: 10.1177/21649561211021794] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 12/25/2022] Open
Abstract
Background Body mass composition is subject to constant change and is multifactorially
determined. Its analysis in different age groups allows a better
understanding of the determinants of the human organism in health and
disease. Aim The study was aimed to conduct cross-sectional assessment of body composition
and selected nutritional indicators in healthy adults. Methods The cross-sectional study carried out from March 2016 to April 2018 was
preceded by a monthly pilot study. All 1333 adults (women 795, 59.6%) aged
20–59 included in the study were from the urban and rural area of the
Podkarpackie Province (Poland). These adults were classified into four
10-year age bands. To obtain reliable assessment, selected screening
(anthropometry) and in-depth (bioelectrical impedance including phase angle
and bioelectrical impedance vector analysis) methods were used. Results In women, the proportion of individuals affected by overweight and obesity
increases significantly with age, with a less pronounced trend in men, as
reflected in the observed differences in individual body composition
components. A slight (0.45–0.60) correlation was also observed between body
mass index (BMI) and percentage of fat mass (FM %) among men with an
increasing strength of the association with age, decreasing in the
50–59 years group. In the female group, the correlations described are at a
much higher level (0.80 or higher). The described changes in body
composition were reflected in body type from athletic to obese, measured by
means of the bioelectrical impedance vector analysis (BIVA) method. Conclusions Age and gender significantly differentiate body composition of the adult
human body. The body composition analysis should be considered as complement
screening assessment method, especially as a support for the assessment of
nutritional status expressed by BMI.
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Affiliation(s)
- Paweł Więch
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
| | - Zdzisława Chmiel
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
| | - Dariusz Bazaliński
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
| | - Marek Sobolewski
- Faculty of Management, Rzeszów University of Technology, Rzeszów, Poland
| | - Izabela Sałacińska
- Institute of Health Sciences, College of Medical Sciences, University of Rzeszów, Rzeszów, Poland
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Phase angle cutoff value as a marker of the health status and functional capacity in breast cancer survivors. Physiol Behav 2021; 235:113400. [PMID: 33766604 DOI: 10.1016/j.physbeh.2021.113400] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Revised: 03/19/2021] [Accepted: 03/22/2021] [Indexed: 12/19/2022]
Abstract
Accurate predictive tools are key factors for cancer care. Phase angle (PhA) has been proposed as a marker of cellular health, particularly of cell-membrane integrity. Cutoff values have been proposed, including for cancer survivors. This study aimed to assess the usefulness of the proposed PhA cutoff, as a marker of bioelectrical impedance analysis (BIA) assessed health-status, and functional capacity in breast cancer (BC) survivors. This cross-sectional study included 25 women (50.6 ± 8.6 yrs) survivors of BC, divided into two groups according to the PhA reference value of 5.6° (group 1 [G1]: PhA ≤ 5.6° [n=13]; group 2 [G2]: PhA > 5.6° [n=12]) (Gupta et al. 2008). BIA-assessed health status parameters included: extracellular water (ECW), intracellular water (ICW), total body water (TBW), PhA, body mass, fat-free mass, muscle mass, body cell mass (BCM). Four functional tests were performed: 30 s chair-stand test, timed up and go test, ball throw test and 6-minute walking test. Results showed G2 had lower ECW/ICW ratio (p=0.001; ES=1.2), ECW/BCM ratio (p=0.001; ES=3.2) and ECW/TBW ratio (p=0.001; ES=4.8). There was no difference in functional capacity between groups. The results of the present study show that patients with higher PhA values have a higher ICW values and preservation in the ECW/ICW ratio, suggesting it's a better cell membrane quality and integrity. Relation of both PhA and cell membrane integrity with functional capacity warrants further research.
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Jung YW, Hong N, Kim CO, Kim HC, Youm Y, Choi JY, Rhee Y. The diagnostic value of phase angle, an integrative bioelectrical marker, for identifying individuals with dysmobility syndrome: the Korean Urban-Rural Elderly study. Osteoporos Int 2021; 32:939-949. [PMID: 33128075 DOI: 10.1007/s00198-020-05708-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 10/20/2020] [Indexed: 12/25/2022]
Abstract
UNLABELLED Low phase angle, a non-invasive bioimpedance marker, is associated with elevated odds of dysmobility syndrome and its components. Phase angle (estimated cutoffs: < 4.8° in men; < 4.5° in women) can be used to detect dysmobility syndrome in community-dwelling older adults as a simple, integrative screening tool. INTRODUCTION Dysmobility syndrome uses a score-based approach to predict fracture risk that incorporates the concepts of osteoporosis, sarcopenia, and obesity. Low phase angle (PhA), a simple, non-invasive bioelectrical impedance marker, was associated with low lean mass, high fat mass, and poor muscle function. We aimed to investigate the association between PhA and dysmobility syndrome, with the exploration of the diagnostic cutoffs. METHODS In a community-dwelling Korean older adult cohort, dysmobility syndrome was defined as the presence of ≥ 3 of the following components: osteoporosis, low lean mass, falls in the preceding year, low grip strength, high fat mass, and poor timed up and go performance. RESULTS Among the 1825 participants (mean age 71.6, women 66.7%), subjects were classified into sex-stratified PhA tertiles. The prevalence of dysmobility syndrome increased from the highest PhA tertile group to the lowest (15.50 to 2.45% in men; 33.41 to 12.25% in women, P for trend < 0.001). The mean PhA values decreased as the dysmobility score increased (5.33° to 4.65° in men; 4.76° to 4.39° in women, P for trend < 0.001). Low PhA (cutoff: < 4.8° in men; < 4.5° in women) was associated with twofold elevated odds of dysmobility syndrome after adjusting for age, sex, and conventional risk factors. Low PhA improved the identification of individuals with dysmobility syndrome when added to the conventional risk model (area under the curve, 0.73 to 0.75, P = 0.002). CONCLUSION Low PhA was associated with dysmobility syndrome and its components, independent of age, sex, body mass index, nutritional status, and inflammation.
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Affiliation(s)
- Y W Jung
- Division of Endocrinology, Endocrine Research Institute, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
| | - N Hong
- Division of Endocrinology, Endocrine Research Institute, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
| | - C O Kim
- Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - H C Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Y Youm
- Department of Sociology, Yonsei University, Seoul, Korea
| | - J -Y Choi
- Department of Radiology, Yonsei University College of Medicine, Seoul, Korea
| | - Y Rhee
- Division of Endocrinology, Endocrine Research Institute, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea
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Segmental Phase Angle and Body Composition Fluctuation of Elite Ski Jumpers between Summer and Winter FIS Competitions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094741. [PMID: 33946810 PMCID: PMC8124535 DOI: 10.3390/ijerph18094741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 01/03/2023]
Abstract
(1) Background: The purpose of this study was to observe segmental phase angle (PhA) and body composition fluctuation of elite ski jumpers. (2) Methods: In the study, 12 professional ski jumpers took part. Body composition was estimated with segmental multi-frequency bioelectrical impedance analysis. Repeated ANOVA was used to check the parameters' variability in time. The symmetry between the right and left side of the body was verified with the t-test for dependent samples. Pearson's linear correlation coefficient was calculated. (3) Results: The most stable parameter was body weight. An increase in the visceral fat area was noted, the fat-free mass dropped, and significant changes were noted in the internal and external cell water parameters. Parameters connected with water between the right and left side of the body were symmetrical. Significant correlation between PhA values and body parameters with regard to fat tissue and PhA values of the legs was noticed when PhA was measured at 50 kHz. (4) Conclusions: PhA could be considered as a ski jumper body symmetry monitoring tool. The described relationship may be useful for the assessment of body fat change, which, in the case of jumpers, is crucial. Moreover, our data suggest that segmental PhA evaluation could be a good solution for ski jumpers as a confirmation if lowered body mass and low BMI are still healthy and increase the chance for longer jumps and good performance.
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Phase Angle as an Easy Diagnostic Tool of Meta-Inflammation for the Nutritionist. Nutrients 2021; 13:nu13051446. [PMID: 33923291 PMCID: PMC8145306 DOI: 10.3390/nu13051446] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/18/2021] [Accepted: 04/21/2021] [Indexed: 01/08/2023] Open
Abstract
Phase angle (PhA), a noninvasive bioimpedance marker, is a useful tool for nutritional screening in several diseases. C-reactive protein (CRP), a strong risk factor for metabolic and cardiovascular diseases, is a commonly used biomarker of meta-inflammation. As both PhA and CRP are influenced by age, BMI, and nutritional status, and exhibit a clear sex dimorphism, we examined the association between PhA and CRP levels in 1855 subjects (680 males and 1175 females), aged 18-59 years, with BMIs ranging from 19.5 to 69.4 kg/m2, stratified according to sex. PhA values and CRP levels were significantly lower in females than males (p < 0.001), while the adherence to the Mediterranean diet (MD) was lower in males compared to females (p < 0.001). After adjusting for age, physical activity, BMI, waist circumference, and adherence to the MD, PhA remained negatively associated with CRP levels in both genders (p < 0.001). In the ROC analysis, PhA ≤ 5.5° in males and ≤5.4° in females were the threshold values predicting increased hs-CRP levels. These results suggested that PhA might represent a valid predictor of CRP levels in both sexes regardless of body weight and adherence to the MD, which avoids the collection of blood sampling and expensive biochemical assays.
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Langer RD, Larsen SC, Ward LC, Heitmann BL. Phase angle measured by bioelectrical impedance analysis and the risk of cardiovascular disease among adult Danes. Nutrition 2021; 89:111280. [PMID: 34090217 DOI: 10.1016/j.nut.2021.111280] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE This study aimed to examine associations between phase angle (PhA) and incident cardiovascular disease (CVD) morbidity and mortality in a healthy Danish subpopulation free of major chronic diseases. METHODS A random subset (n = 2601) of adult men and women born in 1922, 1932, 1942, and 1952 and examined in 1987 and 1988 were included, and followed over 24 y during which 643 men and 570 women developed CVD. Measures at baseline included age, weight, height, whole-body bioimpedance, from which PhA was calculated, and information on lifestyle, obtained by a self-administered questionnaire. The association between PhA and incident CVD was assessed by Cox proportional hazard model with age as the underlying time scale and with additional adjustment for covariates. To explore nonlinear associations, all results were presented using restricted cubic splines, with the median value of PhA as the reference. RESULTS PhA was lower among women who later developed CVD than among women who did not (6.3 vs. 6.0; P < 0.001). The highest risk of CVD was observed at the 5th percentile (hazard ratio: 1.33; 95% confidence interval, 1.11-1.60). Among men, PhA was not significantly associated with risk of CVD (7.1 vs. 7.0; P = 0.246). CONCLUSIONS Among apparently healthy Danish men and women, a lower PhA value was associated with a higher incidence of CVD over 24 y, also after adjusting for potential confounders, and particularly among women. These findings may encourage the future use of PhA as an additional index in predicting CVD. However, more studies are needed to confirm our results.
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Affiliation(s)
- Raquel D Langer
- Growth and Development Laboratory, Center for Investigation in Pediatrics, University of Campinas, São Paulo, Brazil; Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, and University of Copenhagen, Department of Public Health, Section for General Practise, Copenhagen, Denmark.
| | - Sofus C Larsen
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, and University of Copenhagen, Department of Public Health, Section for General Practise, Copenhagen, Denmark
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Berit L Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Bispebjerg and Frederiksberg Hospital, and University of Copenhagen, Department of Public Health, Section for General Practise, Copenhagen, Denmark
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Rinaldi S, Gilliland J, O'Connor C, Seabrook JA, Mura M, Madill J. Exercise capacity and its relationship with body composition and nutrition status in patients with interstitial lung disease. Nutr Clin Pract 2021; 36:891-898. [PMID: 33786852 DOI: 10.1002/ncp.10651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Patients with interstitial lung disease (ILD) are known to have diminished exercise ability. This study aimed to explore the relationship between nutrition status and body composition parameters with exercise capacity in ILD patients. A second aim focused on assessing the appropriateness of surrogate markers of nutrition status in ILD patients. METHODS Disease severity was determined by the percentage of predicted forced vital capacity. Exercise capacity was determined using 6-minute walk distance. Nutrition status was assessed using the subjective global assessment (SGA), standardized phase angle (SPhA), and impedance ratio z-score (z-IR). Bioelectrical impedance analysis estimated body composition parameters. RESULTS 45 of 79 participants (57%) were malnourished according to the SGA. FFM index z-score (z-FFMI) (r = 0.42, P = .02) and SGA (r = 0.49, P < .01) were significant predictors of exercise capacity independent of disease severity. Age (odds ratio [OR] = 1.1; 95% CI, 1.01-1.25; P = .04), low body mass index (OR = 0.73; 95% CI, 0.57-0.92; P = .01), z-FFMI (OR = 0.34; 95% CI, 0.17-0.68; P < .01), and body fat mass index z-score (OR = 0.39; 95% CI, 0.17-0.91; P = .03) were significantly associated with severe malnutrition. There was no significant difference in SPhA across SGA groups; however, a higher z-IR (poorer cell health) significantly increased the odds of severe malnutrition (OR = 2.75; 95% CI, 1.27-6.03; P = .02). CONCLUSION In ILD patients, malnutrition and loss of FFM negatively impact the ability to perform activities of daily living.
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Affiliation(s)
- Sylvia Rinaldi
- School of Health Studies, Western University, London, Ontario, Canada.,School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada.,Human Environments Analysis Laboratory, Western University, London, Ontario, Canada
| | - Jason Gilliland
- School of Health Studies, Western University, London, Ontario, Canada.,Human Environments Analysis Laboratory, Western University, London, Ontario, Canada.,Department of Geography, Western University, London, Ontario, Canada.,Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Children's Health Research Institute, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Colleen O'Connor
- School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada.,Human Environments Analysis Laboratory, Western University, London, Ontario, Canada
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada.,Human Environments Analysis Laboratory, Western University, London, Ontario, Canada.,Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Children's Health Research Institute, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Marco Mura
- Division of Respirology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Janet Madill
- School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada
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Differences in body composition between metabolically healthy and unhealthy midlife women with respect to obesity status. ANTHROPOLOGICAL REVIEW 2021. [DOI: 10.2478/anre-2021-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Body composition (BC) characteristics across metabolic health-by-body mass index categories were examined. Metabolic health (MH) was defined by five biomarkers: waist circumference, blood pressure, levels of triglycerides, high density lipoprotein cholesterol, and fasting glucose. Potential differences in BC characteristics between metabolically healthy obese (MH-O) and metabolically unhealthy obese (MUH-O) women, and between MH normal weight (MH-NW) and MUH normal weight (MUH-NW) women were explored in 276 Slovak midlife women (39-65 years). Body composition parameters were measured with bioimpedance analyzer (BIA 101, Akern, S. r. l.). A simple comparison of the BC data between the subgroups showed significant differences in resistance (Rz, ohm) (p=0.035), muscle mass (MM, kg) (p=0.044), and total body water (TBW, kg) (p=0.047) between MH-O and MUH-O women. However, we did not observe any significant differences in BC characteristics between MH-NW and MUHNW. Specific logistic regression models were used to determine differences in BC characteristics between various obesity phenotypes, with controlling for age, menopausal status, smoking status and sport activity. Our results indicated that increasing age and decreasing Rz were statistically significantly associated with an increased likelihood of exhibiting MUH-O (p=0.031 for age; p=0.032 for Rz). Moreover, other logistic models which included age, menopausal status, biochemical variables and life style factors such as covariates, showed that increasing alanine aminotransferase (ALT) and uric acid (UA) were statistically significantly associated with an increased likelihood of exhibiting MUH-O (p=0.023 for ALT, p=0.010 for UA). In conclusion, MUH-O and MH-O cardiometabolic profiles are characterized by differences in the value of resistance and plasma levels of ALT and UA.
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Kim DH, Oh DJ. Phase angle values, a good indicator of nutritional status, are associated with median value of hemoglobin rather than hemoglobin variability in hemodialysis patients. Ren Fail 2021; 43:327-334. [PMID: 33567950 PMCID: PMC7889140 DOI: 10.1080/0886022x.2020.1870137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background Our aim was to elucidate whether Hb variability affects nutritional status in HD patients. Methods This study included chronic HD patients (n = 76) with available monthly Hb levels up to 24 months prior to the body composition monitoring (BCM) measurement. The parameters obtained in the BCM included body mass index (BMI), lean tissue index (LTI), fat tissue index (FTI), body cell mass index (BCMI), overhydration/extracellular water ratio (OH), and phase angle (PhA). The coefficient of variation (Hb-CV), standard deviation (Hb-SD), and range of Hb (Hb-RAN) were used as indexes of Hb variability. In addition, minimum (Hb-Min), maximum (Hb-Max), average (Hb-Avg), and median (Hb-Med) Hb levels (g/dL) were analyzed. Results There were no significant differences in clinical, biochemical, and nutritional indexes based on the Hb-CV level. Compared to patients with an Hb-Med ≤ 10.77, those with an Hb-Med >10.77 had higher albumin levels, total iron-binding capacity (TIBC), and PhA and lower average weekly prescribed darbepoetin. Age, female sex, OH, and darbepoetin dosage were negatively correlated with PhA. Serum albumin, phosphorus, TIBC, Hb-Med, and Hb-Avg were positively correlated with PhA. In multiple linear regression analysis, PhA was positively associated with Hb-Med and serum albumin level, whereas PhA was negatively associated with age and female sex. The area under the curve (AUC) of Hb-Med was 0.665 (p = 0.040) in predicting PhA >5.00° Conclusions PhA was not affected by indexes of Hb variability, whereas PhA was associated with Hb-Med in chronic HD patients.
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Affiliation(s)
- Do Hyoung Kim
- Division of Nephrology, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
| | - Dong-Jin Oh
- Division of Nephrology, Department of Internal Medicine, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea
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Kim WJ, Jo GY, Park JH, Do HK. Feasibility of segmental bioelectrical impedance analysis for mild- to moderate-degree breast cancer-related lymphedema: Correlation with circumferential volume measurement and phase angle. Medicine (Baltimore) 2021; 100:e23722. [PMID: 33530173 PMCID: PMC7850733 DOI: 10.1097/md.0000000000023722] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 10/24/2020] [Accepted: 11/16/2020] [Indexed: 01/05/2023] Open
Abstract
ABSTRACT Segmental multi-frequency bioelectrical impedance analysis (s-MFBIA) has been adopted recently to evaluate the volume of breast cancer-related lymphedema (BCRL). This procedure uses the segmental phase angle (s-PhA) as an indicator of cellular integrity. In the smaller-built Asian population, the BCRL often has a small volume difference and can be overlooked by tape circumference volume measurement (TVM). This study aimed to investigate the clinical feasibility of s-MFBIA for the assessment of lymphedema severity compared with TVM and evaluate the association between lymphedema severity and cellular integrity of the affected arm based on s-PhA values for a patient with mild- to moderate-degree BCRL.Segmental PhA and extracellular water (ECW)/total body water (TBW) ratio of bilateral arms were measured using InBody S10, an s-MFBIA device, in 128 BCRL patients. Inter-limb volume ratio was measured using TVM. The inter-limb ECW/TBW ratio was correlated with inter-limb volume ratio. Inter-limb ECW/TBW ratio and inter-limb volume ratio were then correlated with inter-limb PhA ratio to demonstrate the association between lymphedema severity and arm cellular integrity.The inter-limb ECW/TBW ratio and inter-limb volume ratio were positively correlated (r = 0.654, P < .001). The same result was obtained after adjusting for age, body mass index, postoperative survival, and duration of lymphedema (r = 0.636, 0.653, 0.652, and 0.648, P < .001). The inter-limb PhA ratio demonstrated significant negative correlation with inter-limb ECW/TBW ratio and inter-limb volume ratio (r = -0.896, -0.562, P < .001).s-MFBIA has high consistency with the conventional TVM method, and its relation to cellular integrity by segmental PhA enables better understanding of the cellular state of the affected limb in mild- to moderate-degree BCRL. Therefore, it is clinically feasible for severity assessment and monitoring of mild- to moderate-degree BCRL in smaller-built Asian patients.
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Affiliation(s)
- Woo-Jin Kim
- Epworth Rehabilitation and Mental Health, Epworth Healthcare, Brighton, Victoria, Australia
| | - Geun-Yeol Jo
- Department of Physical Medicine and Rehabilitation, Haeundae–Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Ji-Ho Park
- Department of Physical Medicine and Rehabilitation, Haeundae–Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Hwan-Kwon Do
- Department of Physical Medicine and Rehabilitation, Haeundae–Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
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Theilla M, Rattanachaiwong S, Kagan I, Rigler M, Bendavid I, Singer P. Validation of GLIM malnutrition criteria for diagnosis of malnutrition in ICU patients: An observational study. Clin Nutr 2020; 40:3578-3584. [PMID: 33413910 DOI: 10.1016/j.clnu.2020.12.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/25/2020] [Accepted: 12/15/2020] [Indexed: 01/07/2023]
Abstract
BACKGROUND & AIMS Patients in the Intensive Care Unit (ICU) are at high risk of malnutrition. The only validated malnutrition assessment tool is the Subjective Global Assessment (SGA). The Global Leadership Initiative on Malnutrition (GLIM) is a new malnutrition assessment tool. The present study compares the nutrition-related parameters of the following tools: GLIM tool, SGA, Phase Angle (PA), Low Fat-Free Mass Index (FFMI), and Patient- and Nutrition-Derived Outcome Risk Assessment score (PANDORA), in an attempt to validate an objective tool. METHODS Eighty-four ICU patients were included. The tools mentioned above were assessed for their validity in diagnosing malnutrition. All patients were defined as suffering from acute disease and received medical nutrition therapy. To evaluate whether there is a correlation between the GLIM criteria, SGA, PA, and low FFMI, we compared the SGA, PA, and low FFMI to the GLIM criteria using Spearman correlation coefficients and a Chi-square test. Also, a Mann-Whitney U test was used to test the mean differences between the GLIM criteria and the PANDORA. The area under the curve (AUC) of the proposed parameters was evaluated for diagnosis of malnutrition to seek cutoff points that yield good sensitivity and specificity. RESULTS Mean age was 50 ± 20 years, BMI 25.3 ± 5.1 kg/m2, APACHE II 20.5 ± 7.7, PANDORA score 32 ± 8.5. GLIM malnutrition criteria were significantly correlated with the gold standard SGA assessment and with low FFMI, with PA (Phase Angle), and with the PANDORA score. The area under the curve, by using the ROC curve analysis for GLIM criteria stratified by the SGA results, was 0.85 (P < 0.001). Sensitivity was 85%, and specificity 79%. However, when comparing the low FFMI, PA, and PANDORA to the GLIM criteria, the ROC curve analysis results were considered poor rank. CONCLUSIONS The SGA malnutrition assessment highly validated the GLIM criteria framework combined with the two-criteria diagnosis of malnutrition with a high level of precision. The GLIM malnutrition assessment seems to be acceptable in the ICU setting.
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Affiliation(s)
- Miriam Theilla
- Department of General Intensive Care and Institute for Nutrition Research, Israel; Nutrition Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel; Steyer School of Health Professions, Nursing Department, Sackler School of Medicine, Tel Aviv University, Israel.
| | - Sornwichate Rattanachaiwong
- Division of Clinical Nutrition, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ilya Kagan
- Department of General Intensive Care and Institute for Nutrition Research, Israel; Nutrition Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
| | - Merav Rigler
- Department of General Intensive Care and Institute for Nutrition Research, Israel; Nutrition Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
| | - Itai Bendavid
- Department of General Intensive Care and Institute for Nutrition Research, Israel; Nutrition Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
| | - Pierre Singer
- Department of General Intensive Care and Institute for Nutrition Research, Israel; Nutrition Department, Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel
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Alvero-Cruz JR, Parent Mathias V, García Romero JC, Rosety I, Rosety MA, Diaz AJ, Ordoñez FJ, Rosety-Rodriguez M. The Predictive Role of Raw Bioelectrical Impedance Variables in Disordered Eating Attitudes in Female Ballet Dance Students. Nutrients 2020; 12:nu12113374. [PMID: 33147764 PMCID: PMC7693491 DOI: 10.3390/nu12113374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 10/23/2020] [Accepted: 10/29/2020] [Indexed: 11/16/2022] Open
Abstract
The present study used receiver operating characteristic (ROC) curve analysis to investigate the accuracy of body composition and raw bioelectrical impedance analysis (BIA) in correctly classifying disordered eating attitudes (DEA) in dance students. Participants were 81 female dancers assigned in two groups: beginner training (BT; age (mean ± SD) = 10.09 ± 1.2 years, n = 32) and advanced training (AT; age = 15.37 ± 2.1 years, n = 49). Fat mass (FM) was estimated by Slaughter's equation and skeletal muscle with Poortman's equation. Impedance (Z), resistance (R), reactance (Xc) and phase angle (PhA) were obtained through multifrequency BIA at a frequency of 50 kHz. Fat-free mass (FFM) was assessed using Sun's equation. For evaluation of DEA, the Eating Attitudes Test-26 (EAT-26) questionnaire was performed. We defined an EAT-26 score ≥ 20 as positive for DEA. Comparisons between groups were performed by a one-way ANOVA test or Kruskall-Wallis test. Spearman's rank correlation coefficients were performed to assess associations between variables. ROC curve analysis was utilized to test the accuracy of body composition and BIA variables in predicting DEA. In the BT group, Xc and PhA demonstrated high accuracy in predicting DEA with an area under the curve (AUC) of 0.976 (95% confidence interval (CI): 0.85-1.00) and 0.957 (95% CI: 0.82-0.99), respectively, (both p < 0.0001). FFM Sun had an AUC of 0.836 (95% CI: 0.66-0.94) (p < 0.0001) in the BT group and FFM Slaughter was 0.797 (95% CI: 0.66-0.90) (p < 0.001) in the AT group. Reactance and Phase angle were excellent and useful predictors of DEA in the BT group.
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Affiliation(s)
- José Ramón Alvero-Cruz
- Department of Human Physiology, Histology, Pathological Anatomy and Physical Education and Sport, University of Málaga-Andalucía Technology Park, 29071 Málaga, Spain; (V.P.M.); (J.C.G.R.)
- The Biomedical Research Institute of Málaga (IBIMA), 29010 Málaga, Spain
- School of Sports Medicine, Edificio López de Peñalver, Campus de Teatinos, Universidad de Málaga, 29071 Málaga, Spain
- Correspondence:
| | - Verónica Parent Mathias
- Department of Human Physiology, Histology, Pathological Anatomy and Physical Education and Sport, University of Málaga-Andalucía Technology Park, 29071 Málaga, Spain; (V.P.M.); (J.C.G.R.)
| | - Jerónimo C. García Romero
- Department of Human Physiology, Histology, Pathological Anatomy and Physical Education and Sport, University of Málaga-Andalucía Technology Park, 29071 Málaga, Spain; (V.P.M.); (J.C.G.R.)
- The Biomedical Research Institute of Málaga (IBIMA), 29010 Málaga, Spain
- School of Sports Medicine, Edificio López de Peñalver, Campus de Teatinos, Universidad de Málaga, 29071 Málaga, Spain
| | - Ignacio Rosety
- School of Medicine, University of Cádiz, 11003 Cádiz, Spain; (I.R.); (M.A.R.); (F.J.O.); (M.R.-R.)
| | - Miguel A. Rosety
- School of Medicine, University of Cádiz, 11003 Cádiz, Spain; (I.R.); (M.A.R.); (F.J.O.); (M.R.-R.)
| | | | - Francisco J. Ordoñez
- School of Medicine, University of Cádiz, 11003 Cádiz, Spain; (I.R.); (M.A.R.); (F.J.O.); (M.R.-R.)
| | - Manuel Rosety-Rodriguez
- School of Medicine, University of Cádiz, 11003 Cádiz, Spain; (I.R.); (M.A.R.); (F.J.O.); (M.R.-R.)
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Matsumoto D, Inui F, Honda C, Tomizawa R, Watanabe M, Silventoinen K, Sakai N. Heritability and Environmental Correlation of Phase Angle with Anthropometric Measurements: A Twin Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217810. [PMID: 33114521 PMCID: PMC7662672 DOI: 10.3390/ijerph17217810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 10/21/2020] [Accepted: 10/22/2020] [Indexed: 11/04/2022]
Abstract
Bioelectrical impedance analysis (BIA)-derived phase angle (PhA) is a valuable parameter to assess physical health. However, the genetic and environmental aspects of PhA are not yet well understood. The present study aimed to estimate the heritability of PhA and investigate the relationships between PhA and anthropometric measurements. PhA and skeletal muscle mass index (SMI) were examined using multi-frequency BIA in 168 Japanese twin volunteers (54 males and 114 females; mean age = 61.0 ± 16.5 years). We estimated the narrow-sense heritability of these parameters and the genetic and environmental relationships between them using a genetic twin modeling. For the PhA, 51% (95% confidence interval: 0.33, 0.64) of the variance was explained by additive genetic effects, and 49% (95% confidence interval: 0.36, 0.67) was explained by unique environmental effects. The heritability of PhA was lower than the height, body weight, and body mass index. PhA shared almost no genetic variation with anthropometric measurements and SMI but shared an environmental variation (14%) with SMI. These findings suggest that the genes affecting PhA are different than those affecting anthropometric measurements and SMI. The correlation between PhA and SMI is caused by common environmental factors.
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Affiliation(s)
- Daisuke Matsumoto
- Department of Physical Therapy, Faculty of Health Sciences, Kio University, 4-2-2 Umaminaka, Koryo-cho, Kitakatsuragi-gun, Nara 635-0832, Japan
- Health Promotion Center, Kio University, 4-2-2 Umaminaka, Koryo-cho, Kitakatsuragi-gun, Nara 635-0832, Japan;
- Center for Twin Research, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (C.H.); (R.T.); (M.W.); (K.S.); (N.S.)
- Correspondence: ; Tel.: +81-745-54-1601
| | - Fujio Inui
- Health Promotion Center, Kio University, 4-2-2 Umaminaka, Koryo-cho, Kitakatsuragi-gun, Nara 635-0832, Japan;
- Center for Twin Research, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (C.H.); (R.T.); (M.W.); (K.S.); (N.S.)
- Department of Nursing, Faculty of Health Sciences, Kio University, 4-2-2 Umaminaka, Koryo-cho, Kitakatsuragi-gun, Nara 635-0832, Japan
| | - Chika Honda
- Center for Twin Research, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (C.H.); (R.T.); (M.W.); (K.S.); (N.S.)
- Faculty of Nursing, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu, Shiga 520-2192, Japan
| | - Rie Tomizawa
- Center for Twin Research, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (C.H.); (R.T.); (M.W.); (K.S.); (N.S.)
| | - Mikio Watanabe
- Center for Twin Research, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (C.H.); (R.T.); (M.W.); (K.S.); (N.S.)
- Department of Clinical Laboratory and Biomedical Sciences, Division of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Karri Silventoinen
- Center for Twin Research, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (C.H.); (R.T.); (M.W.); (K.S.); (N.S.)
- Department of Social Research, Faculty of Social Sciences, University of Helsinki, P.O. Box 18, 00014 Helsinki, Finland
| | - Norio Sakai
- Center for Twin Research, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan; (C.H.); (R.T.); (M.W.); (K.S.); (N.S.)
- Child Healthcare and Genetic Science Laboratory, Division of Health Sciences, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
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