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Lafontant K, Sterner DA, Fukuda DH, Stout JR, Park JH, Thiamwong L. Comparing Device-Generated and Calculated Bioimpedance Variables in Community-Dwelling Older Adults. SENSORS (BASEL, SWITZERLAND) 2024; 24:5626. [PMID: 39275537 PMCID: PMC11397826 DOI: 10.3390/s24175626] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/27/2024] [Revised: 08/18/2024] [Accepted: 08/29/2024] [Indexed: 09/16/2024]
Abstract
Despite BIA emerging as a clinical tool for assessing older adults, it remains unclear how to calculate whole-body impedance (Z), reactance (Xc), resistance (R), and phase angle (PhA) from segmental values using modern BIA devices that place electrodes on both sides of the body. This investigation aimed to compare both the whole-body and segmental device-generated phase angle (PhADG) with the phase angle calculated using summed Z, Xc, and R from the left, right, and combined sides of the body (PhACalc) and to compare bioelectric variables between sides of the body. A sample of 103 community-dwelling older adults was assessed using a 50 kHz direct segmental multifrequency BIA device. Whole-body PhACalc values were assessed for agreement with PhADG using 2.5th and 97.5th quantile nonparametric limits of agreement and Spearman's rho. Bioelectrical values between sides of the body were compared using Wilcoxon rank and Spearman's rho. A smaller mean difference was observed between PhADG and right PhACalc (-0.004°, p = 0.26) than between PhACalc on the left (0.107°, p = 0.01) and on the combined sides (0.107°, p < 0.001). The sum of Z, R, and PhACalc was significantly different (p < 0.01) between the left (559.66 ± 99.55 Ω, 556.80 ± 99.52 Ω, 5.51 ± 1.5°, respectively) and the right sides (554.60 ± 94.52 Ω, 552.02 ± 94.23 Ω, 5.41 ± 0.8°, respectively). Bilateral BIA values do not appear to be interchangeable when determining whole-body measurements. Present data suggest that using right-sided segmental values would be the most appropriate choice for calculating whole-body bioelectrical variables.
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Affiliation(s)
- Kworweinski Lafontant
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA
- College of Nursing, University of Central Florida, Orlando, FL 32826, USA
| | - Danielle A Sterner
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA
| | - David H Fukuda
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA
| | - Jeffrey R Stout
- Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL 32816, USA
- Disability Aging & Technology Cluster, University of Central Florida, Orlando, FL 32826, USA
| | - Joon-Hyuk Park
- Disability Aging & Technology Cluster, University of Central Florida, Orlando, FL 32826, USA
- Department of Mechanical and Aerospace Engineering, University of Central Florida, Orlando, FL 32826, USA
| | - Ladda Thiamwong
- College of Nursing, University of Central Florida, Orlando, FL 32826, USA
- Disability Aging & Technology Cluster, University of Central Florida, Orlando, FL 32826, USA
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Alirezaei A, Miladipour A, Asgari N, Latifi M, Fazeli SA. Association of phase angle with sarcopenia in patients undergoing maintenance hemodialysis: A case-control study. JOURNAL OF RESEARCH IN MEDICAL SCIENCES : THE OFFICIAL JOURNAL OF ISFAHAN UNIVERSITY OF MEDICAL SCIENCES 2024; 29:40. [PMID: 39239086 PMCID: PMC11376717 DOI: 10.4103/jrms.jrms_38_24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2024] [Revised: 02/07/2024] [Accepted: 03/01/2024] [Indexed: 09/07/2024]
Abstract
Background Sarcopenia, characterized by reduced muscle strength and mass, is commonly observed in patients with kidney disease. This study aimed to investigate the factors that influence sarcopenia in patients undergoing maintenance hemodialysis (HD patients). Materials and Methods A case-control study was conducted from 2022 to 2023, involving a total of 137 HD patients receiving regular dialysis. Relevant data were collected, and based on diagnostic criteria, patients were classified into sarcopenia and nonsarcopenia groups. All patients received polysulfone membrane HD at a flow rate of 500 mL/min. Bioelectrical impedance analysis was used to evaluate phase angle (PhA), muscle volume, and body composition. Results The prevalence of sarcopenia among maintenance HD patients was found to be 40.14%. There was a higher proportion of women (76.36%) with sarcopenia compared to men (P < 0.001). Furthermore, a significant difference was observed in PhA (P < 0.006) between patients undergoing maintenance HD with and without sarcopenia. PhA was positively associated with body mass index, body cell mass, basal metabolic rate, fat-free mass, soft lean mass, and minerals, whereas age and skeletal muscle index showed an inverse significant correlation. Conclusion Sarcopenia, a condition associated with increased mortality risk, affects a considerable proportion of dialysis patients. It is imperative to urgently identify and develop preventive and therapeutic strategies to counteract the detrimental effects of sarcopenia on the health outcomes of kidney patients.
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Affiliation(s)
- Amirhesam Alirezaei
- Clinical Research and Development Center, Shahid Modarres Educational Hospital, Division of Nephrology, Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Amirhossein Miladipour
- Clinical Research and Development Center, Shahid Modarres Educational Hospital, Division of Nephrology, Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Navid Asgari
- Clinical Research and Development Center, Shahid Modarres Educational Hospital, Division of Nephrology, Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Marzieh Latifi
- Medical Ethics and Law Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Amirhossein Fazeli
- Clinical Research and Development Center, Shahid Modarres Educational Hospital, Division of Nephrology, Department of Internal Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Sterner DA, Stout JR, Lafontant K, Park JH, Fukuda DH, Thiamwong L. Phase Angle and Impedance Ratio as Indicators of Physical Function and Fear of Falling in Older Adult Women: Cross-Sectional Analysis. JMIR Aging 2024; 7:e53975. [PMID: 38488531 PMCID: PMC10986333 DOI: 10.2196/53975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/30/2023] [Accepted: 01/29/2024] [Indexed: 03/19/2024] Open
Abstract
Background Older adults experience a significant decline in muscle integrity and function with aging. Early detection of decreased muscle quality can pave the way for interventions to mitigate the progression of age-related physical declines. Phase angle (PhA) and impedance ratio (IR) are measures of muscle integrity, which can be assessed quickly via bioelectrical impedance analysis (BIA) and may be indicative of physical function. Objective This study aimed to characterize the relationships among handgrip strength (HGS), sit-to-stand (STS), BTrackS balance scores, fear of falling (evaluated using the Short Falls Efficacy Scale-International [Short FES-I]), and IR among community-dwelling older adult women classified as having a low or high PhA. Methods A cross-sectional analysis was conducted with 85 older women (mean age 75.0, SD 7.2 years; mean weight 71.0, SD 15.0 kg; mean height 162.6, SD 6.1 cm). To examine the influence of PhA on performance measures, participants were divided into 2 PhA groups: high (>4.1°; n=56) and low (≤4.1°; n=29). Data were nonnormative; hence, the Mann-Whitney U test was used to evaluate between-group differences, and Kendall τ coefficients were used to determine the partial correlations. Results The low PhA group had a significantly higher IR (mean 0.85, SD 0.03) than the high PhA group (mean 0.81, SD 0.03; r=.92; P<.001). The high PhA group had superior HGS (mean 21.4, SD 6.2 kg; P=.007; r=0.36), BTrackS balance scores (mean 26.6, SD 9.5 cm; P=.03; r=0.30), and STS scores (mean 16.0, SD 5.5; P<.001; r=0.49) than the low PhA group (mean HGS 17.6, SD 4.7 kg; mean BTrackS balance score 37.1, SD 21.1 cm; mean STS score 10.7, SD 6.2). Both PhA and IR were significantly correlated with HGS and BTrackS balance, STS, and Short FES-I scores (P<.05). However, on adjusting for the whole sample's age, only PhA was strongly correlated with HGS (τb=0.75; P=.003) and STS scores (τb=0.76; P=.002). Short FES-I scores were moderately correlated with IR (τb=0.46; P=.07) after controlling for age. No significant between-group differences were observed for height, weight, or BMI. Conclusions PhA and IR are associated with physical function and the fear of falling in older women. However, only PhA was significantly associated with physical function (HGS and STS) independent of age. Conversely, only IR was significantly associated with the fear of falling. Diminished physical function and increased IR appear to be characteristics of older women with a PhA of ≤4.1°. These findings suggest that PhA and IR measured through BIA together may serve as a valuable tool for early identification of older women at the risk of functional decline and a heightened fear of falling.
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Affiliation(s)
- Danielle A Sterner
- Physiology of Work and Exercise Response (POWER) Lab, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Jeffrey R Stout
- Physiology of Work and Exercise Response (POWER) Lab, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, United States
| | - Kworweinski Lafontant
- Physiology of Work and Exercise Response (POWER) Lab, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
- College of Nursing, University of Central Florida, Orlando, FL, United States
| | - Joon-Hyuk Park
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, United States
- Mechanical and Aerospace Engineering Department, University of Central Florida, Orlando, FL, United States
| | - David H Fukuda
- Physiology of Work and Exercise Response (POWER) Lab, Institute of Exercise Physiology and Rehabilitation Science, University of Central Florida, Orlando, FL, United States
| | - Ladda Thiamwong
- Disability, Aging, and Technology Cluster, University of Central Florida, Orlando, FL, United States
- College of Nursing, University of Central Florida, Orlando, FL, United States
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Valisoltani N, Mohammadi H, Aliannejad R, Naeini F, Harsini AR, Sadeghi E, Mirzaee P, Imani H. Association of phase angle with sarcopenia and muscle function in patients with COPD: a case-control study. BMC Pulm Med 2024; 24:18. [PMID: 38184558 PMCID: PMC10771663 DOI: 10.1186/s12890-023-02814-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 12/13/2023] [Indexed: 01/08/2024] Open
Abstract
BACKGROUND AND AIMS The predictive value of phase angle for sarcopenia diagnosis has been discussed for years. The present investigation was conducted to determine the association between phase angle and sarcopenia in patients with COPD. METHODS In this case-control study, 222 smoker men were divided into healthy and COPD groups. COPD was diagnosed by a pulmonologist through spirometry. Anthropometric indices, phase angle, muscle function, sarcopenia, and dietary intake were assessed. RESULTS A significant inverse association was observed between phase angle and sarcopenia after adjustment for age and energy intake (OR: 0.31, 95% CI 0.18-0.52) and after adjustment for BMI (OR: 0.31, 95% CI 0.18-0.52). A significant decrease was detected in anthropometric indices and indicators of sarcopenia and muscle function in COPD cases compared to the healthy controls. CONCLUSIONS Although further studies are suggested, phase angle might be considered an indicator of sarcopenia and muscle function in COPD patients.
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Affiliation(s)
- Neda Valisoltani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Science, Tehran, Iran
| | - Hamed Mohammadi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Science, Tehran, Iran
| | - Rasoul Aliannejad
- Department of Pulmonary and Critical Care, School of Medicine, Shariati Hospital, Tehran, Iran
| | - Fatemeh Naeini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Science, Tehran, Iran
| | - Asma Rajabi Harsini
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Science, Tehran, Iran
| | - Erfan Sadeghi
- Research Consultation Center (RCC), Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pouya Mirzaee
- Department of Medicine, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran
| | - Hossein Imani
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Science, Tehran, Iran.
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Kasahara R, Fujita T, Jinbo R, Kubota J, Takano A, Takahashi S, Ohashi Y, Jinbo K, Yamamoto Y, Kai T, Shiga Y, Kimura H, Furukawa M, Owari M, Morishita S. Is Phase Angle Useful in Screening for Sarcopenia in Patients with Hematologic Malignancies? Nutr Cancer 2023; 76:121-127. [PMID: 37987672 DOI: 10.1080/01635581.2023.2283933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 11/10/2023] [Indexed: 11/22/2023]
Abstract
The purposes of this study were to investigate the relationship between sarcopenia and phase angle (PhA), and to examine whether PhA cutoff values can be used to identify sarcopenia in patients with hematologic malignancies. The study population comprised 108 patients with hematologic malignancies who were admitted for chemotherapy, and were undergoing rehabilitation for exercise therapy. The diagnostic criteria for sarcopenia were determined according to the Asian Working Group for Sarcopenia 2019. Muscle strength, endurance, and body composition (including PhA), were assessed. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to investigate associations between sarcopenia and PhA, and to determine cutoff values. Sarcopenia was found in 17.6% of the participants. PhA was significantly associated with sarcopenia (p < 0.01). The areas under the curve were 0.84 for the males and 0.87 for the females, and the cutoff values were 4.75° for the males (sensitivity 69%, specificity 83%) and 3.95° for the females (sensitivity 78%, specificity 85%). Our results suggest that PhA, which can be measured noninvasively, objectively, and rapidly, can be used as a screening tool for sarcopenia in patients with hematologic malignancies.
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Affiliation(s)
- Ryuichi Kasahara
- Department of Rehabilitation, Kita-Fukushima Medical Center, Fukushima, Japan
| | - Takaaki Fujita
- Department of Occupational Therapy, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
| | - Ryohei Jinbo
- Department of Rehabilitation, Kita-Fukushima Medical Center, Fukushima, Japan
| | - Junko Kubota
- Department of Rehabilitation, Kita-Fukushima Medical Center, Fukushima, Japan
| | - Aya Takano
- Department of Rehabilitation, Kita-Fukushima Medical Center, Fukushima, Japan
| | - Shoko Takahashi
- Department of Rehabilitation, Kita-Fukushima Medical Center, Fukushima, Japan
| | - Yuka Ohashi
- Department of Rehabilitation, Kita-Fukushima Medical Center, Fukushima, Japan
| | - Kazumi Jinbo
- Department of Rehabilitation, Kita-Fukushima Medical Center, Fukushima, Japan
| | - Yuichi Yamamoto
- Department of Rehabilitation, Kita-Fukushima Medical Center, Fukushima, Japan
| | - Tatsuyuki Kai
- Department of Hematology, Kita-Fukushima Medical Center, Fukushima, Japan
| | - Yutaka Shiga
- Department of Hematology, Kita-Fukushima Medical Center, Fukushima, Japan
| | - Hideo Kimura
- Department of Hematology, Kita-Fukushima Medical Center, Fukushima, Japan
| | - Miki Furukawa
- Department of Hematology, Kita-Fukushima Medical Center, Fukushima, Japan
| | - Mai Owari
- Department of Hematology, Kita-Fukushima Medical Center, Fukushima, Japan
| | - Shinichiro Morishita
- Department of Physical Therapy, School of Health Sciences, Fukushima Medical University, Fukushima, Japan
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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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Wang Y, Hu Y, Zhang M, Jin H, Wen Y, Tang R, Wang B, Liu B, Liu H. Bioelectrical impedance analysis-derived phase angle predicts sarcopenia in patients on maintenance hemodialysis. Nutr Clin Pract 2023. [PMID: 36808630 DOI: 10.1002/ncp.10967] [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: 07/26/2022] [Revised: 11/27/2022] [Accepted: 01/21/2023] [Indexed: 02/20/2023] Open
Abstract
BACKGROUND This study aimed to investigate the association between phase angle (PhA) and sarcopenia and evaluate its performance as a sarcopenia predictor in patients receveing maintenance hemodialysis (MHD). METHODS All enrolled patients underwent handgrip strength (HGS) and the 6-m walk test, and muscle mass was measured using bioelectrical impedance analysis. Sarcopenia was diagnosed according to the diagnostic criteria of the Asian Sarcopenia Working Group. Logistic regression analysis was used to evaluate the PhA as an independent predictor of sarcopenia after adjusting for confounding factors. The receiver operating characteristic (ROC) curve was used to analyze the predictive value of PhA in sarcopenia. RESULTS Two hundred forty-one patients receiving hemodialysis were enrolled in this study, and the prevalence of sarcopenia was 28.2%. Patients with sarcopenia presented a lower PhA value (4.7° vs 5.5°; P < 0.001), lower muscle mass index (6.0 vs 7.2 [kg/m2 ]; P < 0.001), lower HGS (19.7 vs 26.0 [kg]; P < 0.001), and lower walk speed (0.83 ± 0.27 vs 0.92 ± 0.23 [m/s]; P = 0.007) than patients without sarcopenia. The odds of patients receiving MHD presenting with sarcopenia increased as PhA decreased, even after adjustment (odds ratio = 0.39; 95% CI, 0.18-0.85; P = 0.019). ROC analysis revealed that the best cutoff value of PhA for sarcopenia was 4.95° in patients receiving MHD. CONCLUSION PhA may be a useful and simple predictor for predicting patients undergoing hemodialysis who are at risk of sarcopenia. To further facilitate the application of PhA in the diagnosis of sarcopenia, more research need to be conducted.
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Affiliation(s)
- Ying Wang
- Department of Nephrology, Zhong da Hospital, Southeast University School of Medicine, Nanjing, China.,Department of Clinical Nutrition, School of Medicine, Southeast University, Nanjing, China
| | - Yezi Hu
- Department of Nutrition, Zhong da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Mengyan Zhang
- Department of Nephrology, Zhong da Hospital, Southeast University School of Medicine, Nanjing, China.,Department of Clinical Nutrition, School of Medicine, Southeast University, Nanjing, China
| | - Hui Jin
- Department of Nutrition, Zhong da Hospital, Southeast University School of Medicine, Nanjing, China
| | - Yi Wen
- Department of Nephrology, Zhong da Hospital, Southeast University School of Medicine, Nanjing, China.,Department of Clinical Nutrition, School of Medicine, Southeast University, Nanjing, China
| | - Rining Tang
- Department of Nephrology, Zhong da Hospital, Southeast University School of Medicine, Nanjing, China.,Department of Clinical Nutrition, School of Medicine, Southeast University, Nanjing, China
| | - Bin Wang
- Department of Nephrology, Zhong da Hospital, Southeast University School of Medicine, Nanjing, China.,Department of Clinical Nutrition, School of Medicine, Southeast University, Nanjing, China
| | - Bicheng Liu
- Department of Nephrology, Zhong da Hospital, Southeast University School of Medicine, Nanjing, China.,Department of Clinical Nutrition, School of Medicine, Southeast University, Nanjing, China
| | - Hong Liu
- Department of Nephrology, Zhong da Hospital, Southeast University School of Medicine, Nanjing, China.,Department of Clinical Nutrition, School of Medicine, Southeast University, Nanjing, China
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8
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Fu C, Yan D, Wang L, Duan F, Gu D, Yao N, Sun M, Wang D, Lin X, Wu Y, Wang X, Cheng X, Zhang D. High prevalence of sarcopenia and myosteatosis in patients undergoing hemodialysis. Front Endocrinol (Lausanne) 2023; 14:1117438. [PMID: 37033264 PMCID: PMC10076821 DOI: 10.3389/fendo.2023.1117438] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Accepted: 03/09/2023] [Indexed: 04/11/2023] Open
Abstract
BACKGROUND AND PURPOSE Sarcopenia is highly prevalent (28.5-40.3%) in patients undergoing hemodialysis and leads to poor clinical outcomes. However, the association between muscle quality and sarcopenia in patients receiving hemodialysis remains unclear. Therefore, we aimed to explore the association between muscle cross-sectional area (CSA) and proton-density fat-fraction (PDFF) in patients with sarcopenia undergoing hemodialysis. METHODS Seventy-six patients undergoing hemodialysis for > 3 months were enrolled. Their handgrip strength (HGS), short physical performance battery (SPPB) performance, and appendicular skeletal muscle mass index (ASMI) were measured. Sarcopenia was defined using the Asian Working Group for Sarcopenia 2019 consensus update. All patients underwent quantitative magnetic resonance imaging. CSA and PDFF were measured for the thigh, trunk, and gluteus muscles. RESULTS The prevalence of probable, confirmed, and severe sarcopenia in this study was 73.7%, 51.3%, and 22.4%, respectively. Older age (OR: 1.061, P < 0.003); lower body mass index (BMI) (OR: 0.837, P = 0.008), albumin (OR: 0.765, P = 0.004), prealbumin (OR: 0.987, P = 0.001), predialysis blood urea nitrogen (BUN) (OR: 0.842, P < 0.001), predialysis creatinine (OR: 0.993, P < 0.001), phosphorus (OR: 0.396, P = 0.047); lower CSA of the thigh (OR: 0.58, P = 0.035), third lumbar (L3) trunk (OR: 0.37, P = 0.004), gluteus minimus and medius (OR: 0.28, P = 0.001), and gluteus maximus (OR: 0.28, P= 0.001); and higher PDFF of the thigh (OR: 1.89, P = 0.036) and L3 trunk (OR: 1.71, P = 0.040) were identified as sarcopenia risk factors. The gluteus minimus and medius CSA was lower in patients with sarcopenia than in those without after adjusting for age and BMI (OR: 0.37, P = 0.017). Higher thigh (P = 0.031) and L3 trunk (P = 0.006) muscle PDFF were significantly associated with lower HGS. Furthermore, higher thigh (P = 0.011) and L3 trunk (P = 0.010) muscle PDFF were also inversely correlated with lower ASMI. CONCLUSION Our findings demonstrate the high prevalence of sarcopenia and myosteatosis in patients undergoing hemodialysis and might trigger a paradigm shift in intervention strategies for patients receiving hemodialysis.
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Affiliation(s)
- Chen Fu
- Department of Nephrology, Beijing Jishuitan Hospital, Beijing, China
| | - Dong Yan
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Ling Wang
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Fangfang Duan
- Clinical Epidemiology Research Center, Beijing Jishuitan Hospital, Beijing, China
| | - Dalong Gu
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Ning Yao
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Mingke Sun
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
| | - Di Wang
- Department of Nephrology, Beijing Jishuitan Hospital, Beijing, China
| | - Xuya Lin
- Department of Nephrology, Beijing Jishuitan Hospital, Beijing, China
| | - Yanglei Wu
- MR Collaboration, Siemens Healthineers Ltd., Beijing, China
| | - Xiaofei Wang
- Department of Nephrology, Beijing Jishuitan Hospital, Beijing, China
| | - Xiaoguang Cheng
- Department of Radiology, Beijing Jishuitan Hospital, Beijing, China
- *Correspondence: Xiaoguang Cheng, ; Dongliang Zhang,
| | - Dongliang Zhang
- Department of Nephrology, Beijing Jishuitan Hospital, Beijing, China
- *Correspondence: Xiaoguang Cheng, ; Dongliang Zhang,
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9
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Wu H, Ding P, Wu J, Yang P, Tian Y, Zhao Q. Phase angle derived from bioelectrical impedance analysis as a marker for predicting sarcopenia. Front Nutr 2022; 9:1060224. [PMID: 36590205 PMCID: PMC9798294 DOI: 10.3389/fnut.2022.1060224] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 11/18/2022] [Indexed: 12/23/2022] Open
Abstract
Sarcopenia is commonly defined as the age-related loss of muscle mass and function and may be caused by several factors, such as genetics, environmental conditions, lifestyle, drug use, and, in particular, comorbidities. People with pre-existing conditions are more likely to develop sarcopenia and subsequently have a less favorable prognosis. Recently, phase angle (PhA), which is derived from bioelectrical impedance analysis (BIA), has received a great deal of attention, and numerous studies have been carried out to examine the relationship between PhA and sarcopenia in different conditions. Based on these studies, we expect that PhA could be used as a potential marker for sarcopenia in the future.
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Affiliation(s)
- Haotian Wu
- The Third Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer, Shijiazhuang, China
| | - Ping'an Ding
- The Third Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer, Shijiazhuang, China
| | - Jiaxiang Wu
- The Third Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer, Shijiazhuang, China
| | - Peigang Yang
- The Third Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer, Shijiazhuang, China
| | - Yuan Tian
- The Third Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer, Shijiazhuang, China
| | - Qun Zhao
- The Third Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang, China,Hebei Key Laboratory of Precision Diagnosis and Comprehensive Treatment of Gastric Cancer, Shijiazhuang, China,*Correspondence: Qun Zhao
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10
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Geng J, Wei Y, Xue Q, Deng L, Wang J. Phase angle is a useful bioelectrical marker for skeletal muscle quantity and quality in hospitalized elderly patients. Medicine (Baltimore) 2022; 101:e31646. [PMID: 36397457 PMCID: PMC9666191 DOI: 10.1097/md.0000000000031646] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
To analyze whether phase angle (PhA) can be a useful bioelectrical marker for skeletal muscle quantity and quality in hospitalized elderly patients. Two hundred hospitalized elderly patients were included in this retrospective observational study. PhA was obtained by Bioelectrical Impedance Analysis, skeletal muscle area index (SMI) and skeletal muscle density (SMD) were measured at the third lumbar vertebra level in computed tomography images using SliceOmatic software. PhA was positively associated with SMD and SMI, with correlation coefficients of 0.629 and 0.674, respectively. Multiple logistic regression analysis showed that 1° reduction of PhA was significantly associated with low SMI [odds ratio (OR) = 4.331 (1.681-11.161)] and low SMD [OR = 6.418 (2.963-13.899)]. Receiver operating characteristic curve analysis showed that the area under the curve (AUC) for PhA to identify patients with low SMI was 0.772 for male and 0.784 for female; the AUC for PhA to identify low SMD patients was 0.829 for male and 0.812 for female; the AUC for PhA to identify low SMD combined with low SMD patients was 0.801 for male and 0.773 for female. The results of this study showed that PhA was highly related to SMI, which can indicate the quantity of skeletal muscle in the entire body, and was highly related to SMD, which can be used to assess skeletal muscle quality. Therefore, PhA may be a useful bioelectrical marker for skeletal muscle quantity and quality.
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Affiliation(s)
- Jiaxu Geng
- Department of Gerontology, Peking University People’s Hospital, Beijing, China
| | - Yanan Wei
- Department of Gerontology, Peking University People’s Hospital, Beijing, China
| | - Qian Xue
- Department of Gerontology, Peking University People’s Hospital, Beijing, China
| | - Lihua Deng
- Department of Gerontology, Peking University People’s Hospital, Beijing, China
| | - Jingtong Wang
- Department of Gerontology, Peking University People’s Hospital, Beijing, China
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11
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Wathanavasin W, Banjongjit A, Avihingsanon Y, Praditpornsilpa K, Tungsanga K, Eiam-Ong S, Susantitaphong P. Prevalence of Sarcopenia and Its Impact on Cardiovascular Events and Mortality among Dialysis Patients: A Systematic Review and Meta-Analysis. Nutrients 2022; 14:nu14194077. [PMID: 36235729 PMCID: PMC9572026 DOI: 10.3390/nu14194077] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 09/20/2022] [Accepted: 09/26/2022] [Indexed: 11/05/2022] Open
Abstract
Sarcopenia in end-stage kidney disease patients requiring dialysis is a frequent complication but remains an under-recognized problem. This meta-analysis was conducted to determine the prevalence of sarcopenia and explored its impacts on clinical outcomes, especially cardiovascular events, and mortality in dialysis patients. The eligible studies were searched from PubMed, Scopus, and Cochrane Central Register of Controlled trials up to 31 March 2022. We included studies that reported the interested outcomes, and the random-effects model was used for analysis. Forty-one studies with 7576 patients were included. The pooled prevalence of sarcopenia in dialysis patients was 25.6% (95% CI 22.1 to 29.4%). Sarcopenia was significantly associated with higher mortality risk (adjusted OR 1.83 (95% CI 1.40 to 2.39)) and cardiovascular events (adjusted OR 3.80 (95% CI 1.79 to 8.09)). Additionally, both low muscle mass and low muscle strength were independently related to increased mortality risk in dialysis patients (OR 1.71; 95% CI (1.20 to 2.44), OR 2.15 (95% CI 1.51 to 3.07)), respectively. This meta-analysis revealed that sarcopenia was highly prevalent among dialysis patients and shown to be an important predictor of cardiovascular events and mortality. Future intervention research to alleviate this disease burden in dialysis patients is needed.
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Affiliation(s)
- Wannasit Wathanavasin
- Nephrology Unit, Department of Medicine, Charoenkrung Pracharak Hospital, Bangkok Metropolitan Administration, Bangkok 10120, Thailand
| | - Athiphat Banjongjit
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10120, Thailand
| | - Yingyos Avihingsanon
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10120, Thailand
| | - Kearkiat Praditpornsilpa
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10120, Thailand
| | - Kriang Tungsanga
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10120, Thailand
| | - Somchai Eiam-Ong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10120, Thailand
| | - Paweena Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok 10120, Thailand
- Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok 10120, Thailand
- Correspondence: ; Tel.: +66-22-564-251; Fax: +66-22-564-560
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12
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Chang LY, Ding Y, Zhang HM, Wang S. “Re. Predictive value of phase angle in sarcopenia in patients on maintenance hemodialysis”: Author's response. Nutrition 2022; 98:111634. [DOI: 10.1016/j.nut.2022.111634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 02/14/2022] [Indexed: 11/24/2022]
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