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Carretero Gómez J, González Gónzalez P, Galeano Fernández TF, Córdoba Bueno S, Boyero Calvo N, Salgado Cardoso B, Arévalo Lorido JC. Bioelectrical impedance-derived phase angle (PhA) in people living with obesity: Role in sarcopenia and comorbidities. Nutr Metab Cardiovasc Dis 2024; 34:2511-2518. [PMID: 39069470 DOI: 10.1016/j.numecd.2024.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 06/17/2024] [Accepted: 06/18/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND AND AIM Obesity is characterized by alterations in fat and muscle mass. Phase angle (PhA) is considered an index of muscle mass, and is related to comorbidities in SO. This work aimed to assess the relationship between PhA, muscle mass, inflammation, and comorbidities in obesity. METHODS AND RESULTS We included 198 outpatients with obesity (BMI≥30) divided into tertiles according to PhA distribution (<5°, 5°-6°, >7°). Body composition was analyzed using bioimpedance (Tanita MC-780P Multi-Frequency Segmental Body Composition Analyzer). Quantitative variables were compared using the Kruskal-Wallis test and qualitative variables using the chi-square test. A correspondence analysis was built to show the influence of qualitative variables on subjects in each tertile. Patients in the lowest tertile had the lowest skeletal muscle mass and appendicular skeletal muscle mass index (ASMI); the highest inflammatory index (albumin and derived neutrophil-to-lymphocyte ratio, Alb-dNLR); and the highest percentage of individuals with a history of type 2 diabetes mellitus (T2DM), chronic kidney disease (CKD), and heart failure (HF). The correspondence analysis showed an association between the lowest tertile and presence of HF with preserved ejection fraction (HFpEF) and CKD. On the logistic regression model, ASMI (OR 0.9, 95%CI 0.85-0.95, p = 0.0004), Alb-dNLR (OR 1.04, 95%CI 1.04-16.4, p = 0.04) and HFpEF and T2DM were significantly associated with the lowest PhA. CONCLUSIONS Identifying high-risk individuals living with obesity is a priority. These results show that lower PhA is related to inflammation, poorer skeletal muscle mass and consequently, their impact on obesity-related comorbidities and clinical outcomes.
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Affiliation(s)
- Juana Carretero Gómez
- Internal Medicine Department, University Hospital Complex of Badajoz, Avda de Elvas, S/N. 06085, Badajoz, Spain.
| | - Patricia González Gónzalez
- Internal Medicine Department, University Hospital Complex of Badajoz, Avda de Elvas, S/N. 06085, Badajoz, Spain
| | | | - Sonia Córdoba Bueno
- Internal Medicine Department, University Hospital Complex of Badajoz, Avda de Elvas, S/N. 06085, Badajoz, Spain
| | - Natalia Boyero Calvo
- Internal Medicine Department, University Hospital Complex of Badajoz, Avda de Elvas, S/N. 06085, Badajoz, Spain
| | - Belén Salgado Cardoso
- Internal Medicine Department, University Hospital Complex of Badajoz, Avda de Elvas, S/N. 06085, Badajoz, Spain
| | - José Carlos Arévalo Lorido
- Internal Medicine Department, University Hospital Complex of Badajoz, Avda de Elvas, S/N. 06085, Badajoz, Spain
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Zeng Y, Chen Y, Yang Y, Qiu Y, Fu P, Yuan H. Bioelectrical impedance analysis-derived phase angle predicts possible Sarcopenia in patients on maintenance hemodialysis: a retrospective study. BMC Nephrol 2024; 25:357. [PMID: 39415123 PMCID: PMC11484146 DOI: 10.1186/s12882-024-03787-5] [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: 03/10/2024] [Accepted: 09/30/2024] [Indexed: 10/18/2024] Open
Abstract
BACKGROUND The prevalence of possible sarcopenia is notably high among maintenance hemodialysis (MHD) patients. Possible sarcopenia, defined as a decrease in muscle strength and/or somatic function, is an early and reversible condition between non-sarcopenic and sarcopenia, and early recognition and intervention for possible sarcopenia is important for preventing adverse outcomes and improving the quality of life of these patients. This study aimed to establish a simple and effective model for screening and identifying MHD patients at high risk of possible sarcopenia by using 50 kHz-Whole Body Phase Angle (PhA), with a specific focus on gender differences. METHODS This prospective cross-sectional study was conducted from September to December 2023 at the Wenjiang Hemodialysis Center in the Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China. A total of 244 MHD patients, including 130 males and 114 females, were enrolled. Data were collected prospectively, including demographic information and physical measurements. All participants provided informed consent before enrollment. Measurements were taken post-dialysis to ensure consistency. The whole-body phase angle was measured using the InBody S10 device, grip strength was measured using an electronic grip strength tester, and physical function was assessed by the Short Physical Performance Battery (SPPB). The Skeletal Muscle Index (SMI) was also calculated. RESULTS A total of 244 patients receiving hemodialysis were enrolled in this study. Among these, 109 patients were categorized as non-sarcopenic, 111 as having possible sarcopenia, and 24 as sarcopenic. The prevalence of sarcopenia among MHD patients is 9.8%, while the prevalence of possible sarcopenia is 45.5%. The receiver operating characteristic (ROC) curve analysis showed that for male patients, the AUC of PhA for predicting possible sarcopenia was 0.798, with a sensitivity of 80.36%, specificity of 69.70%, and a cutoff value of 6.20°. For female patients, the AUC of PhA was 0.701, with a sensitivity of 70.91% and specificity of 62.79%, and a cutoff value of 5.70°. CONCLUSIONS PhA may be a useful and simple predictor of the risk of possible sarcopenia in MHD patients, and more research is needed to further promote the use of PhA in possible sarcopenia.
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Affiliation(s)
- Ying Zeng
- Department of Nephrology, Institute of Kidney Diseases, West China Hospital of Sichuan University, Chengdu, 610041, China
- West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Yang Chen
- Department of Nephrology, Institute of Kidney Diseases, West China Hospital of Sichuan University, Chengdu, 610041, China
- West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Yujie Yang
- Department of Nephrology, Institute of Kidney Diseases, West China Hospital of Sichuan University, Chengdu, 610041, China
- West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Ying Qiu
- Department of Nephrology, Institute of Kidney Diseases, West China Hospital of Sichuan University, Chengdu, 610041, China
- West China School of Nursing, Sichuan University, Chengdu, 610041, China
| | - Ping Fu
- Department of Nephrology, Institute of Kidney Diseases, West China Hospital of Sichuan University, Chengdu, 610041, China
| | - Huaihong Yuan
- Department of Nephrology, Institute of Kidney Diseases, West China Hospital of Sichuan University, Chengdu, 610041, China.
- West China School of Nursing, Sichuan University, Chengdu, 610041, China.
- Guoxue Alley, Chengdu, Sichuan province, China.
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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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Murakami T, Kobayashi T, Ono H, Shibuma H, Tsuji K, Nikkuni E, Mori N, Ohkouchi S, Tabata M, Irokawa T, Ogawa H, Takahashi T, Kurosawa H. Phase angle as an indicator of sarcopenia and malnutrition in patients with chronic obstructive pulmonary disease. Respir Investig 2024; 62:651-656. [PMID: 38761479 DOI: 10.1016/j.resinv.2024.05.012] [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: 03/21/2024] [Revised: 05/08/2024] [Accepted: 05/12/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Phase angle (PhA), which is measured using bioelectrical impedance analysis, is an indicator of muscle quality and malnutrition. PhA has been shown to be correlated with sarcopenia and malnutrition; however, studies on patients with chronic obstructive pulmonary disease (COPD) are limited. In this study, we investigated the correlation between PhA and sarcopenia and malnutrition and determined the cutoff values of PhA for those in patients with COPD. METHODS This study included 105 male patients with COPD (mean age 75.7 ± 7.7 years, mean forced expiratory volume in 1s % predicted [%FEV1] 57.0 ± 20.1%) and 12 male controls (mean age 74.1 ± 3.8 years) who were outpatients between December 2019 and March 2024. PhA was measured using the InBody S10, and its correlation with sarcopenia and malnutrition was assessed. The cutoff PhA values for sarcopenia and malnutrition were determined using receiver operating characteristic curves. RESULTS The prevalence rates of sarcopenia and malnutrition were 31% and 22%, respectively, in patients with COPD. PhA significantly correlated with sarcopenia- and malnutrition-related indicators. Multivariate logistic regression analysis independently correlated PhA with sarcopenia and malnutrition. The cutoff values of the PhA for sarcopenia and malnutrition were 4.75° (AUC = 0.78, 95% CI = 0.68-0.88) and 4.25° (AUC = 0.75, 95% CI = 0.63-0.86), respectively. CONCLUSIONS PhA was significantly correlated with sarcopenia and malnutrition in Japanese patients with COPD and may be a useful diagnostic indicator.
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Affiliation(s)
- Tomoyuki Murakami
- Department of Rehabilitation, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, 2-29-1, Yamatomachi, Wakabayashi-ku, Sendai 984-8560, Miyagi, Japan; Department of Occupational Health, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Takeshi Kobayashi
- Department of Rehabilitation, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, 2-29-1, Yamatomachi, Wakabayashi-ku, Sendai 984-8560, Miyagi, Japan
| | - Hiroto Ono
- Department of Rehabilitation, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, 2-29-1, Yamatomachi, Wakabayashi-ku, Sendai 984-8560, Miyagi, Japan
| | - Hayato Shibuma
- Department of Occupational Health, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Kazuhiro Tsuji
- Department of Occupational Health, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Etsuhiro Nikkuni
- Department of Occupational Health, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Naoki Mori
- Department of Occupational Therapy, Yamagata Prefectural University of Health Sciences, 260, Kamiyanagi, Yamagata, Yamagata 990-2212, Japan
| | - Shinya Ohkouchi
- Department of Occupational Health, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Masao Tabata
- Department of Occupational Health, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Toshiya Irokawa
- Department of Occupational Health, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Hiromasa Ogawa
- Department of Occupational Health, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Aoba-ku, Sendai, Miyagi 980-8575, Japan
| | - Tsuneyuki Takahashi
- Department of Respiratory Internal Medicine, Tohoku Medical and Pharmaceutical University Wakabayashi Hospital, 2-29-1, Yamatomachi, Wakabayashi-ku, Sendai 984-8560, Miyagi, Japan
| | - Hajime Kurosawa
- Department of Occupational Health, Tohoku University Graduate School of Medicine, 2-1, Seiryomachi, Aoba-ku, Sendai, Miyagi 980-8575, Japan.
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Muršić D, Glunčić TJ, Ostojić J, Škrinjarić-Cincar S, Kardum LB, Dokoza M, Lazarušić NK, Bešić E, Samaržija M, Dugac AV. Body composition, pulmonary function tests, exercise capacity, and quality of life in chronic obstructive pulmonary disease patients with obesity. Postgrad Med J 2024; 100:469-474. [PMID: 38377471 DOI: 10.1093/postmj/qgae024] [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: 10/31/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/22/2024]
Abstract
PURPOSE OF THE STUDY Larger proportions of chronic obstructive pulmonary disease (COPD) patients are currently overweight or with obesity than underweight, and the combination of COPD and obesity is increasing. The purpose of this study was to investigate differences in the body composition, pulmonary function tests, exercise capacity, and health-related quality of life among normal weight, overweight, and obese patients with COPD. STUDY DESIGN A total of 514 patients with COPD were included in the study. According to the World Health Organization criteria for body mass index, the patients were classified as normal weight, overweight, and obese. Evaluations included fat-free mass, fat-free mass index, phase angle, pulmonary function tests, and 6-minute walk test. Dyspnea was assessed using the modified Medical Research Council dyspnea scale, and the health-related quality of life was evaluated using COPD Assessment Test and St. George's Respiratory Questionnaire. Values were compared among the three groups. RESULTS There were 315 male and 199 female patients, with a mean age of 66.7 ± 8.4 years. Fat-free mass, fat-free mass index, and phase angle values were significantly higher in COPD patients with obesity than in other patients (P < .001, P < .001, P < .001). Forced expiratory volume in 1 s, forced expiratory volume in 1 s/forced vital capacity, and diffusing capacity of lung for carbon monoxide value in pulmonary function tests were significantly higher in COPD patients with obesity than in other patients (P = .046, P < .001, P < .001), while the forced vital capacity values were similar in all groups. Exercise capacity (6-min walk test distance), dyspnea symptoms (modified Medical Research Council scale), and health-related quality of life (COPD Assessment Test and St. George's Respiratory Questionnaire) did not differ significantly between groups. CONCLUSIONS According to our study, obesity has no negative effect on pulmonary function tests, dyspnea perception, exercise capacity, and health-related quality of life.
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Affiliation(s)
- Davorka Muršić
- Clinic for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Tajana Jalušić Glunčić
- Clinic for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Jelena Ostojić
- Clinic for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
| | - Sanda Škrinjarić-Cincar
- Department of Internal Medicine and History of Medicine, Faculty of Medicine, University of Osijek, 31000 Osijek, Croatia
| | | | - Martina Dokoza
- Department of Internal Medicine, Zadar General Hospital, 23000 Zadar, Croatia
| | | | - Erim Bešić
- Department of Biophysics, Faculty of Pharmacy and Biochemistry, University of Zagreb, 10000 Zagreb, Croatia
| | - Miroslav Samaržija
- Clinic for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Andrea Vukić Dugac
- Clinic for Respiratory Diseases Jordanovac, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
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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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Zhang P, Liu S, Zhu X, Liu H, Zeng L, Yan J, Liu J. The effects of a physical exercise program in Chinese kidney transplant recipients: a prospective randomised controlled trial. Clin Kidney J 2023; 16:1316-1329. [PMID: 37529646 PMCID: PMC10387397 DOI: 10.1093/ckj/sfad065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Indexed: 08/03/2023] Open
Abstract
Background Kidney transplant has become the preferred therapy for end-stage renal disease. However, kidney transplant recipients (KTRs) still face several challenges, such as physical inactivity. The purpose of this study was to explore the effects of a nurse-led physical exercise program in Chinese KTRs. Methods A total of 106 participants were enrolled from the Third Xiangya Hospital of Central South University between July 2021 and June 2022 and randomly assigned to the control or intervention groups. Participants in the control group were provided with routine nursing care and participants in the intervention group received a nurse-led rigorous physical exercise program that was divided into two stages: the pre-discharge stage and the post-discharge stage. The pre-discharge stage included the non-ambulatory and ambulatory stages. The Chinese traditional exercise Baduanjin was incorporated into the physical exercise during the ambulatory stage. The post-discharge stage continued the same exercise as the ambulatory stage at home. After 3 months of intervention, both groups received the same follow-up for 3 months. The primary and secondary outcomes of all participants were collected. The data were analysed with repeated measures analysis of variance to examine the effectiveness of the intervention. Results Compared with the control group, the intervention group had less fatigue and more motivation to be active in primary outcomes. Moreover, patients in the intervention group had a higher phase angle, a longer 6-minute walk distance, more 30-second chair stand times and decreased anxiety and depression levels in secondary outcomes. No adverse events were observed during the intervention. There were no significant differences in all dimensions of the quality-of-life questionnaire between the intervention and the control group. Conclusion Chinese KTRs could benefit from the nurse-led physical exercise program post-operatively. Trial registration ChiCTR2100048755.
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Affiliation(s)
- Pengpeng Zhang
- Department of Transplantation, Third Xiangya Hospital of Central South University, Changsha, China
| | - Shan Liu
- Adelphi University College of Nursing and Public Health, Garden City, NY, USA
| | - Xiao Zhu
- Department of Transplantation, Third Xiangya Hospital of Central South University, Changsha, China
| | - Huan Liu
- Department of Transplantation, Third Xiangya Hospital of Central South University, Changsha, China
| | - Le Zeng
- Department of Transplantation, Third Xiangya Hospital of Central South University, Changsha, China
| | - Jin Yan
- Nursing Department, Third Xiangya Hospital of Central South University, Changsha, China
| | - Jia Liu
- Correspondence to: Jia Liu; E-mail:
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Wang X, Liang Q, Li Z, Li F. Body Composition and COPD: A New Perspective. Int J Chron Obstruct Pulmon Dis 2023; 18:79-97. [PMID: 36788999 PMCID: PMC9922509 DOI: 10.2147/copd.s394907] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/02/2023] [Indexed: 02/10/2023] Open
Abstract
The proportion of obese or overweight patients in COPD patients is increasing. Although BMI, WC and other easy to measure indicators have been proven to be related to the risk of COPD, they cannot accurately reflect the distribution and changes of body composition, ignoring the body composition (such as fat distribution, muscle content, water content, etc.), the relationship between it and disease risk may be missed. By analyzing the correlation between different body composition indexes and COPD patients, we can provide new research ideas for the prognosis judgment or intervention of COPD disease.
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Affiliation(s)
- Xin Wang
- Department of Integrated Pulmonology, Fourth Clinical Medical College of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Xinjiang National Clinical Research Base of Traditional Chinese Medicine, Urumqi, Xinjiang, People’s Republic of China
| | - Qianqian Liang
- Department of Integrated Pulmonology, Fourth Clinical Medical College of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Xinjiang National Clinical Research Base of Traditional Chinese Medicine, Urumqi, Xinjiang, People’s Republic of China
| | - Zheng Li
- Department of Integrated Pulmonology, Fourth Clinical Medical College of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Xinjiang National Clinical Research Base of Traditional Chinese Medicine, Urumqi, Xinjiang, People’s Republic of China
- Xinjiang Key Laboratory of Respiratory Disease Research, Urumqi, Xinjiang, People’s Republic of China
- Xinjiang Clinical Medical Research Center of Respiratory Obstructive Diseases, Urumqi, Xinjiang, People’s Republic of China
| | - Fengsen Li
- Department of Integrated Pulmonology, Fourth Clinical Medical College of Xinjiang Medical University, Urumqi, Xinjiang, People’s Republic of China
- Xinjiang National Clinical Research Base of Traditional Chinese Medicine, Urumqi, Xinjiang, People’s Republic of China
- Xinjiang Key Laboratory of Respiratory Disease Research, Urumqi, Xinjiang, People’s Republic of China
- Xinjiang Clinical Medical Research Center of Respiratory Obstructive Diseases, Urumqi, Xinjiang, People’s Republic of China
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Tsuji H, Tetsunaga T, Misawa H, Nishida K, Ozaki T. Association of phase angle with sarcopenia in chronic musculoskeletal pain patients: a retrospective study. J Orthop Surg Res 2023; 18:87. [PMID: 36737742 PMCID: PMC9898892 DOI: 10.1186/s13018-023-03567-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 01/27/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND In chronic musculoskeletal pain patients, detection of sarcopenia is of significant clinical interest. Phase angle, which can be measured through bioelectrical impedance analysis (BIA), can detect sarcopenia; however, the evidence in chronic musculoskeletal pain patients is limited. This study aimed to assess the relationship between phase angle and sarcopenia in patients with chronic musculoskeletal pain. Our hypothesis was that phase angle would be a useful indicator to identify sarcopenia in patients with chronic musculoskeletal pain. METHODS A total of 190 patients (51 men and 139 women) with chronic musculoskeletal pain were included in this retrospective cross-sectional study. Patient data of backgrounds, numeric rating scale score for pain, skeletal muscle index, and phase angle assessed using BIA were retrospectively reviewed. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia criteria 2019. RESULTS A total of 51 patients (26.7%), including 10 men (19.6%) and 41 women (29.5%), were diagnosed with sarcopenia. Phase angle, sarcopenia-related factors, age, and body mass index (BMI) differed significantly in patients with and without sarcopenia. On multiple logistic regression analysis, the prevalence of sarcopenia was significantly correlated with phase angle and BMI. The areas under the curve exhibited high accuracy in discriminating sarcopenia in men and moderate accuracy in both sexes and in women. CONCLUSIONS Phase angle may be a valid discriminator of sarcopenia in patients with chronic musculoskeletal pain.
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Affiliation(s)
- Hironori Tsuji
- Department of Orthopedic Surgery, Okayama Red Cross Hospital, 2-1-1 Aoe, Kitaku, Okayama City, 700-8607 Japan
| | - Tomoko Tetsunaga
- grid.412342.20000 0004 0631 9477Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Kitaku, Okayama City, 700-8558 Japan ,grid.412342.20000 0004 0631 9477Department of Locomotive Pain Center, Okayama University Hospital, 2-5-1, Shikata-Cho, Kitaku, Okayama City, 700-8558 Japan
| | - Haruo Misawa
- grid.412342.20000 0004 0631 9477Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Kitaku, Okayama City, 700-8558 Japan
| | - Keiichiro Nishida
- grid.412342.20000 0004 0631 9477Department of Orthopedic Surgery, Okayama University Hospital, 2-5-1, Shikata-Cho, Kitaku, Okayama City, 700-8558 Japan ,grid.412342.20000 0004 0631 9477Department of Locomotive Pain Center, Okayama University Hospital, 2-5-1, Shikata-Cho, Kitaku, Okayama City, 700-8558 Japan
| | - Toshifumi Ozaki
- grid.261356.50000 0001 1302 4472Department of Orthopedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, 2-5-1 Shikata-Cho, Kitaku, Okayama City, 700-8558 Japan
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10
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Song HC, Shin J, Hwang JH, Kim SH. Utility of the Global Leadership Initiative on Malnutrition criteria for the nutritional assessment of patients with end-stage renal disease receiving chronic hemodialysis. J Hum Nutr Diet 2023; 36:97-107. [PMID: 35441765 DOI: 10.1111/jhn.13019] [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: 09/20/2021] [Accepted: 04/08/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Malnutrition is associated with adverse outcomes in patients on chronic haemodialysis. Thus, identifying accurate methods for diagnosing malnutrition is essential. The present retrospective study investigated the utility of the new Global Leadership Initiative on Malnutrition (GLIM) criteria in patients undergoing chronic haemodialysis. METHODS Phase angle and fat-free mass index (FFMI) were derived using bioelectrical impedance analysis. Malnutrition was determined when the subjects had at least one phenotypic criterion (weight loss, low body mass index [BMI] or FFMI). RESULTS This study included 103 patients undergoing chronic haemodialysis and 46 (44.7%) patients were diagnosed as malnourished. Malnutrition determined using the GLIM criteria was associated with increased risks of all-cause death (hazard ratio = 3.0, p = 0.044) and infection requiring hospitalisation (hazard ratio = 2.4, p = 0.015), independent of age, sex and comorbidities. However, malnutrition was not related to major adverse cardiovascular events (p = 0.908). We further evaluated the longitudinal changes in phenotypic parameters. Subjects with median levels of high-sensitivity C-reactive protein exceeding 5 mg L-1 exhibited decreased body weight and BMI (p = 0.015 and 0.016, respectively). In addition, body weight, BMI and FFMI were reduced in subjects with a median protein catabolic rate of < 1.0 mg kg-1 day-1 , even after adjustment for age, sex and comorbidities (p = 0.026, 0.053 and 0.039, respectively). CONCLUSIONS Malnutrition assessed using the GLIM criteria could be a useful predictor of mortality and infection in patients on chronic haemodialysis. To improve nutritional status, approaches for decreasing inflammation and increasing protein intake are needed.
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Affiliation(s)
- Hyun Chul Song
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Jungho Shin
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Jin Ho Hwang
- Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Su Hyun Kim
- Department of Internal Medicine, Chung-Ang University Gwangmyeong Hospital, Gwangmyeong, Korea
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11
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De Benedetto F, Marinari S, De Blasio F. Phase angle in assessment and monitoring treatment of individuals with respiratory disease. Rev Endocr Metab Disord 2023; 24:491-502. [PMID: 36694055 DOI: 10.1007/s11154-023-09786-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 01/26/2023]
Abstract
Phase angle (PhA) represents a raw variable measured with bioelectrical impedance analysis (BIA) that is used to assess malnutrition in many diseases, including respiratory diseases, mainly chronic obstructive pulmonary disease (COPD). COPD patients with reduced PhA are older, more hypoxic and hypercapnic; patients with more severe COPD have reduced cell mass, evident skeletal muscle depletion, and worsening gas exchange. Malnourished patients with stable COPD in long-term oxygen therapy (LTOT) have more intense dyspnea at rest, greater weight loss over the past 12 months, and more exacerbations per year. Multiple regression analysis highlighted the significance of PhA° in the estimation of muscle strength: hand grip strength (HGS) and in that of respiratory muscles: maximal inspiratory pressure / max. expiratory pressure ratio (MIP/MEP). Furthermore, the relationship between PhA° and all-cause mortality in COPD patients was confirmed with the Cox regression model, Kaplan-Meier test, and log-rank tests. The role of malnutrition in idiopathic pulmonary fibrosis (IPF) is confirmed by the PhA° measurements which, regardless of body weight, is associated with the reduction in muscle mass of these patients, reduces their strength and exercise capacity, and greatly influences the prognosis. In conclusion PhA is a novel biomarker of morbidity and mortality in patients with severe respiratory diseases.
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Affiliation(s)
- Fernando De Benedetto
- Scientific Director FISAR Foundation (Fondazione Salute Ambiente e Respiro), Chieti, Italy.
| | | | - Francesco De Blasio
- Respiratory Medicine and Pulmonary Rehabilitation Unit - Clinic Center Private Hospital, Naples, Italy
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12
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Cancello R, Brunani A, Brenna E, Soranna D, Bertoli S, Zambon A, Lukaski HC, Capodaglio P. Phase angle (PhA) in overweight and obesity: evidence of applicability from diagnosis to weight changes in obesity treatment. Rev Endocr Metab Disord 2022; 24:451-464. [PMID: 36484943 PMCID: PMC9735068 DOI: 10.1007/s11154-022-09774-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 12/13/2022]
Abstract
Phase angle (PhA) is a recently proposed marker of nutritional status in many clinical conditions. Its use in patients with obesity presents different critical concerns due to the higher variability of the two measured parameters (resistance, R, and reactance, Xc) that contribute to the determination of PhA. Controversial is the relation between PhA and BMI that might vary with graded levels of obesity due to the variation in fat and free fat mass. Obesity is frequently associated with metabolic, hepatic, cardiovascular and kidney diseases that introduce variations in PhA values, in relation to multimorbidity and severity degree of these diseases. It is reported that the improvement of clinical condition is associated with a positive change in PhA. Also, the treatment of obesity with weight loss might confirm this effect, but with different responses in relation to the type and duration of the intervention applied. In fact, the effect appears not only related to the percentage of weight loss but also the possible loss of free fat mass and the nutritional, metabolic and structural modifications that might follow each therapeutic approach to decrease body weight. We can conclude that the PhA could be used as marker of health status in patients with obesity supporting an appropriate weight loss intervention to monitor efficacy and fat free mass preservation.
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Affiliation(s)
- Raffaella Cancello
- grid.418224.90000 0004 1757 9530Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
| | - Amelia Brunani
- grid.418224.90000 0004 1757 9530Laboratory of Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, Piancavallo Verbania, Italy
| | - Ettore Brenna
- grid.418224.90000 0004 1757 9530Biostatistic Unit, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Davide Soranna
- grid.418224.90000 0004 1757 9530Biostatistic Unit, IRCCS Istituto Auxologico Italiano, Milano, Italy
| | - Simona Bertoli
- grid.418224.90000 0004 1757 9530Obesity Unit and Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS Istituto Auxologico Italiano, Milan, Italy
- grid.4708.b0000 0004 1757 2822Department of Food, Environmental and Nutritional Sciences (DeFENS), International Center for the Assessment of Nutritional Status (ICANS), University of Milan, Via Sandro Botticelli 21, 20133 Milan, Italy
| | - Antonella Zambon
- grid.418224.90000 0004 1757 9530Biostatistic Unit, IRCCS Istituto Auxologico Italiano, Milano, Italy
- grid.7563.70000 0001 2174 1754Department of Statistics and Quantitative Methods, University of Milan-Bicocca, Milan, Italy
| | - Henry C. Lukaski
- grid.266862.e0000 0004 1936 8163Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, USA
| | - Paolo Capodaglio
- grid.418224.90000 0004 1757 9530Laboratory of Biomechanics, Rehabilitation and Ergonomics, IRCCS, Istituto Auxologico Italiano, Piancavallo Verbania, Italy
- grid.7605.40000 0001 2336 6580Department of Surgical Sciences, Physical Medicine and Rehabilitation, University of Torino, 10126 Torino, Italy
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13
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Correlation of the Phase Angle with Muscle Ultrasound and Quality of Life in Obese Females. DISEASE MARKERS 2022; 2022:7165126. [PMID: 35983408 PMCID: PMC9381286 DOI: 10.1155/2022/7165126] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 07/05/2022] [Accepted: 07/28/2022] [Indexed: 11/18/2022]
Abstract
Introduction. Phase angle (PhA) has been suggested to be an indicator of body cell mass and nutritional status. Clinically, the phase angle supposedly reflects body cell mass and cell membrane function, and the higher the phase angle, the better is the cell function. Muscle ultrasound (US) is an emerging nutritional assessment technique. Objective. The aim of this study was to investigate the usefulness and correlation of PhA with muscle US of quadriceps rectus femoris (QRF) in obese female subjects and the relationship with quality of life and physical performance. Material and Methods. In a total of healthy 50 obese female patients, anthropometric data by BIA, muscle mass by ultrasound at the QRF level, analytical determination, blood pressure, and quality of life were measured. Physical performance was assessed, too. Results. In total, 50 female obese patients were included with a mean age of 45.9 ± 2.4 years. The mean body mass index was 32.1 ± 1.6 kg/m2 with a mean weight of 83.5 ± 14.6 kg. Correlation analysis showed a positive correlation of PhA with all US parameters corrected by squared height (anteroposterior muscle thickness, circumference, cross-sectional area, and Echo-intensity). The correlation analysis of biochemical parameters with PhA showed a positive correlation with serum albumin and total protein levels. Physical activity and vitality scores of SF36 were correlated with PhA. Finally, PhA was positive correlated with physical performance, doing push-ups in 30 seconds (
=0.42;
=0.03) and doing squats in 30 seconds (
=0.54;
=0.02), without correlation with the time of 1.5 km walk. Conclusion. PhA was correlated with muscle area, muscle circumference, muscle echo intensity, serum protein, quality of life SF-36, and strength physical performance.
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14
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Shin J, Hwang JH, Han M, Cha RH, Kang SH, An WS, Kim JC, Kim SH. Phase angle as a marker for muscle health and quality of life in patients with chronic kidney disease. Clin Nutr 2022; 41:1651-1659. [DOI: 10.1016/j.clnu.2022.06.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/16/2022] [Accepted: 06/04/2022] [Indexed: 11/24/2022]
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15
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Irisawa H, Mizushima T. Assessment of changes in muscle mass, strength, and quality and activities of daily living in elderly stroke patients. Int J Rehabil Res 2022; 45:161-167. [PMID: 35170496 PMCID: PMC9071026 DOI: 10.1097/mrr.0000000000000523] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Accepted: 01/31/2022] [Indexed: 11/25/2022]
Abstract
Whether poststroke rehabilitation improves muscle mass and quality along with the recovery of muscle strength is not clear. In this study, we examined the changes in muscle strength, muscle mass, and muscle quality in patients undergoing poststroke rehabilitation and assessed the relationship of these variables with improvement in activities of daily living (ADL). This prospective study was conducted at stroke rehabilitation unit in Japan. Muscle mass and quality were assessed using bioelectrical impedance analysis (BIA). ADLs were assessed using the functional independence measure (FIM). Grip strength of the nonaffected and affected sides was measured using hand dynamometer. All measurements were performed at admission to the stroke rehabilitation unit and at 4 weeks thereafter. We assessed changes in motor FIM items and examined the relationships among the measured variables. This study included 179 patients. Patients received stroke rehabilitation 7 days a week individually. Muscle strength and quality significantly increased after 4 weeks on both the sides. Muscle mass decreased after 4 weeks; however, there was no significant difference between the two time points. Changes in muscle strength and quality showed a significant correlation with improvement in ADLs [r = 0.66 (male), 0.45 (female) and 0.55 (male), 0.31 (female), respectively]; however, muscle mass showed no correlation with improvement in ADLs. Poststroke rehabilitation improves muscle strength and quality, as well as ADLs. Muscle mass is not an appropriate measure to assess the effects of stroke rehabilitation; it is desirable to instead use muscle strength and quality to assess stroke rehabilitation.
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Affiliation(s)
- Hiroshi Irisawa
- Department of Rehabilitation Medicine, Dokkyo Medical University, Mibu, Japan
| | - Takashi Mizushima
- Department of Rehabilitation Medicine, Dokkyo Medical University, Mibu, Japan
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16
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Relationship between Nutritional Status, Body Composition, Muscle Strength, and Functional Recovery in Patients with Proximal Femur Fracture. Nutrients 2022; 14:nu14112298. [PMID: 35684096 PMCID: PMC9183158 DOI: 10.3390/nu14112298] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/28/2022] [Accepted: 05/28/2022] [Indexed: 12/10/2022] Open
Abstract
Sarcopenia is a major issue among the elderly. However, the effects of nutritional status and body composition on functional recovery in patients with proximal femur fractures (PFF) remain unclear. Hence, this study aimed to investigate the effects of nutritional status, body composition (skeletal muscle mass and muscle quality measured by phase angle [PhA] values), and muscle strength on the improvement in activities of daily living (ADL) in patients with PFF. We enrolled patients with PFF admitted to a rehabilitation unit. Nutritional status, body composition, grip strength, and motor Functional Independence Measure (FIM) score were assessed on admission day and at 4 weeks thereafter. Of 148 patients, 84 had femoral neck fractures, and 64 had trochanteric fractures. The mean motor FIM score was 49.2 points at admission and 64.9 points after 4 weeks. In multivariate analysis, higher geriatric nutritional risk index and PhA measured by anthropometry were associated with a significantly higher FIM score after 4 weeks. Muscle strength and quality changes significantly correlated with ADL improvement. Poor nutritional status and decreased muscle strength and quality interfered with ADL recovery. Nutritional management before injury and from the acute phase, and rehabilitation to maintain skeletal muscle status, are important for ADL recovery.
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17
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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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18
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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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19
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Machado FVC, Bloem AEM, Schneeberger T, Jarosch I, Gloeckl R, Winterkamp S, Franssen FME, Koczulla AR, Pitta F, Spruit MA, Kenn K. Relationship between body composition, exercise capacity and health-related quality of life in idiopathic pulmonary fibrosis. BMJ Open Respir Res 2021; 8:e001039. [PMID: 34711642 PMCID: PMC8557280 DOI: 10.1136/bmjresp-2021-001039] [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] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/18/2021] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Bioelectrical impedance analysis (BIA) can be used to estimate Fat-Free Mass Index (FFMI). However, the use of directly measured BIA variables, such as phase angle (PhA), has gained attention. The frequency of low FFMI and PhA and its associations with exercise capacity and health-related quality of life (HRQL) in patients with idiopathic pulmonary fibrosis (IPF) have been scarcely studied. OBJECTIVES To investigate the frequency of low FFMI and PhA and their associations with exercise capacity and HRQL in patients with IPF. METHODS Patients underwent assessment of lung function, body composition, exercise capacity by the 6 min walk distance (6MWD), and HRQL by the Medical Outcomes Study Short-Form 36-item Questionnaire (SF-36). Patients were classified as presenting normal or low PhA or FFMI, accordingly to the 10th percentiles of age-sex-body mass index (BMI)-specific reference values. RESULTS 98 patients (84 males, age: 68±8 years, forced vital capacity: 64%±18%predicted) were included. 24 patients presented low PhA. They were characterised by worse lung function, exercise capacity and HRQL compared with patients with normal PhA. 10 patients presented low FFMI, but despite differences in body composition, no differences were found between these patients and patients with normal FFMI. In a single regression analysis, age, lung function and body composition variables (except FFMI) were related to 6MWD and SF-36 Physical Summary Score (R²=0.06-0.36, p<0.05). None of the variables were related to SF-36 Mental Summary Score. CONCLUSION One-fourth of the patients with IPF with normal to obese BMI present abnormally low PhA. Patients classified as low PhA presented worse lung function, exercise capacity and HRQL.
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Affiliation(s)
- Felipe V C Machado
- Department of Research and Development, Ciro - Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
- Department of Physiotherapy, Laboratory of Research in Respiratory Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Ada E M Bloem
- University of Applied Sciences Utrecht, Institute of Movement Studies, Faculty of Health Care, Utrecht, The Netherlands
- Department of Pulmonology, ILD Centre of Excellence, St. Antonius Hospital, Nieuwegein, The Netherlands
| | - Tessa Schneeberger
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Marburg, Germany
| | - Inga Jarosch
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Marburg, Germany
| | - Rainer Gloeckl
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Marburg, Germany
| | - Sandra Winterkamp
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
| | - Frits M E Franssen
- Department of Research and Development, Ciro - Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Andreas R Koczulla
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Marburg, Germany
| | - Fabio Pitta
- Department of Physiotherapy, Laboratory of Research in Respiratory Physiotherapy, State University of Londrina, Londrina, Brazil
| | - Martijn A Spruit
- Department of Research and Development, Ciro - Centre of Expertise for Chronic Organ Failure, Horn, The Netherlands
- Department of Respiratory Medicine, NUTRIM School of Nutrition and Translational Research in Metabolism, Maastricht University Medical Centre+, Maastricht, The Netherlands
| | - Klaus Kenn
- Institute for Pulmonary Rehabilitation Research, Schoen Klinik Berchtesgadener Land, Schoenau am Koenigssee, Germany
- Department of Pulmonary Rehabilitation, Philipps-University of Marburg, Marburg, Germany
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20
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Custódio Martins P, de Lima TR, Silva AM, Santos Silva DA. Association of phase angle with muscle strength and aerobic fitness in different populations: A systematic review. Nutrition 2021; 93:111489. [PMID: 34688022 DOI: 10.1016/j.nut.2021.111489] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/30/2021] [Accepted: 09/03/2021] [Indexed: 12/16/2022]
Abstract
OBJECTIVES The aim of this study was to summarize the evidence on the association of phase angle (PhA) with muscle strength and aerobic fitness in different populations. METHODS A systematic search on this topic was performed in nine electronic databases (CINAHL, LILACS, PubMed, SciELO, Scopus, SPORTDiscus, ScienceDirect, MEDLINE, and Web of Science) in January 2021. Studies with different designs that permitted extraction of information about the relationships between PhA and muscle strength and between PhA and aerobic fitness were included. A total of 4446 studies were initially identified; 34 were included after reading of the title, abstract, full text, and references. Four of the studies included had a longitudinal design, with samples consisting of participants ages 6 to 92 years. Thirty-two of the 34 studies evaluated the relationship between PhA and muscle strength, two cross-sectional studies investigated only PhA and aerobic fitness, and three cross-sectional studies evaluated both components (muscle strength and aerobic fitness). RESULTS PhA was directly associated with muscle strength in 30 cross-sectional studies and two longitudinal studies; the two studies that did not find a direct relationship had a cross-sectional design. For aerobic fitness, the five studies identified reported a direct relationship with PhA. CONCLUSIONS PhA is directly associated with muscle strength and aerobic fitness in different age groups (children, adolescents, adults, and older adults) and in people with different health conditions (human immunodeficiency virus, Crohn's disease, chronic obstructive pulmonary disease, bariatric surgery, kidney transplant, cancer, hemodialysis, and sarcopenia).
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Affiliation(s)
- Priscila Custódio Martins
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianópolis, Brazil.
| | - Tiago Rodrigues de Lima
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianópolis, Brazil.
| | - Analiza Mónica Silva
- Exercise and Health Laboratory, CIPER, Faculdade Motricidade Humana, Universidade Lisboa, Cruz-Quebrada, Portugal.
| | - Diego Augusto Santos Silva
- Research Center in Kinanthropometry and Human Performance, Sports Center, Federal University of Santa Catarina, Florianópolis, Brazil.
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21
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Dynapenia is highly prevalent in older patients with advanced idiopathic pulmonary fibrosis. Sci Rep 2021; 11:17884. [PMID: 34504219 PMCID: PMC8429581 DOI: 10.1038/s41598-021-97424-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 07/12/2021] [Indexed: 02/06/2023] Open
Abstract
Body composition and muscle strength are emerging aspects in idiopathic pulmonary fibrosis (IPF) clinical assessment. We aimed to study the relationships of handgrip strength (HGS) with anthropometric variables, body composition, and disease staging, and to evaluate the prevalence of dynapenia in 102 clinically stable IPF patients (70 M; mean age: 69.4 years). Fat-free mass (FFM), skeletal muscle (SM) were estimated with bioimpedance analysis. HGS was measured with a digital handle dynamometer for both dominant and non-dominant body sides. Dynapenia was identified according to six recognized criteria sets. Mean body mass index (BMI) was 28.2 ± 4.7 kg/m2, with a prevalence of overweight (BMI > 25 and < 30 kg/m2) and obesity (BMI ≥ 30 kg/m2) of 35% and 37%, respectively. FFM and SM were greater in males, whereas percentage body fat was higher in women. HGS was higher and declined with age slightly more rapidly in men, showing a stronger correlation with FFM and SM. Dynapenia prevalence ranged from 20.6 to 56.9%, depending on the criteria used, and was more frequent in older patients and advanced disease. Dynapenia is highly prevalent in IPF. HGS is a promising proxy marker of muscle function to be used in clinical evaluation and follow-up programs.
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Di Vincenzo O, Marra M, Sacco AM, Pasanisi F, Scalfi L. Bioelectrical impedance (BIA)-derived phase angle in adults with obesity: A systematic review. Clin Nutr 2021; 40:5238-5248. [PMID: 34474193 DOI: 10.1016/j.clnu.2021.07.035] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/05/2021] [Accepted: 07/28/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Bioimpedance analysis-derived phase angle (PhA), as marker of body cell mass and cell integrity, might be altered in obesity, a condition which is characterized by alterations in muscle structure and function. The aim of this systematic review was to evaluate whether and to which extent PhA varies in individuals/patients with excess body weight focusing on: a) changes in PhA due to obesity; b) changes in PhA after bariatric interventions or training programs. METHODS According to PRISMA criteria, a systematic literature search until February 2021 using PubMed, Embase, Scopus, and Web of Science was performed. Selection criteria included studies on patients with obesity without comorbidities other than metabolic diseases. RESULTS A total of 278 articles were first identified. After removing duplicates and excluding studies that did not fulfil the inclusion criteria, the full text of the remaining 80 potentially relevant studies was examined to finally retrieve 11 cross-sectional and 10 longitudinal studies. Few studies have shown that PhA is lower in individuals/patients with obesity than in controls. The only study on the matter showed a decrease with age after the fourth decade of life. Four out of five studies reported consistently greater mean values in men than in women. In two studies PhA was lower in patients with severe obesity; in addition, Patients with low PhA had higher BMI and PhA was inversely correlated with fat mass. Longitudinal studies showed that PhA markedly decreased after bariatric surgery and slightly increased after training programs. CONCLUSIONS Thus, a relatively low number of studies have evaluated PhA in individuals/patients with obesity with sometimes contradictory and preliminary results. PhA might be useful to evaluate muscle quality in individuals/patients with obesity but further studies are needed to more accurately associate this variable with changes in muscle structure and strength, as well as in metabolic functions.
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Affiliation(s)
- Olivia Di Vincenzo
- Department of Clinical Medicine and Surgery, Federico II University of Naples, via S. Pansini 5, 80131, Naples, Italy; Casa di Cura Santa Maria del Pozzo, via Pomigliano 40, 80049, Somma Vesuviana (NA), Italy.
| | - Maurizio Marra
- Department of Clinical Medicine and Surgery, Federico II University of Naples, via S. Pansini 5, 80131, Naples, Italy
| | - Anna Maria Sacco
- Department of Public Health, Federico II University of Naples, via S. Pansini 5, 80131, Naples, Italy
| | - Fabrizio Pasanisi
- Department of Clinical Medicine and Surgery, Federico II University of Naples, via S. Pansini 5, 80131, Naples, Italy
| | - Luca Scalfi
- Department of Public Health, Federico II University of Naples, via S. Pansini 5, 80131, Naples, Italy; Casa di Cura Santa Maria del Pozzo, via Pomigliano 40, 80049, Somma Vesuviana (NA), Italy
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Scialo F, Amato F, Cernera G, Gelzo M, Zarrilli F, Comegna M, Pastore L, Bianco A, Castaldo G. Lung Microbiome in Cystic Fibrosis. Life (Basel) 2021; 11:life11020094. [PMID: 33513903 PMCID: PMC7911450 DOI: 10.3390/life11020094] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 12/21/2022] Open
Abstract
The defective mucociliary clearance due to CFTR malfunctioning causes predisposition to the colonization of pathogens responsible for the recurrent inflammation and rapid deterioration of lung function in patients with cystic fibrosis (CF). This has also a profound effect on the lung microbiome composition, causing a progressive reduction in its diversity, which has become a common characteristic of patients affected by CF. Although we know that the lung microbiome plays an essential role in maintaining lung physiology, our comprehension of how the microbial components interact with each other and the lung, as well as how these interactions change during the disease's course, is still at an early stage. Many challenges exist and many questions still to be answered, but there is no doubt that manipulation of the lung microbiome could help to develop better therapies for people affected by CF.
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Affiliation(s)
- Filippo Scialo
- Dipartimento di Scienze Mediche Traslazionali, University of Campania “L. Vanvitelli”, 80131 Napoli, Italy;
- CEINGE, Biotecnologie Avanzate, 80145 Napoli, Italy; (F.A.); (G.C.); (M.G.); (F.Z.); (M.C.); (L.P.); (G.C.)
- Correspondence:
| | - Felice Amato
- CEINGE, Biotecnologie Avanzate, 80145 Napoli, Italy; (F.A.); (G.C.); (M.G.); (F.Z.); (M.C.); (L.P.); (G.C.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80145 Napoli, Italy
| | - Gustavo Cernera
- CEINGE, Biotecnologie Avanzate, 80145 Napoli, Italy; (F.A.); (G.C.); (M.G.); (F.Z.); (M.C.); (L.P.); (G.C.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80145 Napoli, Italy
| | - Monica Gelzo
- CEINGE, Biotecnologie Avanzate, 80145 Napoli, Italy; (F.A.); (G.C.); (M.G.); (F.Z.); (M.C.); (L.P.); (G.C.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80145 Napoli, Italy
| | - Federica Zarrilli
- CEINGE, Biotecnologie Avanzate, 80145 Napoli, Italy; (F.A.); (G.C.); (M.G.); (F.Z.); (M.C.); (L.P.); (G.C.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80145 Napoli, Italy
| | - Marika Comegna
- CEINGE, Biotecnologie Avanzate, 80145 Napoli, Italy; (F.A.); (G.C.); (M.G.); (F.Z.); (M.C.); (L.P.); (G.C.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80145 Napoli, Italy
| | - Lucio Pastore
- CEINGE, Biotecnologie Avanzate, 80145 Napoli, Italy; (F.A.); (G.C.); (M.G.); (F.Z.); (M.C.); (L.P.); (G.C.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80145 Napoli, Italy
| | - Andrea Bianco
- Dipartimento di Scienze Mediche Traslazionali, University of Campania “L. Vanvitelli”, 80131 Napoli, Italy;
| | - Giuseppe Castaldo
- CEINGE, Biotecnologie Avanzate, 80145 Napoli, Italy; (F.A.); (G.C.); (M.G.); (F.Z.); (M.C.); (L.P.); (G.C.)
- Dipartimento di Medicina Molecolare e Biotecnologie Mediche, Università di Napoli Federico II, 80145 Napoli, Italy
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Bioelectrical impedance analysis (BIA) -derived phase angle in sarcopenia: A systematic review. Clin Nutr 2020; 40:3052-3061. [PMID: 33183880 DOI: 10.1016/j.clnu.2020.10.048] [Citation(s) in RCA: 114] [Impact Index Per Article: 28.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/14/2020] [Accepted: 10/23/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND & AIMS Bioelectrical impedance analysis-derived phase angle (PhA) has been gaining attention in the clinical evaluation of nutritional status because it is thought to be a proxy of water distribution and body cell mass; it is also associated to muscle strength and is an effective predictor of different clinical outcomes. Since an association may be expected between PhA and sarcopenia (defined by low skeletal muscle mass and impaired muscle function), the aim of this systematic review was to evaluate: a) changes in PhA due to sarcopenia; b) prevalence of sarcopenia according to PhA values; c) derivation of phase angle cut-offs for detecting sarcopenia; d) sarcopenia and PhA as predictors of clinical outcomes. METHODS A systematic research on electronic databases (PubMed, Embase, Scopus and Web of Science) from inception to January 31st, 2020 was performed according to PRISMA checklist. Using PICOS strategy, "P" corresponded to participants of any age, gender or ethnicity, "I" designated diagnosis of sarcopenia, "C" indicated subjects without sarcopenia, "O" corresponded to PhA, and "S" selected all study types. Methodological quality was assessed using the National Institute of Health (NIH) quality assessment tool. RESULTS Through the initial literature search and after removing duplicates and excluding papers by screening titles and abstracts, 79 potentially relevant studies were examined. Thirteen studies (7668 subjects) met the inclusion criteria. The overall risk of bias was low. Sarcopenia was associated with a significant lower PhA in seven studies out of eight, while five studies out of six reported a high prevalence of sarcopenia was in patients with low PhA. Different cut-off point values from 4.05 to 5.05° have been derived for the identification of sarcopenia. PhA and sarcopenia were independent predictors of survival in cancer patients and geriatric hospitalized patients. CONCLUSIONS Data from the selected papers demonstrate that PhA is decreased in sarcopenic subjects and the prevalence of sarcopenia is higher in subjects with low PhA. Further studies are needed to determine to what extent PhA may be valuable in detecting low muscle quality and/or identifying sarcopenia.
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Mollica M, Aronne L, Paoli G, Flora M, Mazzeo G, Tartaglione S, Polito R, Tranfa C, Ceparano M, Komici K, Mazzarella G, Iadevaia C. Elderly with COPD: comoborbitidies and systemic consequences. JOURNAL OF GERONTOLOGY AND GERIATRICS 2020. [DOI: 10.36150/2499-6564-434] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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Zanella PB, Àvila CC, Chaves FC, Gazzana MB, Berton DC, Knorst MM, de Souza CG. Phase Angle Evaluation of Lung Disease Patients and Its Relationship with Nutritional and Functional Parameters. J Am Coll Nutr 2020; 40:529-534. [PMID: 32780649 DOI: 10.1080/07315724.2020.1801535] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND This study aimed to determine the value of phase angle (PhA) in patients with chronic obstructive pulmonary disease (COPD) and pulmonary hypertension (PH) and its association with nutritional and functional parameters. METHODS A cross-sectional study of 77 patients under follow-up at the pulmonary outpatient clinic of a public hospital. Anthropometric measurements and functional assessments of physical and pulmonary capacity were performed, and a regular physical activity questionnaire was administered. RESULTS The sample consisted of 38 patients with COPD (mean age, 63.8 ± 9.9 years; 68.4% female) and 39 patients with PH (mean age, 46.6 ± 14.4 years; 79.5% female). There was no difference in anthropometric measurements between patients with COPD and PH. Patients with COPD had mild to moderate limitations of pulmonary function, while patients with PH had only mild limitations (p < 0.01). Although the median distance covered in the 6-minute walk test (6MWT) was different between the COPD and PH groups (p < 0.05), it was considered adequate for these populations. Mean PhA was within the range considered adequate in patients with COPD (6.3°±1°) and PH (6.2°±0.8°) (p > 0.05). In the statistical analyses, although the correlations were weak, adequate PhA correlated with fat free mass index, 6MWT, disease staging, forced vital capacity, and forced expiratory volume in the first second. CONCLUSION The anthropometric profile of both patient groups was very similar, and PhA values were within the expected range. Despite weak correlations, PhA is a clinical component to be followed and investigated in patients with lung disease.
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Affiliation(s)
- Priscila Berti Zanella
- Postgraduate Program in Pulmonary Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Camila Coutinho Àvila
- Postgraduate Program in Pulmonary Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Fernanda Cardoso Chaves
- Department of Nutrition, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Marcelo Basso Gazzana
- Pulmonology Unit - Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegr, RS, Brazil
| | - Danilo Cortozi Berton
- Postgraduate Program in Pulmonary Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Pulmonology Unit - Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegr, RS, Brazil
| | - Marli Maria Knorst
- Postgraduate Program in Pulmonary Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Pulmonology Unit - Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegr, RS, Brazil
| | - Carolina Guerini de Souza
- Postgraduate Program in Pulmonary Sciences, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Department of Nutrition, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Food and Nutrition Research Center, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Association of phase angle with sarcopenia and its components in physically active older women. Aging Clin Exp Res 2020; 32:1469-1475. [PMID: 31463928 DOI: 10.1007/s40520-019-01325-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 08/14/2019] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of the present study was to associate phase angle (PhA) with sarcopenia and its components in physically active older women. METHODS A cross-sectional study was performed with 94 physically active older women. PhA and muscle mass were assessed by bioelectrical impedance. Muscle strength was measured by handgrip strength (HGS) and functional capacity was evaluated by 4-meter walk test. Sarcopenia was diagnosed according to the European Consensus on Definition and Diagnosis of Sarcopenia (2010). Participants were evaluated according to the PhA tercile. The individuals were divided into two groups: 1st vs. 2nd and 3rd terciles. The individuals in the first tercile were considered having low PhA (< 5.7º). RESULTS Low PhA was not associated with sarcopenia (OR = 1.50 (0.520-4.319)), low muscle mass index (OR = 1.50 (0.520-4.319)), low HGS (OR = 3.15 (0.954-10.401)) and low walk speed (OR = 1.46 (0.384-5.534)). In addition, PhA had a weak correlation with walk speed (r = 0.24, p = 0.023) and walk speed was able to predict the PhA variations by 3.9%. CONCLUSION PhA was not associated with sarcopenia and its components in physically active older women. Although PhA was correlated with walk speed, the biological meaning of this association is questionable, since the power of the prediction was low.
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Lan CC, Lai SR, Chien JY. Nonpharmacological treatment for patients with nontuberculous mycobacterial lung disease. J Formos Med Assoc 2020; 119 Suppl 1:S42-S50. [PMID: 32499207 DOI: 10.1016/j.jfma.2020.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 04/30/2020] [Accepted: 05/11/2020] [Indexed: 12/18/2022] Open
Abstract
Patients with nontuberculous mycobacterial lung disease (NTM-LD) often have significant exercise intolerance and poorer health-related quality of life (HRQL). The goals of treatment for NTM-LD should include reducing the severity of symptoms, improving HRQL, and reducing acute exacerbations. Nonpharmacological treatment, including pulmonary rehabilitation program and optimal nutritional strategy, should be one part of treatment for NTM-LD. A pulmonary rehabilitation (PR) program can comprise education, airway clearance techniques instruction, exercise training program, and inspiratory muscle training (IMT). Airway clearance techniques can improve the volume of sputum expectorated, cough symptom, breathlessness, and HRQL. Exercise training can improve exercise capacity and HRQL, and reduce acute exacerbations and dyspnea. Clinical benefits of IMT remain controversial but high-intensity IMT has been shown to be effective in increasing respiratory muscle strength with concurrent improvement of HRQL and exercise capacity. Body weight and muscle mass loss are common in patients with NTM-LD. An adequate protein and caloric diet combined with antioxidant nutrients might be the most appropriate dietary strategy. Comprehensive treatment for NTM-LD should include the combination of both pharmacological and nonpharmacological treatments. The management programs should be tailored to the individual's condition.
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Affiliation(s)
- Chou-Chin Lan
- Division of Pulmonary Medicine, Taipei Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation School of Medicine, Tzuchi University, New Taipei City, Taiwan
| | - Sheng-Ru Lai
- Department of Dietetics, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Jung-Yien Chien
- Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan.
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Di Vincenzo O, Marra M, Sammarco R, Speranza E, Cioffi I, Scalfi L. Body composition, segmental bioimpedance phase angle and muscular strength in professional volleyball players compared to a control group. J Sports Med Phys Fitness 2020; 60:870-874. [DOI: 10.23736/s0022-4707.20.10548-6] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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Di Vincenzo O, Marra M, Scalfi L. Bioelectrical impedance phase angle in sport: a systematic review. J Int Soc Sports Nutr 2019; 16:49. [PMID: 31694665 PMCID: PMC6833254 DOI: 10.1186/s12970-019-0319-2] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 10/16/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Phase angle (PhA) is a raw BIA variable that has been gaining attention in recent years because it is supposed to be an index of the ratio between extracellular and intracellular water, body cell mass, and cellular integrity. The aim of this systematic review was to evaluate the variability of PhA between different sports and its relationships with sport performance. Additionally, we investigated whether PhA depends on gender or age, and analyzed the differences between athletes and controls. METHODS A systematic research using PubMed, Scopus and Web of Science up to June 2019 was performed. Selection criteria included studies on subjects who practice sports in planned and continuous modality at competitive or elite level. RESULTS Thirty-five papers met the inclusion criteria (twenty-one cross-sectional data, fourteen longitudinal data). A few but convincing studies have shown that mean PhA is higher in athletes vs. controls. PhA increases with age and is likely to be higher in male than female athletes. A large variability in PhA is observed for the same sport, while it is still uncertain to what extent PhA differs between various sports. There are no clear relationships of PhA with sport performance or training/untraining. CONCLUSION It is still to be defined to what extent PhA varies between different sports and changes with training/untraining. It can be argued that for a given sport much more data should be collected in a systematic way and for a period of time appropriate in order to determine changes and trends. This is even more crucial in the case of intervention studies.
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Affiliation(s)
- Olivia Di Vincenzo
- Department of Clinical Medicine and Surgery, Federico II University Hospital, Via S. Pansini 5, 80138 Naples, Italy
| | - Maurizio Marra
- Department of Clinical Medicine and Surgery, Federico II University Hospital, Via S. Pansini 5, 80138 Naples, Italy
| | - Luca Scalfi
- Department of Public Health, School of Medicine, Federico II University, Naples, Italy
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de Blasio F, Scalfi L, Di Gregorio A, Alicante P, Bianco A, Tantucci C, Bellofiore B, de Blasio F. Raw Bioelectrical Impedance Analysis Variables Are Independent Predictors of Early All-Cause Mortality in Patients With COPD. Chest 2019; 155:1148-1157. [DOI: 10.1016/j.chest.2019.01.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2018] [Revised: 12/12/2018] [Accepted: 01/02/2019] [Indexed: 02/07/2023] Open
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Dos Reis AS, Santos HO, Limirio LS, de Oliveira EP. Phase Angle Is Associated With Handgrip Strength but Not With Sarcopenia in Kidney Transplantation Patients. J Ren Nutr 2018; 29:196-204. [PMID: 30583912 DOI: 10.1053/j.jrn.2018.10.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Revised: 09/17/2018] [Accepted: 10/07/2018] [Indexed: 01/19/2023] Open
Abstract
OBJECTIVES Phase angle (PhA) is a cell health marker and has been associated with muscle mass and strength in non-kidney disease individuals. However, it is unknown whether PhA is a predictor of sarcopenia and its components in kidney transplantation patients. The aim of the present study was to associate PhA with sarcopenia and its components in kidney transplantation patients. DESIGN AND METHODS One hundred and twenty-nine kidney transplantation individuals were evaluated in a cross-sectional study. PhA and muscle mass were evaluated using bioelectrical impedance. Handgrip strength (HGS) was performed with a hand dynamometer and functional capacity with 4-m walk test. Sarcopenia was diagnosed according to the European Consensus Diagnostic Criteria for Sarcopenia. Participants were divided according to the PhA tercile, and 2 groups were evaluated: first versus second and third terciles, according to sex. The individuals in the first tercile had PhA values <5.8° and <6.2° for women and men, respectively. RESULTS Individuals in the lower tercile of PhA showed lower odds of having higher values of HGS (kg; odds ratio [OR] = 0.89; 95% confidence interval [CI]: 0.82-0.97) and higher odds to have low HGS (OR = 5.97; 95% CI: 1.05-33.98). However, PhA was not associated with sarcopenia (OR = 1.95; 95% CI: 0.71-5.39), low muscle mass index (OR = 1.17; 95% CI: 0.41-3.36), and low functional capacity (OR = 2.47; 95% CI: 0.45-13.48). CONCLUSION PhA was associated with HGS but not with sarcopenia and its other components. These results suggest that PhA can be used as a possible predictor of muscle strength in kidney transplantation patients.
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Affiliation(s)
- Aline S Dos Reis
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Heitor O Santos
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Larissa S Limirio
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil
| | - Erick P de Oliveira
- School of Medicine, Federal University of Uberlandia (UFU), Uberlandia, Minas Gerais, Brazil.
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Yoshida T, Yamada Y, Tanaka F, Yamagishi T, Shibata S, Kawakami Y. Intracellular-to-total water ratio explains the variability of muscle strength dependence on the size of the lower leg in the elderly. Exp Gerontol 2018; 113:120-127. [DOI: 10.1016/j.exger.2018.09.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 09/22/2018] [Accepted: 09/24/2018] [Indexed: 12/25/2022]
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De Benedetto F, Pastorelli R, Ferrario M, de Blasio F, Marinari S, Brunelli L, Wouters EFM, Polverino F, Celli BR. Supplementation with Qter ® and Creatine improves functional performance in COPD patients on long term oxygen therapy. Respir Med 2018; 142:86-93. [PMID: 30170808 DOI: 10.1016/j.rmed.2018.08.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/01/2018] [Accepted: 08/05/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Skeletal muscle dysfunction and poor functional capacity are important extra-pulmonary manifestations of chronic obstructive pulmonary disease (COPD), especially in COPD patients on long-term O2 therapy (LTOT). Beside the role of pulmonary rehabilitation, the effect of nutritional interventions is still controversial, and there are knowledge gaps on the effective role of nutraceutical supplementation on hard endpoints. The aim of this study was to investigate the effects of nutritional supplementation with Coenzyme Q10 (QTer®) - a powerful antioxidant with the potential to reduce oxidative stress and improve mitochondrial function - and Creatine on functional, nutritional, and metabolomic profile in COPD patients on long-term O2 therapy. METHODS One-hundred and eight patients with COPD from 9 Italian hospitals were enrolled in this double-blinded randomized placebo-controlled clinical study. At baseline and after 2 months of therapy, the patients underwent spirometry, 6-minute walk test (6MWT), bioelectrical impedance analysis, and activities of daily living questionnaire (ADL). Also, dyspnea scores and BODE index were calculated. At both time points, plasma concentration of CoQ10 and metabolomic profiling were measured. FINDINGS Ninety patients, who randomly received supplementation with QTer® and Creatine or placebo, completed the study. Compared with placebo, supplemented patients showed improvements in 6MWT (51 ± 69 versus 15 ± 91 m, p < 0.05), body cell mass and phase angle, sodium/potassium ratio, dyspnea indices and ADL score. The CoQ10 plasma concentration increased in the supplementation group whereas it did not change in the placebo group. The metabolomics profile also differed between groups. Adverse events were similar in both groups. INTERPRETATION These results show that in patients with COPD, dietary supplementation with CoQ10 and Creatine improves functional performance, body composition and perception of dyspnea. A systemic increase in some anti-inflammatory metabolites supports a pathobiological mechanism as a reason for these benefits. Further trials should help clarifying the role of QTer® and Creatine supplementation in patients with COPD.
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Affiliation(s)
| | - Roberta Pastorelli
- Department of Environmental Health Science, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | - Manuela Ferrario
- Department of Electronics, Information, and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy
| | | | | | - Laura Brunelli
- Department of Environmental Health Science, IRCCS-Istituto di Ricerche Farmacologiche Mario Negri, Milano, Italy
| | - Emiel F M Wouters
- Department of Respiratory Medicine, Maastricht University Medical Center, Maastricht, Netherlands
| | | | - Bartolome R Celli
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, United States
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Jun MH, Kim S, Ku B, Cho J, Kim K, Yoo HR, Kim JU. Glucose-independent segmental phase angles from multi-frequency bioimpedance analysis to discriminate diabetes mellitus. Sci Rep 2018; 8:648. [PMID: 29330426 PMCID: PMC5766497 DOI: 10.1038/s41598-017-18913-7] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 12/19/2017] [Indexed: 01/13/2023] Open
Abstract
We investigated segmental phase angles (PAs) in the four limbs using a multi-frequency bioimpedance analysis (MF-BIA) technique for noninvasively diagnosing diabetes mellitus. We conducted a meal tolerance test (MTT) for 45 diabetic and 45 control subjects stratified by age, sex and body mass index (BMI). HbA1c and the waist-to-hip-circumference ratio (WHR) were measured before meal intake, and we measured the glucose levels and MF-BIA PAs 5 times for 2 hours after meal intake. We employed a t-test to examine the statistical significance and the area under the curve (AUC) of the receiver operating characteristics (ROC) to test the classification accuracy using segmental PAs at 5, 50, and 250 kHz. Segmental PAs were independent of the HbA1c or glucose levels, or their changes caused by the MTT. However, the segmental PAs were good indicators for noninvasively screening diabetes In particular, leg PAs in females and arm PAs in males showed best classification accuracy (AUC = 0.827 for males, AUC = 0.845 for females). Lastly, we introduced the PA at maximum reactance (PAmax), which is independent of measurement frequencies and can be obtained from any MF-BIA device using a Cole-Cole model, thus showing potential as a useful biomarker for diabetes.
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Affiliation(s)
- Min-Ho Jun
- KM Fundamental Research Division, Korea Institute of Oriental Medicine (KIOM), 1672 Yuseongdaero, Yuseong-gu, Daejeon, Republic of Korea
| | - Soochan Kim
- Department of Electrical and Electronic Engineering & Institute for IT Convergence, Hankyong National University, 327 Jungang-no, Anseong-si, Gyeonggi-do, Republic of Korea
| | - Boncho Ku
- KM Fundamental Research Division, Korea Institute of Oriental Medicine (KIOM), 1672 Yuseongdaero, Yuseong-gu, Daejeon, Republic of Korea
| | - JungHee Cho
- KM Fundamental Research Division, Korea Institute of Oriental Medicine (KIOM), 1672 Yuseongdaero, Yuseong-gu, Daejeon, Republic of Korea
| | - Kahye Kim
- KM Fundamental Research Division, Korea Institute of Oriental Medicine (KIOM), 1672 Yuseongdaero, Yuseong-gu, Daejeon, Republic of Korea
| | - Ho-Ryong Yoo
- Internal Medicine of Cardiovascular, Daejeon Oriental Hospital of Oriental Medical College of Daejeon University, 22-5 Daehung-dong, Jung-gu, Daejeon, 301-724, Republic of Korea
| | - Jaeuk U Kim
- KM Fundamental Research Division, Korea Institute of Oriental Medicine (KIOM), 1672 Yuseongdaero, Yuseong-gu, Daejeon, Republic of Korea.
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