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Yang J, Yu J, Kim J, Park E. Association between Physical Activity and Phase Angle Obtained via Bioelectrical Impedance Analysis in South Korean Adults Stratified by Sex. Nutrients 2024; 16:2136. [PMID: 38999883 PMCID: PMC11242964 DOI: 10.3390/nu16132136] [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: 05/31/2024] [Revised: 06/28/2024] [Accepted: 07/02/2024] [Indexed: 07/14/2024] Open
Abstract
This cross-sectional study aimed to examine the association of various aspects of physical activity, including intensity, duration, type, and purpose, with the phase angle (PhA), an objective indicator of health, in Korean adults after stratification by sex. Data from the 2022 Korean National Health and Nutrition Examination Survey, a nationwide, representative, population-based survey, were used. In total, 3996 participants were included in the study. Participants self-reported their weekly intensity, frequency, duration of engagement in physical activity. PhA was categorized into two groups on the basis of sex-specific averages. Multiple logistic regression analysis was used to investigate the relationship between physical activity and PhA, and proportional odds logistic regression analysis was performed to determine the association between physical activity and different subclasses of PhA. A positive association was found between sufficiently active aerobic physical activity and PhA compared with inactive physical activity (sufficiently active, male: odds ratio = 1.952, 95% confidence interval = 1.373-2.776; female: odds ratio = 1.333, 95% confidence interval = 1.019-1.745). This association was further strengthened when aerobic physical activity was accompanied by muscle-strengthening activity (sufficiently active with muscle-strengthening activity, male: aOR = 2.318, 95% CI = 1.512-3.554; female: aOR = 1.762, 95% CI = 1.215-2.556) and vigorous-intensity activities (sufficiently active with sufficient vigorous-intensity activity, male: aOR = 2.785, 95% CI = 1.647-4.709; female: aOR = 2.505, 95% CI = 1.441-4.356) and when there was more leisure-time physical activity than occupational physical activity (sufficiently active with more leisure-time physical activity, male: aOR = 2.158, 95% CI = 1.483-3.140; female: aOR = 1.457, 95% CI = 1.078-1.969). Furthermore, the inclusion of muscle-strengthening activity made a significant difference in the values of PhA for males with insufficiently active physical activity (aOR = 2.679, 95% CI = 1.560-4.602). For females with highly active physical activity (aOR = 1.521, 95% CI = 1.068-2.166), the inclusion of muscle-strengthening and vigorous-intensity activities were significantly associated with higher values for PhA. This study can be utilized to provide specific suggestions for better health programs and can change perception that only occupational physical activity is enough. This study also indicated that PhA can be used for personalized health assessments.
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Affiliation(s)
- Jiwon Yang
- Medical Courses, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jiho Yu
- Medical Courses, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Jinhyun Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul 03722, Republic of Korea
- Department of Psychiatry, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
| | - Euncheol Park
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul 03722, Republic of Korea
- Institute of Health Services Research, Yonsei University, Seoul 03722, Republic of Korea
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Tapasco-Tapasco LO, Gonzalez-Correa CA, Letourneur A. Phase angle and impedance ratio as meta-inflammation biomarkers after a colon cleansing protocol in a group of overweight young women. Physiol Meas 2024; 45:055021. [PMID: 38697207 DOI: 10.1088/1361-6579/ad46df] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 05/01/2024] [Indexed: 05/04/2024]
Abstract
Objective. Blood C-reactive protein (CRP) and the electrical bioimpedance spectroscopy (EBIS) variables phase angle (PhA) and impedance ratio (IR) have been proposed as biomarkers of metainflammation in overweight/obesity. CRP involves taking blood samples, while PhA and IR imply a less-than-2-minute-non-invasive procedure. In this study, values for these variables and percent body fat mass (PBFM) were obtained and compared before and immediately after a colon cleansing protocol (CCP), aimed at modulating intestinal microbiota and reducing metainflammation, as dysbiosis and the latter are intrinsically related, as well as along a period of 8 weeks after it.Approach. 20 female volunteers (20.9-24.9 years old) participated: 12 in an overweight group (OG), and 8 in a lean group (LG). TheOGwas divided in two subgroups (n= 6, each): control (CSG) and experimental (ESG). TheESGunderwent a 6-day CCP at week 2, while 5 volunteers in theCSGunderwent it at week 9.Main results.Pre/post-CCP mean values for the variables in theOGwere: PBFM (34.3/31.3%), CRP (3.7/0.6 mg dl-1), PhA (6.9/7.5°) and IR*10 (0.78/0.77). CalculatedR2correlation factors among these variables are all above 0.89. The favourable changes first seen in theESGwere still present 8 weeks after the CCP.Significance.(a) the CCP drastically lowers meta-inflammation, (b) EBIS can be used to measure metainflammation, before and after treatment, (c) for microbiota modulation, CCP could be a good alternative to more drastic procedures like faecal microbiota transplantation; (d) reestablishing eubiosis by CCP could be an effective coadjutant in the treatment of overweight young adult women.
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Affiliation(s)
- L O Tapasco-Tapasco
- Research Group on Electrical Bioimpedance (GruBIE), University of Caldas, Manizales, Caldas, Colombia
| | - C A Gonzalez-Correa
- Research Group on Electrical Bioimpedance (GruBIE), University of Caldas, Manizales, Caldas, Colombia
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Salazar-Solarte AM, Torres-Canchala L, Carrera-Gil F, Quimbayo-Wilches DM. Pulmonary function and body composition parameters of children with cystic fibrosis from a hight complexity institution between 2015 and 2018. Pediatr Neonatol 2024:S1875-9572(24)00047-0. [PMID: 38658270 DOI: 10.1016/j.pedneo.2023.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Revised: 10/25/2023] [Accepted: 11/10/2023] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND An adequate nutritional status in patients with cystic fibrosis correlates with higher survival and better pulmonary function. Body mass index (BMI) is an anthropometric indicator with independent association with pulmonary function, and it can hide alterations of nutritional status in cystic fibrosis. OBJECTIVE To determine the relationship of lung function with BMI and body composition parameters in children with cystic fibrosis in a Hight Complexity institution between 2015 and 2018. MATERIALS AND METHODS It was an observational study with analytical, cross-sectional, and retrospective scope, including 33 patients between 5 and 17 years old. Spearman's test was applied to evaluate correlation of FEV1 (forced expiratory volume in first second) with BMI and five body composition parameters by bioelectrical impedance using InbodyS10 equipment. Statistical significance was considered with p < 0.05. RESULTS Positive correlation was obtained between FEV1 and appendicular skeletal muscle mass between lung function and percentage of fat-free mass (p = 0.006) and phase angle (p = 0.001). Percent fat mass had a negative correlation with FEV1 (p = 0.007). BMI and fat free mass index did not correlate with lung function (p = 0.085). CONCLUSIONS Appendicular skeletal muscle mass correlated better than BMI with lung function in children with cystic fibrosis. It is recommended to perform anthropometric follow-up by BMI complemented with body composition study in children with cystic fibrosis. Analyses with larger populations are required to standardize its use.
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Affiliation(s)
- Aura María Salazar-Solarte
- Pediatrics Department, Hospital Universitario Fundación Valle del Lili, Cali, Colombia; Faculty of Health Sciences, Universidad Icesi, Cali, Colombia; Interdisciplinary Research Group in Epidemiology and Public Health, Universidad Libre, Seccional, Cali, Colombia.
| | | | - Frank Carrera-Gil
- Faculty of Health Sciences, Pontificia Universidad Javeriana, Cali, Colombia
| | - Diana María Quimbayo-Wilches
- Pediatrics Department, Hospital Universitario Fundación Valle del Lili, Cali, Colombia; Faculty of Health Sciences, Universidad Icesi, Cali, Colombia; Pediatrics and Gastroenterology Department. Hospital Universitario Fundación Valle del Lili, Cali, Colombia
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Voulgaridou G, Tyrovolas S, Detopoulou P, Tsoumana D, Drakaki M, Apostolou T, Chatziprodromidou IP, Papandreou D, Giaginis C, Papadopoulou SK. Diagnostic Criteria and Measurement Techniques of Sarcopenia: A Critical Evaluation of the Up-to-Date Evidence. Nutrients 2024; 16:436. [PMID: 38337720 PMCID: PMC10856900 DOI: 10.3390/nu16030436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/22/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024] Open
Abstract
Sarcopenia, a geriatric syndrome characterized by progressive skeletal muscle mass and function decline, poses a significant health risk among the elderly, contributing to frailty, falls, hospitalization, loss of independence and mortality. The prevalence of sarcopenia varies significantly based on various factors, such as living status, demographics, measurement techniques and diagnostic criteria. Although the overall prevalence is reported at 10% in individuals aged 60 and above, disparities exist across settings, with higher rates in nursing homes and hospitals. Additionally, the differences in prevalence between Asian and non-Asian countries highlight the impact of cultural and ethnic factors, and variations in diagnostic criteria, cut-off values and assessment methods contribute to the observed heterogeneity in reported rates. This review outlines diverse diagnostic criteria and several measurement techniques supporting decision making in clinical practice. Moreover, it facilitates the selection of appropriate tools to assess sarcopenia, emphasizing its multifactorial nature. Various scientific groups, including the European Working Group of Sarcopenia in Older People (EWGSOP), the International Working Group on Sarcopenia (IWGS), the Asian Working Group on Sarcopenia (AWGS), the American Foundation for the National Institutes of Health (FNIH) and the Sarcopenia Definition and Outcomes Consortium (SDOC), have published consensus papers outlining diverse definitions of sarcopenia. The choice of diagnostic criteria should be aligned with the specific objectives of the study or clinical practice, considering the characteristics of the study population and available resources.
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Affiliation(s)
- Gavriela Voulgaridou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (G.V.); (D.T.); (M.D.)
| | - Stefanos Tyrovolas
- Department of Nutrition and Food Studies, George Mason University, Fairfax, VA 22030, USA;
- WHOCC Centre for Community Health Services, School of Nursing, The Hong Kong Polytechnic University, Hong Kong SAR, China
- Research, Innovation and Teaching Unit, Parc Sanitari Sant Joan de Déu, 08830 Sant Boi de Llobregat, Spain
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 28029 Madrid, Spain
| | - Paraskevi Detopoulou
- Department of Clinical Nutrition, General Hospital Korgialenio Benakio, Athanassaki 2, 11526 Athens, Greece
| | - Despoina Tsoumana
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (G.V.); (D.T.); (M.D.)
| | - Mariella Drakaki
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (G.V.); (D.T.); (M.D.)
| | - Thomas Apostolou
- Department of Physiotherapy, School of Health Sciences, International Hellenic University, 57400 Thessaloniki, Greece;
| | | | - Dimitrios Papandreou
- Department of Clinical Nutrition & Dietetics, College of Health, University of Sharjah, Sharjah P.O. Box 27272, United Arab Emirates;
| | - Constantinos Giaginis
- Department of Food Science and Nutrition, School of Environment, University of Aegean, 81400 Myrina, Greece;
| | - Sousana K. Papadopoulou
- Department of Nutritional Sciences and Dietetics, International Hellenic University, 57400 Thessaloniki, Greece; (G.V.); (D.T.); (M.D.)
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Jun MH, Ku B, Kim K, Lee KH, Kim JU. A screening method for mild cognitive impairment in elderly individuals combining bioimpedance and MMSE. Front Aging Neurosci 2024; 16:1307204. [PMID: 38327500 PMCID: PMC10847325 DOI: 10.3389/fnagi.2024.1307204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 01/08/2024] [Indexed: 02/09/2024] Open
Abstract
We investigated a screening method for mild cognitive impairment (MCI) that combined bioimpedance features and the Korean Mini-Mental State Examination (K-MMSE) score. Data were collected from 539 subjects aged 60 years or older at the Gwangju Alzheimer's & Related Dementias (GARD) Cohort Research Center, A total of 470 participants were used for the analysis, including 318 normal controls and 152 MCI participants. We measured bioimpedance, K-MMSE, and the Seoul Neuropsychological Screening Battery (SNSB-II). We developed a multiple linear regression model to predict MCI by combining bioimpedance variables and K-MMSE total score and compared the model's accuracy with SNSB-II domain scores by the area under the receiver operating characteristic curve (AUROC). We additionally compared the model performance with several machine learning models such as extreme gradient boosting, random forest, support vector machine, and elastic net. To test the model performances, the dataset was divided into a training set (70%) and a test set (30%). The AUROC values of SNSB-II scores were 0.803 in both sexes, 0.840 for males, and 0.770 for females. In the combined model, the AUROC values were 0.790 (0.773) for males (and females), which were significantly higher than those from the model including MMSE scores alone (0.723 for males and 0.622 for females) or bioimpedance variables alone (0.640 for males and 0.615 for females). Furthermore, the accuracies of the combined model were comparable to those of machine learning models. The bioimpedance-MMSE combined model effectively distinguished the MCI participants and suggests a technique for rapid and improved screening of the elderly population at risk of cognitive impairment.
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Affiliation(s)
- Min-Ho Jun
- Digital Health Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
| | - Boncho Ku
- Digital Health Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
| | - Kahye Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
| | - Kun Ho Lee
- Gwangju Alzheimer’s Disease and Related Dementias (GARD) Cohort Research Center, Chosun University, Gwangju, Republic of Korea
- Department of Biomedical Science, Chosun University, Gwangju, Republic of Korea
- Dementia Research Group, Korea Brain Research Institute, Daegu, Republic of Korea
| | - Jaeuk U. Kim
- Digital Health Research Division, Korea Institute of Oriental Medicine (KIOM), Daejeon, Republic of Korea
- School of Korean Convergence Medical Science, University of Science and Technology, Daejeon, Republic of Korea
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6
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Silva AM, Campa F, Stagi S, Gobbo LA, Buffa R, Toselli S, Silva DAS, Gonçalves EM, Langer RD, Guerra-Júnior G, Machado DRL, Kondo E, Sagayama H, Omi N, Yamada Y, Yoshida T, Fukuda W, Gonzalez MC, Orlandi SP, Koury JC, Moro T, Paoli A, Kruger S, Schutte AE, Andreolli A, Earthman CP, Fuchs-Tarlovsky V, Irurtia A, Castizo-Olier J, Mascherini G, Petri C, Busert LK, Cortina-Borja M, Bailey J, Tausanovitch Z, Lelijveld N, Ghazzawi HA, Amawi AT, Tinsley G, Kangas ST, Salpéteur C, Vázquez-Vázquez A, Fewtrell M, Ceolin C, Sergi G, Ward LC, Heitmann BL, da Costa RF, Vicente-Rodriguez G, Cremasco MM, Moroni A, Shepherd J, Moon J, Knaan T, Müller MJ, Braun W, García-Almeida JM, Palmeira AL, Santos I, Larsen SC, Zhang X, Speakman JR, Plank LD, Swinburn BA, Ssensamba JT, Shiose K, Cyrino ES, Bosy-Westphal A, Heymsfield SB, Lukaski H, Sardinha LB, Wells JC, Marini E. The bioelectrical impedance analysis (BIA) international database: aims, scope, and call for data. Eur J Clin Nutr 2023; 77:1143-1150. [PMID: 37532867 DOI: 10.1038/s41430-023-01310-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 07/10/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Bioelectrical impedance analysis (BIA) is a technique widely used for estimating body composition and health-related parameters. The technology is relatively simple, quick, and non-invasive, and is currently used globally in diverse settings, including private clinicians' offices, sports and health clubs, and hospitals, and across a spectrum of age, body weight, and disease states. BIA parameters can be used to estimate body composition (fat, fat-free mass, total-body water and its compartments). Moreover, raw measurements including resistance, reactance, phase angle, and impedance vector length can also be used to track health-related markers, including hydration and malnutrition, and disease-prognostic, athletic and general health status. Body composition shows profound variability in association with age, sex, race and ethnicity, geographic ancestry, lifestyle, and health status. To advance understanding of this variability, we propose to develop a large and diverse multi-country dataset of BIA raw measures and derived body components. The aim of this paper is to describe the 'BIA International Database' project and encourage researchers to join the consortium. METHODS The Exercise and Health Laboratory of the Faculty of Human Kinetics, University of Lisbon has agreed to host the database using an online portal. At present, the database contains 277,922 measures from individuals ranging from 11 months to 102 years, along with additional data on these participants. CONCLUSION The BIA International Database represents a key resource for research on body composition.
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Affiliation(s)
- Analiza M Silva
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002, Lisbon, Portugal.
| | - Francesco Campa
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Silvia Stagi
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
| | - Luís A Gobbo
- Skeletal Muscle Assessment Laboratory, Physical Education Department, School of Technology and Science, São Paulo State University, Presidente Prudente, 19060-900, Brazil
| | - Roberto Buffa
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
| | - Stefania Toselli
- Department for Life Quality Studies, University of Bologna, 47921, Rimini, Italy
| | - Diego Augusto Santos Silva
- Research Center of Kinanthropometry and Human Performance, Sports Center, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Ezequiel M Gonçalves
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Raquel D Langer
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Gil Guerra-Júnior
- Growth and Development Laboratory, Center for Investigation in Pediatrics (CIPED), School of Medical Sciences, University of Campinas (UNICAMP), Campinas, 13083-887, Brazil
| | - Dalmo R L Machado
- Laboratory of Kinanthropometry and Human Performance, School of Physical Education and Sport of Ribeirão Preto, University of São Paulo, 05508-030, São Paulo, Brazil
| | - Emi Kondo
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Hiroyuki Sagayama
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Naomi Omi
- Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 305-8574, Japan
| | - Yosuke Yamada
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, 566-0002, Japan
| | - Tsukasa Yoshida
- National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Osaka, 566-0002, Japan
| | - Wataru Fukuda
- Yokohama Sports Medical Center, Yokohama Sport Association, Kanagawa, 222-0036, Japan
| | - Maria Cristina Gonzalez
- Postgraduate Program in Nutrition and Food, Federal University of Pelotas, 96010-610 Pelotas, Brazil
| | - Silvana P Orlandi
- Nutrition Department, Federal University of Pelotas, 96010-610, Pelotas, Brazil
| | - Josely C Koury
- Nutrition Institute, State University of Rio de Janeiro, 20550-013, Rio de Janeiro, Brazil
| | - Tatiana Moro
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Antonio Paoli
- Department of Biomedical Science, University of Padova, 35100, Padova, Italy
| | - Salome Kruger
- Centre of Excellence for Nutrition, North-West University, Potchefstroom, 2520, South Africa
| | - Aletta E Schutte
- School of Population Health, University of New South Wales, The George Institute for Global Health, Sydney, NSW, Australia
| | | | | | | | - Alfredo Irurtia
- National Institute of Physical Education of Catalonia (INEFC), University of Barcelona (UB), Barcelona, Spain
| | - Jorge Castizo-Olier
- School of Health Sciences, TecnoCampus, Pompeu Fabra University, Barcelona, Spain
| | - Gabriele Mascherini
- Department of Experimental and Clinical Medicine, University of Florence, Firenze, Italy
| | - Cristian Petri
- Department of Sports and Computer Science, Section of Physical Education and Sports, Universidad Pablo de Olavide, Seville, Spain
| | - Laura K Busert
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mario Cortina-Borja
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | | | | | | | - Hadeel Ali Ghazzawi
- Department of Nutrition and Food Technology, School of Agriculture, The University of Jordan, Amman, Jordan
| | - Adam Tawfiq Amawi
- Department of Physical and Health Education, Faculty of Educational Sciences, Al-Ahliyya Amman University, Al-Salt, Jordan
| | - Grant Tinsley
- Energy Balance & Body Composition Laboratory, Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX, 79409, USA
| | - Suvi T Kangas
- International Rescue Committee, New York, NY, 10168, USA
| | - Cécile Salpéteur
- Department of Expertise and Advocacy, Action contre la Faim, 93358, Montreuil, France
| | - Adriana Vázquez-Vázquez
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Mary Fewtrell
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Chiara Ceolin
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, 35128, Italy
| | - Giuseppe Sergi
- Department of Medicine (DIMED), Geriatrics Division, University of Padova, Padova, 35128, Italy
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, QLD, 4072, Australia
| | - Berit L Heitmann
- Research Unit for Dietary Studies, The Parker Institute, Frederiksberg and Bispebjerg Hospital, Copenhagen, Denmark
- Section for general Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Roberto Fernandes da Costa
- Department of Physical Education, Research Group in Physical Activity and Health, Federal University of Rio Grande do Norte, Natal, Brazil
| | - German Vicente-Rodriguez
- Faculty of Health and Sport Science FCSD, Department of Physiatry and Nursing, University of Zaragoza, 50009, Zaragoza, Spain
| | - Margherita Micheletti Cremasco
- Laboratory of Anthropology, Anthropometry and Ergonomics, Department of Life Sciences and Systems Biology, University of Torino, 10123, Torino, Italy
| | - Alessia Moroni
- Laboratory of Anthropology, Anthropometry and Ergonomics, Department of Life Sciences and Systems Biology, University of Torino, 10123, Torino, Italy
| | - John Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Jordan Moon
- United States Sports Academy, Daphne, AL, 36526, USA
| | - Tzachi Knaan
- Weight Management, Metabolism & Sports Nutrition Clinic, Metabolic Lab, Tel-Aviv, Tel Aviv-Yafo, Israel
| | - Manfred J Müller
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | - Wiebke Braun
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | - José M García-Almeida
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital, Malaga University, 29010, Malaga, Spain
| | | | - Inês Santos
- Laboratório de Nutrição, Faculdade de Medicina, Centro Académico de Medicina de Lisboa, Universidade de Lisboa, Lisboa, Portugal
| | - Sofus C Larsen
- Research Unit for Dietary Studies at the Parker Institute, Bispebjerg and Frederiksberg Hospital, The Capital Region, Frederiksberg, Denmark
- The Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Xueying Zhang
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| | - John R Speakman
- Shenzhen Key Laboratory of Metabolic Health, Center for Energy Metabolism and Reproduction, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
- School of Biological Sciences, University of Aberdeen, Aberdeen, UK
| | - Lindsay D Plank
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Boyd A Swinburn
- School of Population Health, University of Auckland, Auckland, New Zealand
| | - Jude Thaddeus Ssensamba
- Center for Innovations in Health Africa (CIHA Uganda), Kampala, Uganda
- Makerere University Walter Reed Project, Kampala, Uganda
| | - Keisuke Shiose
- Faculty of Education, University of Miyazaki, Miyazaki, Japan
| | - Edilson S Cyrino
- Metabolism, Nutrition, and Exercise Laboratory. Physical Education and Sport Center, State University of Londrina, Rod. Celso Garcia Cid, Km 380, 86057-970, Londrina-PR, Brazil
| | - Anja Bosy-Westphal
- Department of Human Nutrition, Institute of Human Nutrition and Food Sciences, Christian-Albrechts University, 24105, Kiel, Germany
| | | | - Henry Lukaski
- Department of Kinesiology and Public Health Education, Hyslop Sports Center, University of North Dakota Grand Forks, Grand Forks, ND, 58202, USA
| | - Luís B Sardinha
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, 1499-002, Lisbon, Portugal
| | - Jonathan C Wells
- Population, Policy & Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Elisabetta Marini
- Department of Life and Environmental Sciences, University of Cagliari, Cittadella Universitaria, Monserrato, 09042, Cagliari, Italy
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7
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Leo S, Marinelli F, Zurlo IV, Guarini V, Accettura C, Falco A, Leone S, Saracino V, Giudetti AM, Piscitelli P. Bioimpedentiometry parameters used as indicators of frailty and malnutrition: association between G8 score and Phase angle (PHA) in elderly cancer patients. Aging Clin Exp Res 2023; 35:2219-2225. [PMID: 37626230 DOI: 10.1007/s40520-023-02512-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 07/18/2023] [Indexed: 08/27/2023]
Abstract
BACKGROUND Since the incidence of cancer increases with age, in older cancer patients important information may be missed without a Comprehensive Geriatric Assessment (CGA). On the other side, CGA is a time-consuming and complex instrument, so that Geriatric 8 (G8) has been proposed as a more feasible screening tool to identify patients who could benefit from a CGA evaluation. G8 consists of 8 questions (patient age + 7 items derived from the Mini Nutritional Assessment questionnaire). A G8 score ≤ 14 is considered associated with frailty and risk of malnutrition. Another screening test is Bioelectrical Impedance Analysis (Bioimpedentiometry, BIA), which enables to evaluate the nutritional status through a specific parameter known as Phase angle (PhA). This study is aimed at assessing the ability of G8 alone or in combination with PhA to detect elderly cancer patients at higher risk for malnutrition who cannot undergo immediate anticancer treatments. METHODS A total of 289 cancer patients (168 men and 121 women) aged ≥ 70 years old were enrolled and performed both G8 test, body mass index (BMI) and BIA assessments. A concurrent G8 score ≤ 14 and PhA < 5 defined subjects most exposed to the risk of malnutrition. RESULTS An association between BMI and G8 (p < 0.001, OR 1.54) and a clinically significant relationship between G8 and PhA (p = 0.013) were observed. CONCLUSION G8 can be used to identify patients at risk for malnutrition who would benefit from comprehensive CGA. The concurrent use of G8 and BIA presents a higher power in discriminating subjects at higher risk of malnutrition than a single test. This study suggests the need for routine assessment of nutritional status in cancer patients using combinations of methods, in order to implement strategies for individually-tailored care before starting any treatment.
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Affiliation(s)
- Silvana Leo
- Division of Oncology, Vito Fazzi Hospital, Lecce, Italy
| | - Fabiana Marinelli
- Department of Biological and Environmental Sciences and Technologies (DISTEBA), University of Salento, Lecce, Italy
| | | | | | | | | | - Stefania Leone
- Department of Biological and Environmental Sciences and Technologies (DISTEBA), University of Salento, Lecce, Italy
| | | | - Anna Maria Giudetti
- Department of Biological and Environmental Sciences and Technologies (DISTEBA), University of Salento, Lecce, Italy
| | - Prisco Piscitelli
- Division of Oncology, Vito Fazzi Hospital, Lecce, Italy.
- Department of Biological and Environmental Sciences and Technologies (DISTEBA), University of Salento, Lecce, Italy.
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8
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Muramae N, Matsuda T, Inagaki S, Takahashi H, Abe K, Nakatani S, Takahashi M, Kato K, Sakaguchi K, Ogawa W. Determinants of phase angle in Japanese patients with diabetes. Diabetol Int 2023; 14:339-343. [PMID: 37781466 PMCID: PMC10533457 DOI: 10.1007/s13340-023-00633-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 05/08/2023] [Indexed: 10/03/2023]
Abstract
Phase angle, obtained using bioelectrical impedance analysis, non-invasively reflects the whole-body cellular condition and nutritional status and may be helpful as a prognostic factor. Patients with diabetes had a smaller phase angle than healthy subjects. However, the clinical significance of phase angle has not yet been elucidated. Therefore, the purpose of this study was to clarify the relationship between phase angle and HbA1c in patients with diabetes and the clinical relevance of phase angle. A retrospective, multicenter, cross-sectional study was conducted with Japanese patients with diabetes. Body composition was determined with bioelectrical impedance analysis, and this was used to obtain phase angle. Phase angle was assessed in relation to clinical parameters, body composition parameters, and HbA1c levels. A total of 655 patients were enrolled (400 men and 255 women, aged 57.1 ± 14.8 years, body mass index 25.6 ± 5.2 kg/m2, HbA1c 8.1 ± 1.9%). Even in patients with diabetes, the phase angle was higher in men than in women and did not differ between the types of diabetes. Multiple regression analysis, performed with phase angle as the objective variable, and age, sex, diabetes type, HbA1c, albumin level, and body mass index as explanatory variables, revealed that phase angle was negatively affected by HbA1c (B = - 0.043, 95% Confidence interval: - 0.07 to - 0.02, p < 0.001). HbA1c, age, sex, albumin level, and body mass index were independent determinants of phase angle in participants with diabetes.
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Affiliation(s)
- Naokazu Muramae
- Department of General Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
- Department of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan
| | | | - Satoshi Inagaki
- School of Nursing, Kobe City College of Nursing, Kobe, Japan
| | | | - Kozue Abe
- Matsuda Diabetes Clinic, Kobe, Japan
| | - Saki Nakatani
- Department of Nutrition, Kobe University Hospital, Kobe, Japan
| | | | - Kenji Kato
- Faculty of Nursing Science, Kobe Women’s University, Kobe, Japan
| | - Kazuhiko Sakaguchi
- Department of General Internal Medicine, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650-0017 Japan
- Department of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan
| | - Wataru Ogawa
- Department of Diabetes and Endocrinology, Kobe University Graduate School of Medicine, Kobe, Japan
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Kajiyama S, Nakanishi N, Yamamoto S, Ichikawa T, Okamura T, Hashimoto Y, Kitagawa N, Hamaguchi M, Fukui M. The Impact of Nutritional Markers and Dietary Habits on the Bioimpedance Phase Angle in Older Individuals. Nutrients 2023; 15:3599. [PMID: 37630789 PMCID: PMC10458185 DOI: 10.3390/nu15163599] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 08/13/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Low phase angle (PhA), as determined via bioelectrical impedance analysis, reflects unhealthy aging and mortality. In this study, we assessed whether nutritional status, including serum nutritional markers and dietary habits, is related to PhA in older individuals. We recruited 212 participants (aged ≥ 65 years) who underwent medical health checkups. PhA was measured using a multi-frequency impedance body composition analyzer. Habitual food and nutrient intake was evaluated using a brief, self-administered diet history questionnaire. Low PhA values were defined as ≤4.95 in males and ≤4.35 in females. Males with low PhA had poor exercise habits (p = 0.0429) and a lower body mass index (p = 0.0024). PhA was significantly correlated with serum cholinesterase levels, a nutritional status marker (r = 0.3313, p = 0.0004 in males; r = 0.3221, p = 0.0070 in females). The low-PhA group had significantly lower total energy and carbohydrate intake per ideal body weight (IBW) than the high-PhA group in males (total energy intake:30.2 ± 9.8 and 34.5 ± 9.3 kcal/kg/day, p = 0.0307; carbohydrate intake:15.2 ± 4.9 and 18.0 ± 5.8 kcal/kg/day, p = 0.0157). Total energy intake per IBW (adjusted odds ratio [95% confidence interval], 0.94 [0.89-1.00] per 1 kcal/kg/day increase) was independently associated with a low PhA in males. Our study revealed that lower total energy intake independently impacted low PhA in older males.
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Affiliation(s)
- Shintaro Kajiyama
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Naoko Nakanishi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Shinta Yamamoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Takahiro Ichikawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Takuro Okamura
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Yoshitaka Hashimoto
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Department of Diabetes and Endocrinology, Matsushita Memorial Hospital, Moriguchi 570-8540, Japan
| | - Noriyuki Kitagawa
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Kameoka Municipal Hospital, Kyoto 621-8585, Japan
| | - Masahide Hamaguchi
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
| | - Michiaki Fukui
- Department of Endocrinology and Metabolism, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
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Baş D, Atahan C, Tezcanli E. An analysis of phase angle and standard phase angle cut-off values and their association with survival in head and neck cancer patients undergoing radiotherapy. Clin Nutr 2023; 42:1445-1453. [PMID: 37451156 DOI: 10.1016/j.clnu.2023.06.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 06/18/2023] [Accepted: 06/26/2023] [Indexed: 07/18/2023]
Abstract
OBJECTIVE The objective of this study is to identify the cutoff values for phase angle (PA) and standard phase angle (SPA) parameters, as determined by bioelectrical impedance analysis (BIA), for predicting malnutrition and investigating their association with overall survival in head and neck cancer (HNC) patients undergoing radiotherapy. METHODS In this study, nutritional assessment and follow-up of HNC patients undergoing radiotherapy (RT) between November 2017 and September 2022 were assessed. Nutritional assessment, body composition (BC), and PA results obtained from BIA (Tanita MC-980) were retrospectively evaluated. Statistical Package for Social Sciences (SPSS) version 25.0 (IBM Corp., Armonk, NY, USA) was used for statistical analysis. The results were evaluated at a confidence interval of 95% and a significance level of p ≤ 0.05. RESULTS A total of 53 patients, including 37 (70%) men and 16 (30%) women, with a median age of 60 (23-87 years) were included. The median follow-up time was 51 (range 24-59) months. The mean PA of the patients was calculated as 4.99° (±0.92, 95% CI: 4.74-5.25). The PA of patients with malnutrition (4.66° ± 0.87) was lower than that of well-nourished patients (5.71° ± 0.56) (p < 0.001). As a result of the ROC analysis based on this finding, the ideal PA cut-off point for determining the presence of malnutrition was found to be 5.65, with a sensitivity of 85%, specificity of 79%, accuracy of 83%, and a model discrimination power of excellent level (AUC: 85%, p < 0.001). The median overall survival time of the patients was calculated as 51 months (24-59 months). The mortality rate during the follow-up period was 13%, while the 1-, 3-, and 5-year overall survival rates of the patients were 96.1%, 89.3%, and 86.8%, respectively. Patients with SPA values less than -1.65 had a 5-year overall survival rate of 77.4%, while those with SPA values greater than or equal to -1.65 had a 5-year overall survival rate of 100% (p = 0.030) CONCLUSION: Our study recommends using PA and SPA as standard criteria for detecting malnutrition in HNC patients undergoing RT, with cut-off points of 5.65 and -1.65 respectively, to prevent treatment interruptions and improve outcomes. Further research is needed to validate the SPA cut-off value and its relationship with clinical outcomes, as SPA may be a more effective predictor of malnutrition and overall survival than PA alone.
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Affiliation(s)
- Dilşat Baş
- Acıbadem Altunizade Hospital, Department of Nutrition and Dietetics, Istanbul, Turkiye; Istanbul Galata University, Department of Nutrition and Dietetics, School of Health Sciences, Istanbul, Turkiye.
| | - Ceren Atahan
- Acibadem Mehmet Ali Aydınlar University, Medical School, Radiation Oncology Department, Istanbul, Turkiye.
| | - Evrim Tezcanli
- Acibadem Altunizade Hospital, Radiation Oncology Department, Istanbul, Turkiye.
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11
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Graybeal AJ, Tinsley GM, Brandner CF, Aultman R. Raw bioelectrical impedance measurements are not different between White and Black adults when matched for sex, age, BMI, and other physical characteristics. Nutr Res 2023; 112:1-10. [PMID: 36933277 PMCID: PMC10079621 DOI: 10.1016/j.nutres.2023.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 03/18/2023]
Abstract
Raw bioelectrical impedance measurements are often used as a prognosticator of health status because of their association with disease states and malnutrition. Although studies consistently show the effect of physical characteristics on bioelectrical impedance, few investigations describe the effect of race, particularly for Black adults, and many bioelectrical impedance standards were produced from primarily White adults almost 2 decades ago. Therefore, this study sought to evaluate the racial differences in bioelectrical impedance measurements using bioimpedance spectroscopy between non-Hispanic White and non-Hispanic Black adults matched for age, sex, and body mass index. We hypothesized that Black adults would have a lower phase angle from higher resistance and lower reactance compared with White adults. One hundred non-Hispanic White (n = 50) and non-Hispanic Black (n = 50) males (n = 34) and females (n = 66) matched for sex, age, and body mass index completed this cross-sectional study. Participants underwent several anthropometric assessments, including height, weight, waist circumference, hip circumference, bioimpedance spectroscopy, and dual-energy X-ray absorptiometry. Bioelectrical impedance measures of resistance, reactance, phase angle, and impedance were all collected at frequencies of 5, 50, and 250 kHz and bioelectrical impedance vector analysis was performed using 50-kHz data. There were no significant differences for any anthropometric variable between Black and White participants in the total sample or by sex groups. In addition, there were no significant racial differences for any bioelectrical impedance assessment, including bioelectrical impedance vector analysis. Differences in bioelectrical impedance are likely not a function of race between Black and White adults and concerns regarding its utility should not be based on this characteristic.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS 39406, USA.
| | - Grant M Tinsley
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA
| | - Caleb F Brandner
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Ryan Aultman
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS 39406, USA
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12
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Di Vincenzo O, Marra M, Antognozzi V, Sammarco R, Ballarin G, Cioffi I, Scalfi L, Pasanisi F. Comparison of bioelectrical impedance analysis-derived phase angle in individuals with different weight status. Nutrition 2023; 108:111960. [PMID: 36669366 DOI: 10.1016/j.nut.2022.111960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 12/08/2022] [Accepted: 12/25/2022] [Indexed: 01/01/2023]
Abstract
OBJECTIVE Obesity is characterized not only by an increase of fat mass but also by alterations in skeletal muscle. Bioimpedance analysis (BIA)-derived phase angle (PhA) may provide specific information on the inherent characteristics of fat-free mass, and is widely used as an index of poor nutritional status. The aim of this study was to describe whether and to what extent PhA varies depending on age, sex, and body mass index (BMI) in individuals with different weight status. METHODS We selected 1877 participants for this retrospective study (two weight status groups): 983 individuals with obesity (age 40 ± 13.9 y; BMI 39.5 ± 7.2 kg/m²) and 894 controls (age 40 ± 13.3 y; BMI 24.6 ± 2.7 kg/m²). Anthropometry and PhA at 50 kHz for the whole body were performed in all participants. RESULTS PhA was greater in men than in women, although a decline of PhA was observed with age, which was linear in women and occurred in men after 40 y of age. On the other hand, no significant differences were observed with increasing BMI in either sex; lower values might be observed when BMI >50 kg/m². CONCLUSIONS A more detailed appraisal of BIA-derived PhA in obesity is reported in the present study, providing basic data that might be taken into consideration in prevention and clinical nutrition. Further studies are needed to explore differences of PhA in individuals with different weight status.
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Affiliation(s)
- Olivia Di Vincenzo
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy; Department of Public Health, Federico II University, Naples, Italy.
| | - Maurizio Marra
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | | | - Rosa Sammarco
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Giada Ballarin
- Department of Movement Sciences and Wellbeing, Parthenope University, Naples, Italy
| | - Iolanda Cioffi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Luca Scalfi
- Department of Public Health, Federico II University, Naples, Italy; Casa di Cura Santa Maria del Pozzo, Naples, Italy
| | - Fabrizio Pasanisi
- Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
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13
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Phase angle obtained via bioelectrical impedance analysis and objectively measured physical activity or exercise habits. Sci Rep 2022; 12:17274. [PMID: 36241873 PMCID: PMC9568532 DOI: 10.1038/s41598-022-21095-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 09/22/2022] [Indexed: 02/07/2023] Open
Abstract
The phase angle (PhA), measured via bioelectrical impedance analysis, is considered an indicator of cellular health, where higher values reflect higher cellularity, cell membrane integrity, and better cell function. This study aimed to examine the relationship between PhA and exercise habits or objectively measured physical activity. We included 115 people aged 32-69 years. The body composition and PhA were measured using a bioelectrical impedance device. Physical activity and sedentary behavior (SB) were assessed using a triaxial accelerometer. Exercise habits were also obtained through structured interviews, and participants were categorized into the no exercise habit (No-Ex), resistance training exercise habit (RT), or aerobic training exercise habit (AT) groups. Objectively measured moderate-to-vigorous physical activity or step count significantly correlated with PhA, independent of age, sex, height, percent body fat, body cell mass, and leg muscle power. In contrast, SB was not significant determinants of PhA. People who exercised regularly (RT or AT) had significantly higher PhA values than did those in the No-Ex group. Furthermore, the PhA was not significantly different between the RT and AT groups. Regularly engaging in exercise with moderate-to-vigorous intensity may improve or maintain muscle cellular health and muscle quality.
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14
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de Moraes AM, Quinaud RT, Ferreira GOC, Lima AB, Carvalho HM, Guerra-Júnior G. Age-, sex-, and maturity-associated variation in the phase angle after adjusting for size in adolescents. Front Nutr 2022; 9:939714. [PMID: 35978953 PMCID: PMC9376599 DOI: 10.3389/fnut.2022.939714] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/30/2022] [Indexed: 01/07/2023] Open
Abstract
Background Applied research using the phase angle (PhA) in children and adolescents has increased notably. Using multilevel modeling in a fully Bayesian framework, we examined the relationships between PhA, age, sex, biological maturity status, and body size in 10-16-year-old adolescents. Methods The sample comprised 519 adolescents (women, n = 241; men, n = 278) from Campinas, São Paulo, Brazil. Biological maturity status was assessed with self-examination of pubertal development for sexual maturity and maturity offset protocol to estimate age at peak height velocity (PHV) for somatic maturity status. Stature and body mass were measured by anthropometry. Phase angle was calculated based on raw resistance and reactance values (50 kHz frequency) obtained by bioelectrical impedance with the foot-to-hand technology. Results The multilevel regression analysis revealed that boys had significantly higher values of phase angle than girls, adjusting for age group and sexual maturity status. Overall, older and more mature adolescents had higher values of phase angle. When considering aligning variation in the phase angle by distance to estimated PHV (maturity offset), there was a higher association between the phase angle and time before and after predicted age at PHV for boys (r = 0.31, 90% CI: 0.23 to 0.39) than girls (r = 0.2, 90% CI: 0.11 to 0.28). When including body mass in the multilevel models, corresponding changes in the overall body mass mediate most of the influence of the maturity status and age group on the phase angle. Conclusion The present study demonstrated that the variability in phase angle is related to inter-individual variation in sex, age, and maturity status, as well as differences in body size. Research with adolescents considering phase angle should use multilevel modeling with standardized parameters as default to adjust for the concurrent influence of sex, age, maturity status, and body size.
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Affiliation(s)
- Anderson M. de Moraes
- Department of Physical Education, School of Sports, Pontifical Catholic University of Campinas, São Paulo, Brazil
| | - Ricardo T. Quinaud
- Department of Physical Education, University of Extreme South of Santa Catarina, Criciúma, Santa Catarina, Brazil
| | - Giovana O. C. Ferreira
- Department of Physical Education, School of Sports, Pontifical Catholic University of Campinas, São Paulo, Brazil
| | - Ahlan B. Lima
- Department of Physical Education, University of Extreme South of Santa Catarina, Criciúma, Santa Catarina, Brazil
| | - Humberto M. Carvalho
- Department of Physical Education, University of Extreme South of Santa Catarina, Criciúma, Santa Catarina, Brazil
| | - Gil Guerra-Júnior
- Laboratory of Growth and Development, Center for Investigation in Pediatrics, Department of Pediatrics, School of Medical Sciences, University of Campinas, São Paulo, Brazil
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15
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Bellafronte NT, Govêia TR, Chiarello PG. Sarcopenia in chronic kidney disease: prevalence by different definitions and relationship with adiposity. Appl Physiol Nutr Metab 2022; 47:915-925. [PMID: 35658617 DOI: 10.1139/apnm-2021-0521] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
This was a cross-sectional study with Chronic Kidney Disease (CKD) patients under non-dialysis-dependent (NDD), hemodialysis (HD) and kidney transplant (KTx) treatment aimed to evaluate the prevalence of sarcopenia using the European Working Group on Sarcopenia in Older People (EWGSOP2) and the Foundation of the National Institutes of Health (FNIH) guidelines; also analyze the relationship between sarcopenia and its components with body adiposity. Body composition was assessed by dual energy X-ray absorptiometry (DXA) and anthropometry. Bioelectrical impedance provided data of phase angle and body water. The prevalence of sarcopenia in total sample (n=243; 53% men, 48±10 y) was 7% by FNIH and 5% by EWGSOP2 criteria; and was low in each CKD group independently of the criteria applied (max 11% prevalence). Low muscle mass was present in 39% (FNIH) and 36% (EWGSOP2) and dynapenia in 10% of patients. Sarcopenic patients by EWGSOP2 criteria presented low body adiposity. Conversely, sarcopenic patients by FNIH presented high adiposity. This study suggests that in CKD (i) sarcopenia and low muscle mass prevalence varies according to the diagnostic criteria, (ii) are common conditions, (iii) association with body adiposity depends on the criteria used to define low muscle mass, (iv) FNIH criteria detected high adiposity in individuals with sarcopenia. Novelty bullets: Prevalence of sarcopenia and low muscle mass in CKD varied according to the diagnostic criteria; association of excess adiposity with sarcopenia and low muscle mass depends on muscle mass index applied; FNIH criteria detected higher adiposity in individuals with sarcopenia. NOVELTY BULLETS Prevalence of sarcopenia and low muscle mass in CKD varied according to the diagnostic criteria; Association of excess adiposity with sarcopenia and low muscle mass depends on muscle mass index applied; FNIH criteria detected higher adiposity in individuals with sarcopenia and low muscle mass.
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Affiliation(s)
| | - Thaísa Ribeiro Govêia
- University of São Paulo, Nutrition and Metabolism Undergraduate Course, Ribeirão Preto City, São Paulo State, Brazil;
| | - Paula Garcia Chiarello
- University of São Paulo, Department of Health Sciences, Ribeirão Preto City, São Paulo State, Brazil;
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de Blasio F, Scalfi L, Castellucci B, Sacco AM, Berlingieri GM, Capitelli L, Alicante P, Sanduzzi A, Bocchino M. Poor Nutritional Status and Dynapenia Are Highly Prevalent in Post-Acute COVID-19. Front Nutr 2022; 9:888485. [PMID: 35719154 PMCID: PMC9205211 DOI: 10.3389/fnut.2022.888485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/12/2022] [Indexed: 11/28/2022] Open
Abstract
Poor nutritional status is common (estimated prevalence 5–69%) in acute coronavirus disease-2019 (COVID-19), and has been associated with hospitalization, the need for intensive care, and mortality. Body composition (BC) and muscle function have also been related in such patients to poor disease outcomes. As the evidence in the literature is limited, a cross-sectional study was carried out to determine the frequency of malnutrition in a cohort of post-acute COVID-19 patients referred to a rehabilitation center after hospital discharge. BC and muscle strength were assessed and the differences between bedridden and not bedridden patients were specifically evaluated. The study sample was composed of 144 post-acute COVID-19 patients (mean age 64.8 years; males = 95), 37% of whom were bedridden (males = 60%). Nutritional status was evaluated with Mini-Nutritional Assessment (MNA) and Controlling Nutritional status (CONUT). Fat-free mass (FFM) and skeletal muscle mass (SM) were estimated using bioelectrical impedance analysis (BIA). Raw BIA variables (phase angle = PhA and impedance ratios = IRs) were also determined and handgrip strength (HGS) was measured. Dynapenia was identified according to the 2019 EWGSOP criteria. According to MNA, 18% (n. 26) of patients were malnourished and 62% (n. 89) were at risk of malnutrition. As for CONUT, 21% (n. 31) of cases had moderate–severe malnutrition and 58% (n. 83) had light malnutrition. Abnormalities of raw BIA variables (low PhA and high IRs) and low HGS were more common in bedridden patients, in those who were malnourished, or had low FFM or SM. Dynapenic patients were 65% men and 47% women. In conclusion, malnutrition, BC alterations, and low HGS occur in post-acute COVID-19 patients and are more common in bedridden patients. Further studies are needed to identify reliable algorithms for assessing nutritional status in post-acute COVID-19 patients undergoing rehabilitation.
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Affiliation(s)
- Francesco de Blasio
- Respiratory Medicine and Pulmonary Rehabilitation, Clinic Center, Private Hospital, Naples, Italy
| | - Luca Scalfi
- Department of Public Health, Federico II University, Naples, Italy
| | - Bianca Castellucci
- Respiratory Medicine and Pulmonary Rehabilitation, Clinic Center, Private Hospital, Naples, Italy
| | - Anna Maria Sacco
- Department of Public Health, Federico II University, Naples, Italy
| | | | - Ludovica Capitelli
- Respiratory Medicine Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Paola Alicante
- Department of Public Health, Federico II University, Naples, Italy
| | - Alessandro Sanduzzi
- Respiratory Medicine Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
| | - Marialuisa Bocchino
- Respiratory Medicine Unit, Department of Clinical Medicine and Surgery, Federico II University, Naples, Italy
- *Correspondence: Marialuisa Bocchino
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González-Correa CA, Jaimes SA, Cárdenas-Jiménez JI. Preliminary study on parameterization of raw electrical bioimpedance data with 3 frequencies. Sci Rep 2022; 12:9292. [PMID: 35661777 PMCID: PMC9166711 DOI: 10.1038/s41598-022-13299-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 05/23/2022] [Indexed: 02/05/2023] Open
Abstract
This study tests the geometrical parameterization method for Electrical Bio-Impedance Spectroscopy (EBIS) readings previously proposed by one of the authors. This method uses the data of just three frequencies (therefore called 3P method). The test was carried out by the analysis of parameterization from 26 spectra (selected from 13 data sets) by the non-linear square (NLS) method, the 3P method and a combination of the two (3P-NLS). Additionally, the behaviour of the 3P method for 4 levels of noise and 3 different ways of segmenting the spectra were also explored with a MATLAB simulation of 400 spectra. Finally, a system for the classification of EBIS readings is presented, based on deviations of the raw data from the semi-circle obtained by the parameterization methods. Overall, the results suggest a very good performance of the 3P method when compared with the other two. The 3P method performs very well with levels of noise of 1 and 2%, but performs poorly with levels of noise of 5% and 10%. The results support the idea that the 3P method could be used with confidence for the parameterization of EBIS spectra, after the selection of three adequate frequencies according to specific applications.
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Affiliation(s)
- C A González-Correa
- Research Group on Electrical Bio-impedance (GruBIE), Universidad de Caldas, Manizales, Colombia.
| | - S A Jaimes
- Research Group on Electrical Bio-impedance (GruBIE), Universidad de Caldas, Manizales, Colombia
| | - J I Cárdenas-Jiménez
- Research Group on Thermal-Dielectric Properties of Composites, TDPC-Group, Universidad Nacional de Colombia, Manizales, Colombia
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18
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Orsso CE, Gonzalez MC, Maisch MJ, Haqq AM, Prado CM. Using bioelectrical impedance analysis in children and adolescents: Pressing issues. Eur J Clin Nutr 2022; 76:659-665. [PMID: 34620999 DOI: 10.1038/s41430-021-01018-w] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 09/06/2021] [Accepted: 09/21/2021] [Indexed: 11/08/2022]
Abstract
Single- and multifrequency bioelectrical impedance analysis (BIA) has gained popularity as a tool to assess body composition and health status of children and adolescents, but many questions and misconceptions remain. This review addresses pressing issues researchers and health care providers may encounter when using BIA in the young population. The importance of choosing population-specific and device-specific equations to estimate body composition as well as the use of BIA in longitudinal analyses are discussed. When specific equations are not available, raw bioimpedance values (i.e., resistance, reactance, and impedance) can be used to compute bioimpedance parameters, such as phase angle, impedance ratio, and bioelectrical impedance vector analysis. As interpreting these parameters is challenging, suggestions are provided on the use of reference data, cut-off points, and adjustment factors. Furthermore, unsolved technical and analytical issues are listed. Based on existing issues and potential for future development, a greater interaction between industry and academic researchers to improve the validity of BIA measurements among children and adolescents across their developmental stages is encouraged.
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Affiliation(s)
- Camila E Orsso
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre for Health Innovation, Edmonton, AB, T6G 2E1, Canada.
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, R. Gonçalves Chaves 377, Pelotas, RS, 96010280, Brazil
- Pennington Biomedical Research Center, LSU System, 6400 Perkins Road, Baton Rouge, LA, 70808, USA
| | | | - Andrea M Haqq
- Department of Pediatrics & Department of Agricultural, Food and Nutritional Science, University of Alberta, 1C4 Walter C. Mackenzie Health Sciences Center, Edmonton, AB, T6G 2B7, Canada
| | - Carla M Prado
- Human Nutrition Research Unit, Department of Agricultural, Food and Nutritional Science, University of Alberta, 4-002 Li Ka Shing Centre for Health Innovation, Edmonton, AB, T6G 2E1, Canada
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Reference Percentiles for Bioelectrical Phase Angle in Athletes. BIOLOGY 2022; 11:biology11020264. [PMID: 35205130 PMCID: PMC8869633 DOI: 10.3390/biology11020264] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 02/03/2022] [Accepted: 02/07/2022] [Indexed: 02/01/2023]
Abstract
Simple Summary The bioelectrical phase angle is a raw parameter that can be utilized as an indicator of performance, muscle quantity and hydration status of cells. However, sex- and sport-specific phase angle reference percentiles are lacking for the athletic population. For the first time, this study provides 5th, 15th, 50th, 85th, and 95th reference percentiles for phase angle in male and female athletes practicing different sports. These reference values can be used to track body composition and performance related-outcomes in sports practice, while leveraging the portability of bioelectric impedance analysis. Abstract The present study aimed to develop reference values for bioelectrical phase angle in male and female athletes from different sports. Overall, 2224 subjects participated in this study [1658 males (age 26.2 ± 8.9 y) and 566 females (age 26.9 ± 6.6 y)]. Participants were categorized by their sport discipline and sorted into three different sport modalities: endurance, velocity/power, and team sports. Phase angle was directly measured using a foot-to-hand bioimpedance technology at a 50 kHz frequency during the in-season period. Reference percentiles (5th, 15th, 50th, 85th, and 95th) were calculated and stratified by sex, sport discipline and modality using an empirical Bayesian analysis. This method allows for the sharing of information between different groups, creating reference percentiles, even for sports disciplines with few observations. Phase angle differed (men: p < 0.001; women: p = 0.003) among the three sport modalities, where endurance athletes showed a lower value than the other groups (men: vs. velocity/power: p = 0.010, 95% CI = −0.43 to −0.04; vs. team sports: p < 0.001, 95% CI = −0.48 to −0.02; women: vs. velocity/power: p = 0.002, 95% CI = −0.59 to −0.10; vs. team sports: p = 0.015, 95% CI = −0.52 to −0.04). Male athletes showed a higher phase angle than female athletes within each sport modality (endurance: p < 0.01, 95% CI = 0.63 to 1.14; velocity/power: p < 0.01, 95% CI = 0.68 to 1.07; team sports: p < 0.01, 95% CI = 0.98 to 1.23). We derived phase angle reference percentiles for endurance, velocity/power, and team sports athletes. Additionally, we calculated sex-specific references for a total of 22 and 19 sport disciplines for male and female athletes, respectively. This study provides sex- and sport-specific percentiles for phase angle that can track body composition and performance-related parameters in athletes.
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Lim CKM, Lim JH, Ibrahim I, Chan YM, Zakaria NF, Yahya R, Daud ZAM. Bioelectrical Impedance Analysis Derived-Phase Angle as a Pragmatic Tool to Detect Protein Energy Wasting among Multi-Ethnic Hemodialysis Patients. Diagnostics (Basel) 2021; 11:diagnostics11101745. [PMID: 34679443 PMCID: PMC8534349 DOI: 10.3390/diagnostics11101745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 09/04/2021] [Accepted: 09/19/2021] [Indexed: 11/16/2022] Open
Abstract
Protein-energy wasting (PEW) is a devastating metabolic derangement that leads to increased morbidity and mortality in hemodialysis (HD) patients. This study aimed to determine the diagnostic test accuracy of bioelectrical impedance analysis derived-phase angle (PhA) in detecting PEW among HD patients. This was a multi-centre, cross-sectional study conducted amongst 152 multi-ethnic HD patients in Klang Valley, Malaysia. PEW was assessed using the International Society of Renal Nutrition and Metabolism criteria as the reference method. PhA was measured using a multi-frequency bioelectrical impedance spectroscopy at 50 kHz. Multiple and logistic regressions were used to determine factors associated with PhA and PEW diagnosis, respectively. A receiver operating characteristics curve analysis was used to establish the gender-specific PhA cut-offs to detect PEW. PEW existed in 21.1% of the HD patients. PhA was found as an independent predictor of PEW (adjOR = 0.308, p = 0.001), with acceptable to excellent discriminative performance (adjAUCmale = 0.809; adjAUCfemale = 0.719). Male patients had higher PhA cut-off compared to female patients (4.26° vs. 3.30°). We concluded that PhA is a valid and pragmatic biomarker to detect PEW in multi-ethnic Malaysian HD patients and a gender-specific cut-off is necessary, attributed to the gender differences in body composition.
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Affiliation(s)
- Cordelia-Kheng-May Lim
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia; (C.-K.-M.L.); (J.-H.L.); (I.I.); (Y.-M.C.)
| | - Jun-Hao Lim
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia; (C.-K.-M.L.); (J.-H.L.); (I.I.); (Y.-M.C.)
| | - Imliya Ibrahim
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia; (C.-K.-M.L.); (J.-H.L.); (I.I.); (Y.-M.C.)
| | - Yoke-Mun Chan
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia; (C.-K.-M.L.); (J.-H.L.); (I.I.); (Y.-M.C.)
- Research Center of Excellent (RCoE) Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia
- Department of Dietetics, Hospital Pengajar Universiti Putra Malaysia, UPM Serdang 43400, Malaysia
| | - Nor Fadhlina Zakaria
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia;
| | - Rosnawati Yahya
- Department of Nephrology, Hospital Kuala Lumpur, Kuala Lumpur 50586, Malaysia;
| | - Zulfitri Azuan Mat Daud
- Department of Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia; (C.-K.-M.L.); (J.-H.L.); (I.I.); (Y.-M.C.)
- Research Center of Excellent (RCoE) Nutrition and Non-communicable Diseases, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, UPM Serdang 43400, Malaysia
- Department of Dietetics, Hospital Pengajar Universiti Putra Malaysia, UPM Serdang 43400, Malaysia
- Correspondence: ; Tel.: +603-9769-2431
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21
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Yang Y, Qin X, Chen J, Wang Q, Kong Y, Wan Q, Tao H, Liu A, Li Y, Lin Z, Huang Y, He Y, Lei Z, Liang M. The Effects of Oral Energy-Dense Supplements on Nutritional Status in Nondiabetic Maintenance Hemodialysis Patients: A Randomized Controlled Trial. Clin J Am Soc Nephrol 2021; 16:1228-1236. [PMID: 34155082 PMCID: PMC8455049 DOI: 10.2215/cjn.16821020] [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: 10/28/2020] [Accepted: 05/18/2021] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND OBJECTIVES Fat-based energy-dense nutritional supplements may offer benefits over protein- or carbohydrate-dense supplements for patients receiving dialysis because of the adverse metabolic consequences of the latter. We conducted a randomized controlled trial to assess the effects of the short-term use of a fat-based nutritional supplement on various measures of nutritional status in patients receiving maintenance hemodialysis who have low dietary energy intake. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS We enrolled nondiabetic patients receiving hemodialysis for >3 months who had inadequate dietary energy intake (<30 kcal/kg per day). The participants were randomly assigned in a 1:1 ratio to receive an oral fat-based energy-dense supplement (300 kcal daily) or routine care for 12 weeks (n=120 per group). The primary outcome was the change in phase angle measured by bioelectrical impedance analysis, a marker of cell integrity and body cell mass, from the baseline to week 12. The secondary outcomes were changes in quality of life. Other outcomes included laboratory nutritional indicators and physical examinations. RESULTS The average age of the total population was 47 (SD: 12) years, and 55% were men. The median of dialysis vintage was 43.4 (22.5-76.3) months; 240 participants were randomly assigned to the intervention (n=120) or control group (n=120). In total, 228 (95%) participants completed the trial. The change in phase angle did not differ significantly between the intervention and control groups (estimate, 0.0; 95% confidence interval, -0.1 to 0.1 versus estimate, 0.0; 95% confidence interval, -0.1 to 0.1; estimated difference, 0.0; 95% confidence interval -0.2 to 0.2; P=0.99). None of the 19 domains of quality of life differed between the groups. Adverse events were reported in 23 (19%) participants in the control group and 40 (33%) participants in the intervention group. CONCLUSIONS In nondiabetic patients on maintenance hemodialysis, short-term administration of fat-based energy-dense nutritional supplement has no clinically significant effect on nutritional status as measured by phase angle. PODCAST This article contains a podcast at https://https://www.asn-online.org/media/podcast/CJASN/2021_08_03_CJN16821020.mp3.
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Affiliation(s)
- Yaya Yang
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xianhui Qin
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Junzhi Chen
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qi Wang
- Division of Nephrology, Huadu District People’s Hospital of Guangzhou, Guangzhou, China
| | - Yaozhong Kong
- Division of Nephrology, The First People’s Hospital of Foshan, Foshan, China
| | - Qijun Wan
- Division of Nephrology, Shenzhen Second People’s Hospital, Shenzhen, China
| | - Huiqin Tao
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Aiqun Liu
- Division of Nephrology, The Third Affiliated Hospital of Southern Medical University, Guangzhou, China
| | - Youbao Li
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zizhen Lin
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yan Huang
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yanhuan He
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Zihan Lei
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Min Liang
- National Clinical Research Center for Kidney Disease, State Key Laboratory of Organ Failure Research, Division of Nephrology, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Jun M, Ku B, Kim J, Kim KH, Kim JU. Mediation effect of the duration of diabetes mellitus on the decrease in bioimpedance phase angles in ethnically Korean people: A multicenter clinical study. J Diabetes Investig 2021; 12:790-802. [PMID: 32902171 PMCID: PMC8089017 DOI: 10.1111/jdi.13399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 08/05/2020] [Accepted: 09/01/2020] [Indexed: 12/14/2022] Open
Abstract
AIMS/INTRODUCTION We carried out a multicenter clinical study to investigate whether the decrease in segmental phase angles (PhA values) observed using bioelectrical impedance is useful in screening for diabetes mellitus and monitoring disease progression. MATERIALS AND METHODS The segmental PhA values of the four limbs were acquired using multifrequency bioimpedance at 5, 50 and 250 kHz in three clinics. Differences in PhA values between the diabetes and control groups were analyzed using the two-sample t-test and analysis of variance (anova). Changes in PhA values with increasing durations of diabetes were analyzed using a moderated mediation model and multivariate linear regression analysis. We recruited 217 participants aged ≥40 years (diabetes 158, controls 59, men 106, women 111, A-clinic 71, B-clinic 70 and C-clinic 76). RESULTS PhA values at 50 kHz were significantly decreased in people with diabetes (PhA of the right arm in men: t-value -4.0, P < 0.001; PhA of the right leg in women: t-value -4.6 P < 0.001), and the difference was partially attributable to the duration of diabetes, as well as aging. Specifically, the mediation effect of the duration of diabetes on the decrease in PhA values was 29.8% in the left arm of men, 53.3% in the right arm of women, and 36.3% in the left arm of both sexes. CONCLUSIONS Phase angle values at 50 kHz decreased in people with diabetes, and the changes were exacerbated as the disease duration increased. Thus, bioimpedance PhA values represent a non-invasive tool for monitoring the progression of diabetes mellitus.
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Affiliation(s)
- Min‐Ho Jun
- Korea Institute of Oriental Medicine (KIOM)DeajeonKorea
| | - Boncho Ku
- Korea Institute of Oriental Medicine (KIOM)DeajeonKorea
| | - Jihye Kim
- Korea Institute of Oriental Medicine (KIOM)DeajeonKorea
| | - Keun Ho Kim
- Korea Institute of Oriental Medicine (KIOM)DeajeonKorea
- Korean Convergence MedicineUniversity of Science and TechnologyDeajeonKorea
| | - Jaeuk U Kim
- Korea Institute of Oriental Medicine (KIOM)DeajeonKorea
- Korean Convergence MedicineUniversity of Science and TechnologyDeajeonKorea
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Segmental Phase Angle and Body Composition Fluctuation of Elite Ski Jumpers between Summer and Winter FIS Competitions. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094741. [PMID: 33946810 PMCID: PMC8124535 DOI: 10.3390/ijerph18094741] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 04/22/2021] [Accepted: 04/23/2021] [Indexed: 01/03/2023]
Abstract
(1) Background: The purpose of this study was to observe segmental phase angle (PhA) and body composition fluctuation of elite ski jumpers. (2) Methods: In the study, 12 professional ski jumpers took part. Body composition was estimated with segmental multi-frequency bioelectrical impedance analysis. Repeated ANOVA was used to check the parameters' variability in time. The symmetry between the right and left side of the body was verified with the t-test for dependent samples. Pearson's linear correlation coefficient was calculated. (3) Results: The most stable parameter was body weight. An increase in the visceral fat area was noted, the fat-free mass dropped, and significant changes were noted in the internal and external cell water parameters. Parameters connected with water between the right and left side of the body were symmetrical. Significant correlation between PhA values and body parameters with regard to fat tissue and PhA values of the legs was noticed when PhA was measured at 50 kHz. (4) Conclusions: PhA could be considered as a ski jumper body symmetry monitoring tool. The described relationship may be useful for the assessment of body fat change, which, in the case of jumpers, is crucial. Moreover, our data suggest that segmental PhA evaluation could be a good solution for ski jumpers as a confirmation if lowered body mass and low BMI are still healthy and increase the chance for longer jumps and good performance.
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Yamada Y, Itoi A, Yoshida T, Nakagata T, Yokoyama K, Fujita H, Kimura M, Miyachi M. Association of bioelectrical phase angle with aerobic capacity, complex gait ability and total fitness score in older adults. Exp Gerontol 2021; 150:111350. [PMID: 33872735 DOI: 10.1016/j.exger.2021.111350] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/08/2021] [Accepted: 04/09/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aimed to examine the association between whole-body or segmental phase angle (PhA) based on bioelectrical impedance analysis (BIA) and aerobic capacity (endurance), complex gait ability, and total fitness age score (FAS). METHODS A total of 426 community-dwelling older adults (332 women and 94 men) aged 60 to 93 years participated in this study. PhA and appendicular skeletal mass index (ASMI) were obtained by an eight-electrode standing BIA. Aerobic capacity was assessed using the shuttle stamina walk test (SSTw); complex gait ability, using the timed-up-and-go test (TUG). FAS was obtained using the previously validated multi-dimensional equations based on 7-year longitudinal data. SSTw, TUG, and FAS were compared between the low PhA (<4.4° for women and <5.2° for men) and normal PhA groups. Pearson's correlation between PhA and SSTw, TUG, and FAS was determined. Multiple linear regression analysis was conducted using SSTw, TUG, and FAS as dependent variables. Age, sex, height, body mass index (BMI), ASMI, and PhA were entered into the linear model. RESULTS SSTw and TUG results and FAS were significantly lower in the low PhA group (P < 0.05). PhA was significantly correlated with SSTw, TUG, and FAS (P < 0.001), and leg PhA showed a stronger correlation than whole-body or arm PhA. PhA at 50 kHz had higher correlation coefficients with SSTw, TUG, or FAS compared with PhA at 5 or 250 kHz. Multiple regression analyses indicated that leg PhA at 50 kHz was a significant predictor of SSTw, TUG, and FAS, independent of age, sex, height, BMI, and ASMI. CONCLUSION Our results indicate that leg PhA is associated with multi-dimensional physical fitness in community-dwelling older adults. PhA is a highly informative biomarker of skeletal muscle and exercise physiology in clinical settings.
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Affiliation(s)
- Yosuke Yamada
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan.
| | - Aya Itoi
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan; Department of Health, Sports and Nutrition, Faculty of Health and Welfare, Kobe Women's University, Hyogo, Japan
| | - Tsukasa Yoshida
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Takashi Nakagata
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
| | - Keiichi Yokoyama
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan; Institute for Active Health, Institute of Interdisciplinary Research, Kyoto University of Advanced Science, Kyoto, Japan
| | - Hiroyuki Fujita
- Institute for Active Health, Institute of Interdisciplinary Research, Kyoto University of Advanced Science, Kyoto, Japan
| | - Misaka Kimura
- Institute for Active Health, Institute of Interdisciplinary Research, Kyoto University of Advanced Science, Kyoto, Japan
| | - Motohiko Miyachi
- Department of Physical Activity Research, National Institute of Health and Nutrition, National Institutes of Biomedical Innovation, Health and Nutrition, Tokyo, Japan
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25
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Rinaldi S, Gilliland J, O'Connor C, Seabrook JA, Mura M, Madill J. Exercise capacity and its relationship with body composition and nutrition status in patients with interstitial lung disease. Nutr Clin Pract 2021; 36:891-898. [PMID: 33786852 DOI: 10.1002/ncp.10651] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Patients with interstitial lung disease (ILD) are known to have diminished exercise ability. This study aimed to explore the relationship between nutrition status and body composition parameters with exercise capacity in ILD patients. A second aim focused on assessing the appropriateness of surrogate markers of nutrition status in ILD patients. METHODS Disease severity was determined by the percentage of predicted forced vital capacity. Exercise capacity was determined using 6-minute walk distance. Nutrition status was assessed using the subjective global assessment (SGA), standardized phase angle (SPhA), and impedance ratio z-score (z-IR). Bioelectrical impedance analysis estimated body composition parameters. RESULTS 45 of 79 participants (57%) were malnourished according to the SGA. FFM index z-score (z-FFMI) (r = 0.42, P = .02) and SGA (r = 0.49, P < .01) were significant predictors of exercise capacity independent of disease severity. Age (odds ratio [OR] = 1.1; 95% CI, 1.01-1.25; P = .04), low body mass index (OR = 0.73; 95% CI, 0.57-0.92; P = .01), z-FFMI (OR = 0.34; 95% CI, 0.17-0.68; P < .01), and body fat mass index z-score (OR = 0.39; 95% CI, 0.17-0.91; P = .03) were significantly associated with severe malnutrition. There was no significant difference in SPhA across SGA groups; however, a higher z-IR (poorer cell health) significantly increased the odds of severe malnutrition (OR = 2.75; 95% CI, 1.27-6.03; P = .02). CONCLUSION In ILD patients, malnutrition and loss of FFM negatively impact the ability to perform activities of daily living.
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Affiliation(s)
- Sylvia Rinaldi
- School of Health Studies, Western University, London, Ontario, Canada.,School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada.,Human Environments Analysis Laboratory, Western University, London, Ontario, Canada
| | - Jason Gilliland
- School of Health Studies, Western University, London, Ontario, Canada.,Human Environments Analysis Laboratory, Western University, London, Ontario, Canada.,Department of Geography, Western University, London, Ontario, Canada.,Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Children's Health Research Institute, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Colleen O'Connor
- School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada.,Human Environments Analysis Laboratory, Western University, London, Ontario, Canada
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada.,Human Environments Analysis Laboratory, Western University, London, Ontario, Canada.,Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.,Children's Health Research Institute, London, Ontario, Canada.,Lawson Health Research Institute, London, Ontario, Canada
| | - Marco Mura
- Division of Respirology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Janet Madill
- School of Food and Nutritional Sciences, Brescia University College at Western University, London, Ontario, Canada
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26
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Han BG, Han J, Lee KH. Association of impedance ratio with corrected Geriatric Nutritional Risk Index in older patients with nondialysis chronic kidney disease stage 5. JPEN J Parenter Enteral Nutr 2021; 46:93-103. [PMID: 33586150 DOI: 10.1002/jpen.2089] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 01/27/2021] [Accepted: 02/09/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND The usual calculation of body mass index (BMI) can be misleading in patients with advanced chronic kidney disease (CKD) because their altered fluid balances may not be reflected. We obtained corrected BMI (cBMI) and corrected Geriatric Nutritional Risk Index (cGNRI) values and investigated whether the impedance ratio (IR) of 200/5 kHz, measured using bioimpedance spectroscopy, was associated with cGNRI in older patients with nondialysis CKD stage 5 (CKD5-ND). METHODS Patients over 65 years old (n = 118) were divided into groups by cGNRI tertiles. The differences between the correlations were tested using Steiger's z-test. The IR and cBMI were used as both continuous and categorical variables in the regression analyses to determine the factors that were independently associated with the cGNRI. RESULTS Patients in the third cGNRI tertile had a significantly lower mean IR than those in the other 2 tertiles (P < .001). Across the 3 cGNRI tertile groups, the IR was incrementally lower in the higher cGNRI tertiles (P for trend < .001). The Steiger's z-test showed that the IR had a significantly stronger correlation with cGNRI than cBMI had with cGNRI. In the multivariable linear regression analyses, the IR was independently associated with the cGNRI, after adjusting for various confounders. CONCLUSION The current results revealed that the IR was a more sensitive indicator of nutrition risk than BMI and was independently associated with cGNRI in older patients with CKD5-ND. Our study suggests that the IR is an appropriate tool for nutrition risk screening.
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Affiliation(s)
- Byoung-Geun Han
- Department of Nephrology, Yonsei University Wonju College of Medicine, Wonju, Kang-won, Korea
| | - Jihye Han
- Politics and International Relations, London School of Economics and Political Science, London, United Kingdom.,United Nations Development Programme Seoul Policy Center, Seoul, Korea
| | - Kwang Hoon Lee
- Dr. Lee's Medical Clinic and Hemodialysis Center, Wonju, Kang-won, Korea
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de Almeida C, Penna PM, Pereira SS, Rosa CDOB, Franceschini SDCC. Relationship between Phase Angle and Objective and Subjective Indicators of Nutritional Status in Cancer Patients: A Systematic Review. Nutr Cancer 2020; 73:2201-2210. [PMID: 33251872 DOI: 10.1080/01635581.2020.1850815] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
To investigate the relationship between phase angle (PA) and objective and subjective indicators of nutritional status in cancer patients, as well as to identify cutoff points for PA, to detect malnutrition in these patients. The study was a systematic review, carried out following the guidelines of the Preferred Reporting Items for Systematic Reviews and meta-analyses (PRISMA). Literature search was performed for two authors, in indexed databases, including the National Library of Medicine, Bethesda, MD (PubMed), Latin American and Caribbean Literature in Health Sciences (LILACS), and Scopus (Elsevier). We used the checklist from the Joanna Briggs Institute for assessing the risk of bias. The review was registered with the Systematic Review Registration (PROSPERO), number CRD42020134324. In total, nine papers were eligible. PA was correlated with several objective and subjective indicators of nutritional status in most cases. Cutoff point values for the PA, capable of detecting malnutrition, varied from 4.73° to 6°, despite the modest diagnostic accuracy. We assume that PA may be considered an indicator of nutritional status, when complementing additional data and assisting health practitioners in evaluating individuals with malignant neoplasms. However, a single cutoff point with fair and concomitant sensitivity and specificity was not identified.
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Affiliation(s)
- Carolina de Almeida
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
| | - Paula Moreira Penna
- Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil
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Perteet-Jackson AD, Earthman CP, Larson-Nath CM. Body Composition Post Pediatric Liver Transplant: Implications and Assessment. Nutr Clin Pract 2020; 36:1173-1184. [PMID: 33242232 DOI: 10.1002/ncp.10601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Accepted: 10/17/2020] [Indexed: 12/30/2022] Open
Abstract
Liver disease has a negative influence on growth and development of children. Measurement of body composition as a component of nutrition status assessment in children before and after transplant would facilitate tailoring of nutrition therapy. A comprehensive literature search on pediatric liver transplant and body composition assessment was performed using a modified systematic approach. This review includes evidence specific to body composition of children undergoing liver transplant and a discussion of relevant body composition assessment methods for this population. Malnutrition is commonly seen in children with liver disease prior to transplant because of the disrupted metabolic pathways from liver dysfunction; however, malnutrition is not consistently diagnosed. Within 1 year of transplant, children tend to quickly recover with weight gain and linear growth. In some children, obesity and sarcopenia have been observed as long-term posttransplant outcomes. Body composition assessment tools have been utilized in diagnosing nutrition status in adults; yet there are limited studies that use these tools in the pediatric liver-transplant population. Technologies available to assess body composition include air displacement plethysmography, dual-energy x-ray absorptiometry, bioimpedance, and ultrasound. Total body potassium has been used for body composition assessment in adults and children post liver transplant; however, this method is not applicable in a clinical setting. We conclude that understanding posttransplant body composition could help clinicians diagnose and treat malnutrition.
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Affiliation(s)
- Alissa D Perteet-Jackson
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, St. Paul, Minnesota, USA
| | - Carrie P Earthman
- Department of Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
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Comparison between dual-energy x-ray absorptiometry and bioelectrical impedance for body composition measurements in adults with chronic kidney disease: A cross-sectional, longitudinal, multi-treatment analysis. Nutrition 2020; 82:111059. [PMID: 33341596 DOI: 10.1016/j.nut.2020.111059] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 09/09/2020] [Accepted: 11/02/2020] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The aim of this study was to evaluate the agreement between bioelectrical impedance spectroscopy (BIS) and dual-energy x-ray absorptiometry (DXA) for assessment of body composition in patients with chronic kidney disease (CKD). METHODS We performed cross-sectional and prospective analyses by DXA and BIS in whole body (BISWB) and segmental (BISSEG) protocols in CKD non-dialysis-dependent (n = 81), hemodialysis (n = 83), peritoneal dialysis (n = 24), and renal transplantation (n = 80) patients. Intraclass correlation coefficient (ICC) and Bland-Altman plots were evaluated. Linear regression analysis was performed for bias assessment and development of equations. Receiver operating characteristics curve was constructed for diagnosis of inadequate error tolerance (DXA - BIS >±2kg). RESULTS The agreement with DXA was greater for BISWB than BISSEG; for fat mass (FM; ICC men = 0.894; women = 0.931) than fat-free mass (FFM; ICC men = 0.566; women = 0.525), with greater bias for FFM as muscle increases and for FM in body fat extremes. The agreement was lower for body change analysis (ICC FFM men = 0.196; women = 0.495; ICC FM men = 0.465; women = 0.582). The ratio of extra- to intracellular water (ECW/ICW), body mass index, fat mass index, waist circumference, resistance, and reactance interfered in bias between methods. An ECW/ICW cutoff point of ≥0.7250 for inadequate error tolerance was determined. New prediction equations for FFM (r2 = 0.913) and FM (r2 = 0.887) presented adequate error tolerance in 55% and 63% compared with 30% and 39% of the original equation, respectively. CONCLUSION For body composition evaluation in patients with CKD, BIS applied using the whole body protocol, in normal hydration patients with CKD is as reliable as DXA; BIS must be used with caution in overhydration patients with ECW/ICW ≥ 0.7250. The newly developed equations are indicated for greater precision.
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Jensen B, Braun W, Both M, Gallagher D, Clark P, González DL, Klückmann K, Bosy-Westphal A. Configuration of bioelectrical impedance measurements affects results for phase angle. Med Eng Phys 2020; 84:10-15. [DOI: 10.1016/j.medengphy.2020.07.021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Revised: 07/24/2020] [Accepted: 07/26/2020] [Indexed: 10/23/2022]
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Portugal MRC, Canella DS, Curioni CC, Bezerra FF, Faerstein E, Neves MF, Koury JC. Bioelectrical impedance analysis–derived phase angle is related to risk scores of a first cardiovascular event in adults. Nutrition 2020; 78:110865. [DOI: 10.1016/j.nut.2020.110865] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 03/11/2020] [Accepted: 04/29/2020] [Indexed: 01/25/2023]
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Choi HN, Kim KA, Kim YS, Yim JE. Independent Association of Phase Angle with Fasting Blood Glucose and Hemoglobin A1c in Korean Type 2 Diabetes Patients. Clin Nutr Res 2020; 9:205-212. [PMID: 32789150 PMCID: PMC7402973 DOI: 10.7762/cnr.2020.9.3.205] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 07/15/2020] [Accepted: 07/16/2020] [Indexed: 12/28/2022] Open
Abstract
The relationship between phase angle (PhA) of bioelectrical impedance analysis (BIA) and glycemic parameters in diabetes mellitus (DM) patients has not been well studied. To evaluate the prognostic value of the PhA from BIA as a glycemic marker, we investigated the relationship of PhA with various variables such as age, body mass index (BMI), and glycemic parameters in Korean patients with type 2 DM (T2DM). We evaluated the anthropometric data, body composition, glycemic parameters, and PhA of 321 T2DM patients aged 30–83 years. The patients were classified by sex into men (n = 133) and women (n = 188). General linear models identified the independent effects of PhA after covarying for age, sex and BMI. The PhA, body cell mass (BCM), extracellular mass (ECM), lean body mass, intracellular water (ICW), extracellular water (ECW), total body water (TBW), fasting blood glucose, and hemoglobin A1c (HbA1c) of T2DM Korean patients were significantly higher in men than in women. However, fat mass, ECM/BCM, ECW/ICW, ECW/TBW, and serum insulin were significantly higher in women than in men. Statistically significant independent associations were observed between PhA and age, BCM, ECM, ECM/BCM, ICW, ECW, ECW/ICW, and ECW/TBW for both sexes. There was no significant association between PhA and BMI the patients. Glycemic parameters, such as HbA1c and fasting blood glucose were independently associated with PhA. These results suggest that PhA could be an indicator for assessing ability to control fasting blood glucose in T2DM patients in Korea.
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Affiliation(s)
- Ha-Neul Choi
- Department of Food and Nutrition, Changwon National University, Changwon 51140, Korea
| | - Kyung-Ah Kim
- Department of Food and Nutrition, Chungnam National University, Daejeon 34134, Korea
| | - Young-Seol Kim
- Department of Endocrinology and Metabolism, Kyung Hee University School of Medicine, Seoul 02447, Korea
| | - Jung-Eun Yim
- Department of Food and Nutrition, Changwon National University, Changwon 51140, Korea
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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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Phase Angle from Bioelectric Impedance and Maturity-Related Factors in Adolescent Athletes: A Systematic Review. SUSTAINABILITY 2020. [DOI: 10.3390/su12124806] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Phase angle (PhA) is a body composition (BC) parameter from bioelectrical impedance analysis that is suggested as a marker of cell integrity and general health. In adolescent athletes, PhA values are used to monitor the effects of training and competitions and seem to vary according to age, having an upward trajectory during puberty. Since adolescence is a period composed of maturation stages, the aim of this systematic review was to investigate the relationship between PhA and maturation stage in adolescent athletes. A search was conducted in PubMed/MEDLINE, BVS, Web of Science (WOS), Scopus, Science Direct, and Academic Search Complete (EBSCO) databases up to May 2020. Eligibility criteria followed the PICOS strategy and studies with healthy athletes aged 10–19 years of any level of competition were included. Six cross-sectional studies and two longitudinal studies met the inclusion criteria. Results showed that early and mature athletes have higher PhA than those who are non-matured or maturated late. Thus, PhA is influenced by the pubertal status. Considering BC is one of the factors influencing sports performance together with its growth-related changes, practitioners may use PhA values in BC analysis of adolescent athletes.
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Mattiello R, Amaral MA, Mundstock E, Ziegelmann PK. Reference values for the phase angle of the electrical bioimpedance: Systematic review and meta-analysis involving more than 250,000 subjects. Clin Nutr 2020; 39:1411-1417. [DOI: 10.1016/j.clnu.2019.07.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Revised: 06/25/2019] [Accepted: 07/03/2019] [Indexed: 02/07/2023]
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Yao J, Zhou M, Xu B, Li C, Chen H, Gong D. The association of bioimpedance analysis parameters with the outcomes of critically ill patients. Clin Nutr 2019; 39:2848-2855. [PMID: 31926763 DOI: 10.1016/j.clnu.2019.12.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2019] [Revised: 12/02/2019] [Accepted: 12/15/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND The association between bioimpedance analysis (BIA) parameters and the outcomes of critically ill patients was explored through a retrospective investigation. METHODS The study enrolled patients in the intensive care units of our hospital who had a record of BIA measurements as well as disease severity scores assessed by Acute Physiology and Chronic Health Evaluation II (APACHE II), Simplified Acute Physiology Score II (SAPS II) and Sequential Organ Failure Assessment (SOFA). The associations between clinical conditions, outcomes and BIA parameters were analysed. The relationship between individual bioimpedance values and the current frequencies fit well to a natural logarithmic function, providing a regression coefficient S value. Other parameters obtained from the BIA measurements included phase angle (PA), the ratio of bioimpedance at high and low frequencies (IR), extracellular water (ECW), intracellular water (ICW) and total body water (TBW). RESULTS Among 201 enrolled patients, the 90-day in-hospital mortality was 35.8%. Compared to the survivors at 7-days, for the non-survivors, the IR, S value, ratio of ECW/weight and ratio of ECW/TBW were higher, and the PA was lower (P < 0.05). Compared to the survivors at 90-days, for the non-survivors, the IR, S value and ratio of ECW/weight were higher, and the PA was lower (P < 0.05). Multinomial logistic regression analysis results showed that only SAPS II and S value were independent risk factors for 7-day and 90-day death (P < 0.01). When analysed by ROC, the AUC of the S value for predicting 7-day and 90-day death was non-significantly lower than SAPS II (S vs. SAPS II, 0.729 vs. 0.747 (7-day); 0.701 vs. 0.779 (90-day), P > 0.05). Importantly, both the 7-day and the 90-day mortality in patients with S values ≤-25.5 were 0; for the others, the mortality increased with the rise of S value. For patients with SAPS II ≤33, the mortality varied minimally; and for patients with SAPS II >55, the mortality was 100%. CONCLUSIONS The S value and SAPS II are independent risk factors for 7-day and 90-day death in critically ill patients; the former may have a greater negative predictive value, while the latter may have a greater positive predictive value.
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Affiliation(s)
- Jiashu Yao
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China.
| | - Minlin Zhou
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China.
| | - Bin Xu
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China.
| | - Chuan Li
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China.
| | - Haiyan Chen
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China.
| | - Dehua Gong
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, 210016, China.
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Bellafronte NT, Serafini RKK, Chiarello PG. Relationship between total physical activity and physical activity domains with body composition and energy expenditure among Brazilian adults. Am J Hum Biol 2019; 31:e23317. [PMID: 31486202 DOI: 10.1002/ajhb.23317] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 07/19/2019] [Accepted: 08/17/2019] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate the relationship of total physical activity (PA) and its different domains with sex, weight, body mass index, body composition, and resting energy expenditure (REE) among Brazilian adults. The secondary aim was to assess if the Baecke Habitual Physical Activity Questionnaire (BHPAQ) could be used to screen fat mass excess. METHODS Three hundred and sixty-six volunteers participated. PA was assessed with the BHPAQ, body composition with multifrequency bioelectrical impedance spectroscopy, and REE with indirect calorimetry. RESULTS Total PA and sports/exercise PA were lower in women than men. The participants most active for sports/exercise and leisure-time/locomotion PA domains had higher fat free mass and phase angle, and lower fat mass and weight than the least active subjects. The occupational PA domain was associated with higher fat mass and weight. REE was associated only with the exercise/sports PA domain. The BHPAQ could discriminate subjects with excess body fat with a 9.375 cutoff point for total PA. CONCLUSION Exercise/sports and leisure-time/locomotion are PA domains associated with a better body composition. A gender gap still exists in PA, as women are less active than men. The BHPAQ could screen subjects with excess fat mass.
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Affiliation(s)
- Natália T Bellafronte
- Department of Health Sciences, Ribeirão Preto Faculty of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Renata K K Serafini
- Nutrition and Metabolism Undergraduate Course, Ribeirão Preto Faculty of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Paula G Chiarello
- Department of Health Sciences, Ribeirão Preto Faculty of Medicine, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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An evaluation of phase angle, bioelectrical impedance vector analysis and impedance ratio for the assessment of disease status in children with nephrotic syndrome. BMC Nephrol 2019; 20:331. [PMID: 31438871 PMCID: PMC6704501 DOI: 10.1186/s12882-019-1511-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 08/02/2019] [Indexed: 11/25/2022] Open
Abstract
Background Oedema, characterized by accumulation of extracellular water (ECW), is one of the major clinical manifestations in children suffering from nephrotic syndrome (NS). The lack of a simple, inexpensive and harmless method for assessing ECW may be solved by the use of the bioelectrical impedance analysis (BIA) technique. The aims of this study were to examine whether phase angle (PA), bioelectrical impedance vector analysis (BIVA) and the impedance ratio (IR) reflect change in disease status in children with NS. Methods Eight children (age range: 2–10 years) with active NS (ANS group) were enrolled. In five of these (ANS* subgroup), impedance was also measured at remission (NSR group). Thirty-eight healthy children (age range: 2–10 years) were included as healthy controls (HC group). Whole-body impedance was measured with a bioimpedance spectroscopy device (Xitron 4200) with surface electrodes placed on the wrist and ankle. Results Values of PA, BIVA and IR were found to be significantly lower (p-value range < 0.001 to < 0.01) in the ANS patients compared to the HC and NSR groups. No significant differences were observed between the NSR and HC groups. Conclusion The studied parameters can be used to assess change in disease status in NS patients. Data were consistent with NS being associated with expansion of ECW. Electronic supplementary material The online version of this article (10.1186/s12882-019-1511-y) contains supplementary material, which is available to authorized users.
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Smoking status affects bioimpedance-derived phase angle in men but not in women: The Pró-Saúde Study, Brazil. Nutrition 2019; 61:70-76. [DOI: 10.1016/j.nut.2018.10.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 09/18/2018] [Accepted: 10/23/2018] [Indexed: 12/31/2022]
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Decreased Bioelectrical Impedance Phase Angle in Hospitalized Children and Adolescents with Newly Diagnosed Type 1 Diabetes: A Case-Control Study. J Clin Med 2018; 7:jcm7120516. [PMID: 30518100 PMCID: PMC6306918 DOI: 10.3390/jcm7120516] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Revised: 11/25/2018] [Accepted: 12/03/2018] [Indexed: 01/07/2023] Open
Abstract
The aim of this study was to assess the body composition and nutritional status of hospitalized pediatric patients with newly diagnosed type 1 diabetes by using bioelectrical impedance analysis (BIA) with phase angle (PA) calculation. PA is considered to be a useful and very sensitive indicator of the nutritional and functional status, and it has not yet been evaluated in such a population. Sixty-three pediatric patients aged 4 to 18 years, with newly diagnosed type 1 diabetes, were included in the study. The control group consisted of 63 healthy children and adolescents strictly matched by gender and age in a 1:1 case: control manner. In both groups, BIA with PA calculation was performed. Diabetic patients, in comparison to control subjects, had a highly significantly lower PA of 4.85 ± 0.86 vs. 5.62 ± 0.81, p < 0.001. They also demonstrated a lower percentage of body cell mass (BCM%), 46.89 ± 5.67% vs. 51.40 ± 4.19%, p < 0.001; a lower body cell mass index (BCMI), 6.57 ± 1.80% vs. 7.37 ± 1.72%, p = 0.004; and a lower percentage of muscle mass (MM%), 44.61 ± 6.58% vs. 49.40 ± 7.59%, p < 0.001, compared to non-diabetic controls. The significantly lower PA value in diabetic patients indicate their worse nutritional and functional status compared to healthy subjects. To assess the predictive and prognostic value of this finding in this population, further prospective studies involving larger sample of patients are required.
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Combination of DXA and BIS body composition measurements is highly correlated with physical function-an approach to improve muscle mass assessment. Arch Osteoporos 2018; 13:97. [PMID: 30218261 DOI: 10.1007/s11657-018-0508-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Accepted: 08/15/2018] [Indexed: 02/03/2023]
Abstract
RATIONALE Fluid volume estimates may help predict functional status and thereby improve sarcopenia diagnosis. MAIN RESULT Bioimpedance-derived fluid volume, combined with DXA, improves identification of jump power over traditional measures. SIGNIFICANCE DXA-measured lean mass should be corrected for fluid distribution in older populations; this may be a surrogate of muscle quality. PURPOSE Sarcopenia, the age-related loss of muscle mass and function, negatively impacts functional status, quality of life, and mortality. We aimed to determine if bioimpedance spectroscopy (BIS)-derived estimates of body water compartments can be used in conjunction with dual-energy X-ray absorptiometry (DXA) measures to aid in the prediction of functional status and thereby, ultimately, improve the diagnosis of sarcopenia. METHODS Participants (≥ 70 years) had physical and muscle function tests, DXA, and BIS performed. Using a BMI correction method, intracellular water (ICWc), extracellular water (ECWc), and ECWc to ICWc (E/Ic) ratio was estimated from standard BIS measures. Jump power was assessed using jump mechanography. RESULTS The traditional measure used to diagnose sarcopenia, DXA-derived appendicular lean mass (ALM) corrected for height (ALM/ht2), was the least predictive measure explaining jump power variability (r2 = 0.31, p < 0.0001). The best measure for explaining jump power was a novel variable combining DXA ALM and BIS-derived E/Ic ratio (ALM/(E/Ic); r2 = 0.70, p < 0.0001). ALM/(E/Ic) and ICWc had the highest correlation with jump power and grip strength, specifically jump power (r = 0.84 and r = 0.80, respectively; p < 0.0001). CONCLUSIONS The creation of a novel variable (ALM/(E/Ic)) improved the ability of DXA to predict jump power in an older population. ALM/(E/Ic) substantially outperformed traditional lean mass measures of sarcopenia and could well be an improved diagnostic approach to predict functional status. DXA-measured ALM should be corrected for fluid distribution, i.e., ALM/(E/Ic); this correction may be considered a surrogate of muscle quality.
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Martin L, Hopkins J, Malietzis G, Jenkins JT, Sawyer MB, Brisebois R, MacLean A, Nelson G, Gramlich L, Baracos VE. Assessment of Computed Tomography (CT)-Defined Muscle and Adipose Tissue Features in Relation to Short-Term Outcomes After Elective Surgery for Colorectal Cancer: A Multicenter Approach. Ann Surg Oncol 2018; 25:2669-2680. [PMID: 30006691 DOI: 10.1245/s10434-018-6652-x] [Citation(s) in RCA: 79] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Sarcopenia, visceral obesity (VO), and reduced muscle radiodensity (myosteatosis) are suggested risk factors for postoperative morbidity in colorectal cancer (CRC), but usually are not concurrently assessed. Published thresholds used to define these features are not CRC-specific and are defined in relation to mortality, not postoperative outcomes. This study aimed to evaluate body composition in relation to length of hospital stay (LOS) and postoperative outcomes. METHODS Pre-surgical computed tomography (CT) images were assessed for total area and radiodensity of skeletal muscle and visceral adipose tissue in a pooled Canadian and UK cohort (n = 2100). Sex- and age-specific values for these features were calculated. For 1139 of 2100 patients, LOS data were available, and sex- and age-specific thresholds for sarcopenia, myosteatosis, and VO were defined on the basis of LOS. Association of CT-defined features with LOS and readmissions was explored using negative binomial and logistic regression models, respectively. RESULTS In the multivariable analysis, the predictors of LOS (P < 0.001) were age, surgical approach, major complications (incidence rate ratio [IRR] 2.42; 95% confidence interval [CI] 2.18-2.68), study cohort, and three body composition profiles characterized by myosteatosis combined with either sarcopenia (IRR, 1.27; 95% CI 1.12-1.43) or VO (IRR, 1.25; 95% CI 1.10-1.42), and myosteatosis combined with both sarcopenia and VO (IRR, 1.58; 95% CI 1.29-1.93). In the multivariable analysis, risk of readmission was associated with VO alone (odds ratio [OR] 2.66; 95% CI 1.18-6.00); P = 0.018), VO combined with myosteatosis (OR, 2.72; 95% CI 1.36-5.46; P = 0.005), or VO combined with myosteatosis and sarcopenia (OR, 2.98; 95% CI 1.06-5.46; P = 0.038). Importantly, the effect of body composition profiles on LOS and readmission was independent of major complications. CONCLUSION The findings showed that CT-defined multidimensional body habitus is independently associated with LOS and hospital readmission.
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Affiliation(s)
- Lisa Martin
- Department of Agricultural, Food and Nutritional Science, University of Alberta, Edmonton, AB, Canada
| | - Jessica Hopkins
- Department of Surgery, University of Alberta, Edmonton, AB, Canada.,Department of Oncology, 4023 Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada
| | - Georgios Malietzis
- Department of Surgery, St. Mark's Hospital, Harrow, London, UK.,Department of Surgery and Cancer, Imperial College, London, UK
| | - J T Jenkins
- Department of Surgery, St. Mark's Hospital, Harrow, London, UK.,Department of Surgery and Cancer, Imperial College, London, UK
| | - Michael B Sawyer
- Department of Oncology, 4023 Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada
| | - Ron Brisebois
- Department of Surgery, University of Alberta, Edmonton, AB, Canada
| | - Anthony MacLean
- Department of Surgery, University of Calgary, Calgary, AB, Canada
| | - Gregg Nelson
- Department of Oncology, University of Calgary, Calgary, AB, Canada
| | - Leah Gramlich
- Department of Medicine, University of Alberta, Edmonton, AB, Canada
| | - Vickie E Baracos
- Department of Oncology, 4023 Cross Cancer Institute, University of Alberta, Edmonton, AB, Canada.
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Bioelectrical impedance analysis-derived phase angle at admission as a predictor of 90-day mortality in intensive care patients. Eur J Clin Nutr 2018; 72:1019-1025. [PMID: 29748659 PMCID: PMC6035150 DOI: 10.1038/s41430-018-0167-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 02/26/2018] [Accepted: 03/19/2018] [Indexed: 12/21/2022]
Abstract
BACKGROUND/OBJECTIVES A low bioelectrical impedance analysis (BIA)-derived phase angle (PA) predicts morbidity and mortality in different patient groups. An association between PA and long-term mortality in ICU patients has not been demonstrated before. The purpose of the present study was to determine whether PA on ICU admission independently predicts 90-day mortality. SUBJECTS/ METHODS This prospective observational study was performed in a mixed university ICU. BIA was performed in 196 patients within 24 h of ICU admission. To test the independent association between PA and 90-day mortality, logistic regression analysis was performed using the APACHE IV predicted mortality as confounder. The optimal cutoff value of PA for mortality prediction was determined by ROC curve analysis. Using this cutoff value, patients were categorized into low or normal PA group and the association with 90-day mortality was tested again. RESULTS The PA of survivors was higher than of the non-survivors (5.0° ± 1.3° vs. 4.1° ± 1.2°, p < 0.001). The area under the ROC curve of PA for 90-day mortality was 0.70 (CI 0.59-0.80). PA was associated with 90-day mortality (OR = 0.56, CI: 0.38-0.77, p = 0.001) on univariate logistic regression analysis and also after adjusting for BMI, gender, age, and APACHE IV on multivariable logistic regression (OR = 0.65, CI: 0.44-0.96, p = 0.031). A PA < 4.8° was an independent predictor of 90-day mortality (adjusted OR = 3.65, CI: 1.34-9.93, p = 0.011). CONCLUSIONS Phase angle at ICU admission is an independent predictor of 90-day mortality. This biological marker can aid in long-term mortality risk assessment of critically ill patients.
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Garlini LM, Alves FD, Ceretta LB, Perry IS, Souza GC, Clausell NO. Phase angle and mortality: a systematic review. Eur J Clin Nutr 2018; 73:495-508. [DOI: 10.1038/s41430-018-0159-1] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 03/06/2018] [Indexed: 02/06/2023]
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Więch P, Dąbrowski M, Bazaliński D, Sałacińska I, Korczowski B, Binkowska-Bury M. Bioelectrical Impedance Phase Angle as an Indicator of Malnutrition in Hospitalized Children with Diagnosed Inflammatory Bowel Diseases-A Case Control Study. Nutrients 2018; 10:nu10040499. [PMID: 29673210 PMCID: PMC5946284 DOI: 10.3390/nu10040499] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 04/10/2018] [Accepted: 04/16/2018] [Indexed: 01/05/2023] Open
Abstract
The phase angle (PhA) seems to be a reliable screening tool for the identification of malnutrition risk in hospitalized children with inflammatory bowel disease (IBD). The aim of the present study was to assess the body composition and nutritional status of hospitalized children and adolescents with IBD by using bioelectrical impedance analysis (BIA) with phase angle (PhA) calculation, which has not been evaluated in hospitalized children with IBD yet. A total of 59 children and adolescents aged 4–18 years, with IBD: 34 ulcerative colitis (UC) and 25 Crohn’s disease (CD) were included in the study. The control group consisted of healthy children and adolescents, strictly matched for gender and age in a 1:1 case-control manner. In both groups, BIA was performed and PhA was calculated. IBD patients had significantly lower PhA (UC: 5.34 ± 1.34 vs. 5.96 ± 0.76, p = 0.040; CD: 5.16 ± 1.18 vs. 5.90 ± 0.62, p = 0.009) compared to the control subjects. Significant changes in selected body composition parameters were observed particularly in CD, especially in fat free mass components. Lower phase angle score together with lower body composition parameters and selected nutrition indicators in children and adolescents with IBD demonstrate their worse nutritional and functional status compared to healthy subjects.
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Affiliation(s)
- Paweł Więch
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszów, 35959 Rzeszów, Poland.
| | - Mariusz Dąbrowski
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszów, 35959 Rzeszów, Poland.
- Diabetic Outpatient Clinic, Medical Center "Beta-Med", 35073 Rzeszów, Poland.
| | - Dariusz Bazaliński
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszów, 35959 Rzeszów, Poland.
| | - Izabela Sałacińska
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszów, 35959 Rzeszów, Poland.
| | - Bartosz Korczowski
- Pediatric Department, Clinical Provincial Hospital No. 2 in Rzeszów, Faculty of Medicine, University of Rzeszów, 35301 Rzeszów, Poland.
| | - Monika Binkowska-Bury
- Institute of Nursing and Health Sciences, Faculty of Medicine, University of Rzeszów, 35959 Rzeszów, Poland.
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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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Bellafronte NT, Batistuti MR, dos Santos NZ, Holland H, Romão EA, G. Chiarello P. Estimation of Body Composition and Water Data Depends on the Bioelectrical Impedance Device. JOURNAL OF ELECTRICAL BIOIMPEDANCE 2018; 9:96-105. [PMID: 33584925 PMCID: PMC7852023 DOI: 10.2478/joeb-2018-0014] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2018] [Indexed: 06/12/2023]
Abstract
Overweight, obese and chronic kidney disease patients have an altered and negative body composition being its assessment important. Bioelectrical impedance analysis is an easy-to-operate and low-cost method for this purpose. This study aimed to compare and correlate data from single- and multi-frequency bioelectrical impedance spectroscopy applied in subjects with different body sizes, adiposity, and hydration status. It was a cross-sectional study with 386 non-chronic kidney disease volunteers (body mass index from 17 to 40 kg/m2), 30 patients in peritoneal dialysis, and 95 in hemodialysis. Bioelectrical impedance, body composition, and body water data were assessed with single- and multi-frequency bioelectrical impedance spectroscopy. Differences (95% confidence interval) and agreements (Bland-Atman analyze) between devices were evaluated. The intraclass correlation coefficient was used to measure the strength of agreement and Pearson's correlation to measure the association. Regression analyze was performed to test the association between device difference with body mass index and overhydration. The limits of agreement between devices were very large. Fat mass showed the greatest difference and the lowest intraclass and Pearson's correlation coefficients. Pearson's correlation varied from moderate to strong and the intraclass correlation coefficient from weak to substantial. The difference between devices were greater as body mass index increased and was worse in the extremes of water imbalance. In conclusion, data obtained with single- and multi-frequency bioelectrical impedance spectroscopy were highly correlated with poor agreement; the devices cannot be used interchangeably and the agreement between the devices was worse as body mass index and fat mass increased and in the extremes of overhydration.
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Affiliation(s)
- Natália T. Bellafronte
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Marina R. Batistuti
- Department of Physics and Chemistry, Faculty of Pharmaceutical Sciences, University of São Paulo, Ribeirão Preto, Brazil
| | - Nathália Z. dos Santos
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Héric Holland
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Elen A. Romão
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
| | - Paula G. Chiarello
- Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil
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Shin JH, Kim CR, Park KH, Hwang JH, Kim SH. Predicting clinical outcomes using phase angle as assessed by bioelectrical impedance analysis in maintenance hemodialysis patients. Nutrition 2017; 41:7-13. [PMID: 28760431 DOI: 10.1016/j.nut.2017.02.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/28/2016] [Accepted: 02/21/2017] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Protein-energy wasting is common in patients on hemodialysis and is an independent risk factor for adverse events. The aim of this study was to retrospectively investigate whether phase angle (PA), known as a nutritional marker, can predict various clinical outcomes in patients with end-stage renal disease (ESRD) who are receiving hemodialysis. METHODS Using bioelectrical impedance analysis (BIA), PA was obtained every 6 mo, and patients were divided into two groups according to baseline PA: group A included patients with PA ≥4.5°, and group B included patients with PA <4.5°. RESULTS We followed 142 patients for a median of 29 mo (12-42 mo). We found that a decrease in PA was associated with an increased risk for death that persisted after adjusting for age, sex, and comorbidities (hazard ratio [HR], 0.56; 95% confidence interval [CI], 0.33-0.97). Cardiovascular events were not associated with PA (P = 0.685). We found that PA predicted the occurrence of infection, independent of age, sex, and comorbidities (HR, 0.65; 95% CI, 0.45-0.94). Although levels of hemoglobin did not differ between groups during the study period, patients in group B received higher doses of erythropoiesis-stimulating agents and intravenous iron than those in group A (P = 0.004 and 0.044, respectively). In longitudinal analyses, we did not find increases in PA over time in patients who had a mean dialysis adequacy ≥1.4, daily protein catabolic rate ≥1.2 g/kg, or total carbon dioxide level ≥22 mmol/L. CONCLUSIONS PA assessed in a simple manner using BIA provides practical information to predict clinical outcomes in ESRD patients on maintenance hemodialysis.
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Affiliation(s)
- Jung-Ho Shin
- Division of Nephrology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Chae Rim Kim
- Division of Nephrology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Ki Hyun Park
- Division of Nephrology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Jin Ho Hwang
- Division of Nephrology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea
| | - Su Hyun Kim
- Division of Nephrology, Department of Internal Medicine, Chung-Ang University Hospital, Seoul, Korea.
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