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Alves VA, Giesta JM, Bosa VL, Goldani HAS. Bioelectrical impedance phase angle and nutritional status in children with intestinal failure on prolonged parenteral nutrition. J Pediatr (Rio J) 2024; 100:491-497. [PMID: 38614136 PMCID: PMC11361877 DOI: 10.1016/j.jped.2023.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 12/12/2023] [Accepted: 12/16/2023] [Indexed: 04/15/2024] Open
Abstract
OBJECTIVE To compare the phase angle (PhA) through bioelectrical impedance (BIA) of children with intestinal failure (IF) using prolonged parenteral nutrition (PN) followed by an Intestinal Rehabilitation Program, with a control group. METHODS Children under 10 years of age with IF using prolonged PN for >60 days (study group) were included. The control group consisted of healthy children without chronic pathologies, matched by sex and age. Anthropometric parameters evaluated were: weight, height, weight/age z-score (W/A), height/age z-score (H/A), BMI, BMI/A z-score, arm circumference, triceps skinfold, subscapular skinfold, mid-arm muscle circumference. BIA parameters were resistance (R), reactance (Xc), and phase angle (PhA). RESULTS Twenty-eight children were included in the study group, median (IQR) age was 11 (8-27) months, 53.6 % were male. In the control group, 28 children were included, median (IQR) age was 12.5 (8-24.7) months, 50 % were male. Children from the study group had W/A z-scores and H/A z-scores significantly lower than controls. There was no significant difference between PhA in the study group and controls, [median (IQR) 4.3° (3.8;4.6) vs 4.0° (3.8;5.4) respectively, p = 0.980]. Prematurity was significantly higher in the study group than in the controls, but there was no significant correlation between gestational age at birth and PhA of the children from the study group. CONCLUSION Children with IF using prolonged PN showed lower W/A and H/A compared to the control group, but without significant difference between the PhA of children with IF compared to controls.
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Affiliation(s)
- Victória A Alves
- Post-Graduate Program of Child and Adolescent Health, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil.
| | - Juliana M Giesta
- Post-Graduate Program of Child and Adolescent Health, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Vera L Bosa
- Department of Nutrition, Hospital de Clinicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Helena A S Goldani
- Post-Graduate Program of Child and Adolescent Health, Faculdade de Medicina, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Nishino T, Takahashi K, Ochiai C, Tomori S, Ono S, Mimaki M. Association between serum albumin and body water using a bioelectrical impedance analyzer: a case report of longitudinal variation in a child with initial idiopathic nephrotic syndrome. AME Case Rep 2024; 8:62. [PMID: 39091551 PMCID: PMC11292089 DOI: 10.21037/acr-23-211] [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: 12/13/2023] [Accepted: 03/31/2024] [Indexed: 08/04/2024]
Abstract
Background Bioelectrical impedance analysis (BIA) is a commonly used noninvasive technique for body composition assessment with recently expanded indications. This reproducible measurement method uses electrical conductivity to evaluate body composition, including fluid status. In pediatric idiopathic nephrotic syndrome (INS), albumin leaks into the urine, resulting in dysregulated colloid-osmotic pressure in the blood vessels. This results in decreased circulating blood volume and edema. Blood tests are a useful evaluation method; however, it cannot be performed frequently in children because of their invasive nature. Herein, we present a case of a child with INS demonstrating a longitudinal correlation between serum albumin (S-Alb) levels and extracellular water (ECW)/total body water (TBW) ratio. Case Description A 6-year-old boy was admitted to the hospital for INS treatment after informed consent was obtained. He presented with severe proteinuria symptoms and an increased weight of 3 kg before the onset of INS. Standard treatment with prednisolone (PSL) for 28 days was initiated, and his proteinuria resolved on day 7. During the acute course, albumin replacement was conducted thrice for fluid management purposes and did not cause severe intravascular dehydration. The fluid composition was assessed over time; each measurement lasted for approximately 10 minutes and was performed on the same day as the blood tests. Nine measurements were taken, and S-Alb levels and the ECW/TBW ratio (r=-0.72, P<0.04) exhibited a significant negative correlation. Conclusions BIA can potentially predict S-Alb levels objectively and noninvasively within a short period. Although further validation is needed, this measurement can reduce the invasiveness of testing in children with INS.
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Affiliation(s)
- Tomohiko Nishino
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Kazuhiro Takahashi
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Chiharu Ochiai
- Department of Nutrition, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinya Tomori
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Sayaka Ono
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
| | - Masakazu Mimaki
- Department of Pediatrics, Teikyo University School of Medicine, Tokyo, Japan
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Quist JR, Rud CL, Brantlov S, Ward LC, Dahl Baunwall SM, Hvas CL. Bioelectrical impedance analysis as a clinical marker of health status in adult patients with benign gastrointestinal disease: A systematic review. Clin Nutr ESPEN 2024; 59:387-397. [PMID: 38220401 DOI: 10.1016/j.clnesp.2023.12.145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 12/11/2023] [Accepted: 12/20/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND Body composition reflects nutritional status, disease status and progression, and treatment responses. Mounting evidence supports the use of bioelectrical impedance analysis (BIA) as a non-invasive tool to assess body composition. Patients with benign gastrointestinal (GI) disease experience disease-related alterations in their body composition, and bioimpedance outcomes in patients with benign GI diseases have not previously been summarized. We aimed to evaluate BIA as a clinical body composition marker for benign GI diseases and describe its association with physical health status. METHODS We systematically searched PubMed, Scopus, Web of Science, Embase, and CINAHL from inception to October 2023 (PROSPERO registration: CRD42021265866). Of 971 screened studies, 26 studies were included in the final analysis, comprising a total of 2398 adult patients with benign GI disease. The main outcome was raw impedance data. RESULTS The most frequently reported BIA outcome was phase angle (PhA) (reported in 18 of 26 studies), followed by fat-free-mass (FFM) (reported in 13 of 26 studies). The consensus view of the included studies illustrates that BIA can be a useful tool for evaluating body composition in patients with benign GI diseases, and low PhA and FFM were associated with increased nutritional risk, abnormal physical characteristics, and increased mortality risk. CONCLUSION To fully utilize BIA as a clinical marker of health in patients with benign GI disease, standardized protocols specific to this population are needed and prospective studies testing cut-offs and ranges, accuracy, and other raw BIA parameters for classifying disease status.
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Affiliation(s)
| | - Charlotte Lock Rud
- Department of Hepatology and Gastroenterology, Aarhus University Hospital, Denmark
| | - Steven Brantlov
- Department of Procurement & Clinical Engineering, Central Denmark Region, Denmark
| | - Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
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4
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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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Fernández-Jiménez R, Martín-Masot R, Cornejo-Pareja I, Vegas-Aguilar IM, Herrador-López M, Tinahones FJ, Navas-López VM, Bellido-Guerrero D, García-Almeida JM. Phase angle as a marker of outcome in hospitalized pediatric patients. A systematic review of the evidence (GRADE) with meta-analysis. Rev Endocr Metab Disord 2023; 24:751-765. [PMID: 37486555 PMCID: PMC10404571 DOI: 10.1007/s11154-023-09817-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2023] [Indexed: 07/25/2023]
Abstract
Phase angle (PhA) is a valuable tool for evaluating the nutritional and inflammatory status, which can accompany acute and severe disorders. PhA is a cellular health biomarker, whose value is particularly substantial due to the negative consequences of these situations in the pediatric population. Relevant literature was collected with the aim of comprehensively analysing the evidence on the association between an altered PhA can serve as a predictive-marker for mortality and poor-outcomes in at-risk-pediatric patients. Understanding this relationship could have significant implications for identifying high-risk individuals and implementing timely interventions. A systematic review with meta-analysis was conducted in the primary electronic databases from inception until January 2023. Overall, four studies with a total of 740 patients were eligible for our analysis. Evidence demonstrates that PhA is associated with nutritional status, reflecting undernutrition and changes in body composition related to illness. This review suggests that PhA can indeed be used as an indicator of nutritional status and a tool for predicting prognosis, including mortality and poor-outcomes, in hospitalized pediatric patients. A low PhA was associated with a significant mortality risk [RR:1.51;95%CI (1.22-1.88),p = 0.0002;I2 = 0%,(p = 0.99)] and an increased complications risk [OR:8.17;95%CI (2.44-27.4),p = 0.0007;I2 = 44%,(p = 0.18)]. These findings highlight the importance of taking a comprehensive approach to clinical nutrition, integrating multiple evaluation aspects to establish an accurate diagnosis and personalized therapeutic plans. While PhA emerges as a valuable tool for assessing the risk of malnutrition and as a prognostic-indicator for poor-outcomes in pediatric patients. Further future studies are needed to focus on investigating this relationship in larger and diverse population to strengthen the evidence base.
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Affiliation(s)
- Rocío Fernández-Jiménez
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, Campus Teatinos S/N 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29010 Málaga, Spain
| | - Rafael Martín-Masot
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Isabel Cornejo-Pareja
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, Campus Teatinos S/N 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29010 Málaga, Spain
| | - Isabel M. Vegas-Aguilar
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, Campus Teatinos S/N 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
| | - Marta Herrador-López
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Francisco J. Tinahones
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, Campus Teatinos S/N 29010, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29010 Málaga, Spain
| | - Víctor Manuel Navas-López
- Instituto de Investigación Biomédica de Málaga-Plataforma BIONAND (IBIMA), Virgen de la Victoria University Hospital, 29010 Málaga, Spain
- Pediatric Gastroenterology and Nutrition Unit, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Diego Bellido-Guerrero
- Department of Endocrinology and Nutrition, Complejo Hospitalario Universitario de Ferrol, La Coruña, Ferrol, Spain
| | - José Manuel García-Almeida
- Department of Endocrinology and Nutrition, Virgen de la Victoria Hospital (IBIMA), Malaga University, Campus Teatinos S/N 29010, Malaga, Spain
- Centro de Investigación Biomédica en Red de la Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (ISCIII), 29010 Málaga, Spain
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6
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Nescolarde L, Talluri A, Yanguas J, Lukaski H. Phase angle in localized bioimpedance measurements to assess and monitor muscle injury. Rev Endocr Metab Disord 2023; 24:415-428. [PMID: 36847994 PMCID: PMC10140135 DOI: 10.1007/s11154-023-09790-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/27/2023] [Indexed: 02/28/2023]
Abstract
Localized bioimpedance (L-BIA) measurements are an innovative method to non-invasively identify structural derangement of soft tissues, principally muscles, and fluid accumulation in response to traumatic injury. This review provides unique L-BIA data demonstrating significant relative differences between injured and contralateral non-injured regions of interest (ROI) associated with soft tissue injury. One key finding is the specific and sensitive role of reactance (Xc), measured at 50 kHz with a phase-sensitive BI instrument, to identify objective degrees of muscle injury, localized structural damage and fluid accretion, determined using magnetic resonance imaging. The predominant effect of Xc as an indicator of severity of muscle injury is highlighted in phase angle (PhA) measurements. Novel experimental models utilizing cooking-induced cell disruption, saline injection into meat specimens, and measurements of changing amounts of cells in a constant volume provide empirical evidence of the physiological correlates of series Xc as cells in water. Findings of strong associations of capacitance, computed from parallel Xc (XCP), with whole body counting of 40-potassium and resting metabolic rate support the hypothesis that parallel Xc is a biomarker of body cell mass. These observations provide a theoretical and practical basis for a significant role of Xc, and hence PhA, to identify objectively graded muscle injury and to reliably monitor progress of treatment and return of muscle function.
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Affiliation(s)
- Lexa Nescolarde
- Department of Electronic Engineering, Universitat Politècnica de Catalunya, c/ Jordi Girona 1-3, Edifici C4, 08034, Barcelona, Spain.
| | | | - Javier Yanguas
- Futbol Club Barcelona, Ciutat Esportiva Joan Gamper, Av. c/ Onze de Setembre s/n, 08790, Sant Joan Despí, Barcelona, Spain
| | - Henry Lukaski
- Department of Kinesiology and Public Health Education, University of North Dakota, Grand Forks, ND, 58202, USA
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Abstract
Measurement of phase angle using bioimpedance analysis (BIA) has become popular as an index of so-called "cellular health". What precisely is meant by this term is not always clear but strong relationships have been found between cellular water status (the relative amounts of extra- and intracellular water), cell membrane integrity and cellular mass. Much of the current research is empirical observation and frequently pays little regard to the underlying biophysical models that underpin the BIA technique or attempts to provide mechanistic explanations for the observations. This brief review seeks to provide a basic understanding of the electrical models frequently used to describe the passive electrical properties of tissues with particular focus on phase angle. In addition, it draws attention to some practical concerns in the measurement of phase angle and notes the additional understanding that can be gained when phase angle are obtained with bioimpedance spectroscopy (BIS) rather than single frequency BIA (SFBIA) along with the potential for simulation modelling.
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Affiliation(s)
- Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, St Lucia, Brisbane, 4072, Australia.
| | - Steven Brantlov
- Department of Procurement and Clinical Engineering, Central Denmark Region, Aarhus, Denmark
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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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Kammar-García A, Castillo-Martínez L, Mancilla-Galindo J, Villanueva-Juárez JL, Pérez-Pérez A, Rocha-González HI, Arrieta-Valencia J, Remolina-Schlig M, Hernández-Gilsoul T. SOFA Score Plus Impedance Ratio Predicts Mortality in Critically Ill Patients Admitted to the Emergency Department: Retrospective Observational Study. Healthcare (Basel) 2022; 10:healthcare10050810. [PMID: 35627947 PMCID: PMC9140899 DOI: 10.3390/healthcare10050810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/21/2022] [Accepted: 04/25/2022] [Indexed: 02/01/2023] Open
Abstract
Background: The Sequential Organ Failure Assessment (SOFA) is a scoring system used for the evaluation of disease severity and prognosis of critically ill patients. The impedance ratio (Imp-R) is a novel mortality predictor. Aims: This study aimed to evaluate the combination of the SOFA + Imp-R in the prediction of mortality in critically ill patients admitted to the Emergency Department (ED). Methods: A retrospective cohort study was performed in adult patients with acute illness admitted to the ED of a tertiary-care referral center. Baseline SOFA score and bioelectrical impedance analysis to obtain the Imp-R were performed within the first 24 h after admission to the ED. A Cox regression analysis was performed to evaluate the mortality risk of the initial SOFA score plus the Imp-R. Harrell’s C-statistic and decision curve analyses (DCA) were performed. Results: Out of 325 patients, 240 were included for analysis. Overall mortality was 31.3%. Only 21.3% of non-surviving patients died after hospital discharge, and 78.4% died during their hospital stay. Of the latter, 40.6% died in the ED. The SOFA and Imp-R values were higher in non-survivors and were significantly associated with mortality in all models. The combination of the SOFA + Imp-R significantly predicted 30-day mortality, in-hospital mortality, and ED mortality with an area under the curve (AUC) of 0.80 (95% CI: 74–0.86), 0.79 (95% CI: 0.74–0.86) and 0.75 (95% CI: 0.66–0.84), respectively. The DCA showed that combining the SOFA + Imp-R improved the prediction of mortality through the lower risk thresholds. Conclusions: The addition of the Imp-R to the baseline SOFA score on admission to the ED improves mortality prediction in severely acutely ill patients admitted to the ED.
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Affiliation(s)
- Ashuin Kammar-García
- Dirección de Investigación, Instituto Nacional de Geriatría, Mexico City 10200, Mexico;
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (H.I.R.-G.); (J.A.-V.)
| | - Lilia Castillo-Martínez
- Department of Clinical Nutrition, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (L.C.-M.); (J.L.V.-J.)
| | - Javier Mancilla-Galindo
- Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City 04360, Mexico;
- Licenciatura en Nutrición, Facultad de Ciencias de la Salud, Universidad Autónoma de Tlaxcala, Tlaxcala 90750, Mexico
| | - José Luis Villanueva-Juárez
- Department of Clinical Nutrition, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (L.C.-M.); (J.L.V.-J.)
| | - Anayeli Pérez-Pérez
- Emergency Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (A.P.-P.); (M.R.-S.)
| | - Héctor Isaac Rocha-González
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (H.I.R.-G.); (J.A.-V.)
| | - Jesús Arrieta-Valencia
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (H.I.R.-G.); (J.A.-V.)
| | - Miguel Remolina-Schlig
- Emergency Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (A.P.-P.); (M.R.-S.)
| | - Thierry Hernández-Gilsoul
- Emergency Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City 14080, Mexico; (A.P.-P.); (M.R.-S.)
- Correspondence: ; Tel.: +52-555-4870-900 (ext. 5010)
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10
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Arieta LR, Giuliani-Dewig HK, Gerstner GR, Mota JA, Ryan ED. Segmental bioelectrical impedance spectroscopy: A novel field assessment of muscle size and quality in normal weight and obese older men. Exp Gerontol 2022; 162:111745. [DOI: 10.1016/j.exger.2022.111745] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/02/2022] [Accepted: 02/15/2022] [Indexed: 11/26/2022]
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Ward LC, Koelmeyer LA, Moloney E. Staging Breast Cancer-Related Lymphedema with Bioimpedance Spectroscopy. Lymphat Res Biol 2021; 20:398-408. [PMID: 34756114 DOI: 10.1089/lrb.2021.0013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Background: A number of different classification schemes, with generally similar but not identical criteria, exist to describe the different stages of lymphedema. Criteria may include both subjective and objective assessments. The present study investigated whether bioelectrical impedance parameters had utility in staging breast cancer-related lymphedema. Methods and Results: Hierarchical agglomerative cluster analysis was used to assign women (n = 221) at risk of or with clinically ascribed lymphedema to clusters sharing similar impedance characteristics. Five clusters could be identified with each cluster containing proportions of participants that closely aligned with staging allocation, according to International Society of Lymphology criteria, at initial presentation. The use of cluster analysis for tracking of lymphedema progression or response to treatment is demonstrated. Conclusions: No single assessment provides definitive assignment of a patient to lymphedema stage. Staging is usually achieved by identifying and allocating a patient to a lymphedema stage shared by a group of patients with similar clinical signs. Cluster analysis of impedance data provides similar groupings of patients and could provide a useful adjunct objective assessment for staging lymphedema.
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Affiliation(s)
- Leigh C Ward
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Australia
| | - Louise A Koelmeyer
- Australian Lymphoedema Education, Research & Treatment Program, Department of Clinical Medicine, Macquarie University, Sydney, Australia
| | - Emma Moloney
- Australian Lymphoedema Education, Research & Treatment Program, Department of Clinical Medicine, Macquarie University, Sydney, Australia
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Sacco AM, Valerio G, Alicante P, Di Gregorio A, Spera R, Ballarin G, Scalfi L. Raw bioelectrical impedance analysis variables (phase angle and impedance ratio) are significant predictors of hand grip strength in adolescents and young adults. Nutrition 2021; 91-92:111445. [PMID: 34628279 DOI: 10.1016/j.nut.2021.111445] [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] [Received: 03/20/2021] [Revised: 07/29/2021] [Accepted: 08/02/2021] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Musculoskeletal fitness and body composition are major components of health-related physical fitness that are expected to be linked to each other. The aim of this study was to explore the association of musculoskeletal fitness (expressed as hand grip strength [HGS]) and raw bioelectrical impedance analysis (BIA) variables and other predictors in the second and third decades of life. METHODS Four groups of healthy normal-weight and overweight participants were studied: 130 male adolescents (age 16.0 ± 1.1 y), 143 female adolescents (16.0 ± 0.9 y), 141 young men (25.5 ± 2.0 y), and 141 young women (25.2 ± 1.9 y). Raw BIA variables (impedance [Z] and phase angle [PhA]) for the whole body were measured at four frequencies (5, 50, 100, and 250 kHz), and HGS was measured in both upper limbs. RESULTS HGS was higher in males than females and higher in young men than male adolescents. A fairly strong correlation emerged in both genders between HGS and raw BIA variables-that is, bioimpedance index (height2/Z), PhA, and impedance ratios (Z at high frequency/Z at low frequency). In multiple regression analysis, bioimpedance index, PhA, and impedance ratio were more effective predictors of HGS than BIA-derived estimates of body composition or anthropometric variables such as height, weight, and body mass index. In both genders, HGS was significantly higher in young adults than in adolescents for the same PhA or impedance ratio. CONCLUSIONS This study provides some insight into the use of raw BIA variables and HGS in the first decades of life, suggesting a new approach for a reliable assessment of muscle quality in terms of both muscle structure and strength.
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Affiliation(s)
- Anna Maria Sacco
- Department of Public Health, Federico II University of Naples, Naples, Italy.
| | - Giuliana Valerio
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Paola Alicante
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Ada Di Gregorio
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Rocco Spera
- Department of Public Health, Federico II University of Naples, Naples, Italy
| | - Giada Ballarin
- Department of Movement Sciences and Wellbeing, University of Naples "Parthenope", Naples, Italy
| | - Luca Scalfi
- Department of Public Health, Federico II University of Naples, Naples, Italy
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Bioelectrical spectroscopy impedance phase angle is not associated with nutritional status in a stable cohort of paediatric inflammatory bowel disease patients. Clin Nutr ESPEN 2021; 44:276-281. [PMID: 34330479 DOI: 10.1016/j.clnesp.2021.06.003] [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: 05/29/2021] [Accepted: 06/02/2021] [Indexed: 01/04/2023]
Abstract
BACKGROUND & AIMS Nutritional assessment in paediatric inflammatory bowel disease (IBD) is key to supporting growth whilst minimising adiposity. Bedside assessment using bioelectrical impedance spectroscopy (BIS) has previous identified patients with declining cellular and nutritional health. We aimed to assess BIS measures in stable paediatric IBD patient. METHODS Stable IBD patients were recruited at routine hospital visits. All patients underwent BIS, anthropometry and disease activity assessment. Multivariable regression and receiver operator curve (ROC) analyses were undertaken to assess the utility of BIS phase angle 50 KHz (PA-50) and 200/5 KHz impedance ratio (IR) in nutritional assessment. RESULTS There were 140 study visits from 97 patients, mean age 14.49 years, 62.9% Crohn's disease. Mean BMI Z-score (BMIZ) was 0.31 (range -2.97 to 3.99), 33% of patients were overweight (BMIZ>1) and 13.8% of patients were underweight (BMIZ < -1). Crohn's disease patients had a lower mean BMIZ score 0.14, compared to ulcerative colitis, 0.68, p = 0.007. There was no relationship between PA-50 and BMIZ or disease activity. IR was not related to disease activity but was negatively related to BMIZ in a multivariable regression, accounting for age, sex and disease subtype (beta -0.331, p = 0.001). ROC analyses did not identify a clinically useful cut off for either PA-50 or IR to identify patients with active disease, biologic use or BMIZ>1 or < -1. CONCLUSION BIS appears to have limited added value in nutritional assessment of stable paediatric IBD patients. Nearly 1/3 patients were overweight and personalised approach to supplementation is vital to avoid overnutrition.
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Dheman K, Mayer P, Magno M, Schuerle S. Wireless, Artefact Aware Impedance Sensor Node for Continuous Bio-Impedance Monitoring. IEEE TRANSACTIONS ON BIOMEDICAL CIRCUITS AND SYSTEMS 2020; 14:1122-1134. [PMID: 32877339 DOI: 10.1109/tbcas.2020.3021186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Body bio-impedance is a unique parameter to monitor changes in body composition non-invasively. Continuous measurement of bio-impedance can track changes in body fluid content and cell mass and has widespread applications for physiological monitoring. State-of-the-art implementation of bio-impedance sensor devices is still limited for continuous use, in part, due to artefacts arising at the skin-electrode (SE) interface. Artefacts at the SE interface may arise due to various factors such as motion, applied pressure on the electrode surface, changes in ambient conditions or gradual drying of electrodes. This paper presents a novel bio-impedance sensor node that includes an artefact aware method for bio-impedance measurement. The sensor node enables autonomous and continuous measurement of bio-impedance and SE contact impedance at ten frequencies between 10 kHz to 100 kHz to detect artefacts at the SE interface. Experimental evaluation with SE contact impedance models using passive 2R1C electronic circuits and also with non-invasive in vivo measurements of SE contact impedance demonstrated high accuracy (with maximum error less than 1.5%) and precision of 0.6 Ω. The ability to detect artefacts caused by motion, vertically applied pressure and skin temperature changes was analysed in proof of concept experiments. Low power sensor node design achieved with 50mW in active mode and only 143 μW in sleep mode estimated a battery life of 90 days with a 250 mAh battery and duty-cycling impedance measurements every 60 seconds. Our method for artefact aware bio-impedance sensing is a step towards autonomous and unobtrusive continuous bio-impedance measurement for health monitoring at-home or in clinical environments.
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15
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Bordoni L, Smerilli V, Nasuti C, Gabbianelli R. Mitochondrial DNA methylation and copy number predict body composition in a young female population. J Transl Med 2019; 17:399. [PMID: 31779622 PMCID: PMC6883616 DOI: 10.1186/s12967-019-02150-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 11/19/2019] [Indexed: 12/15/2022] Open
Abstract
Background Since both genomic and environmental factors are involved in obesity etiology, several studies about the influence of adiposity on both nuclear DNA and mitochondrial DNA methylation patterns have been carried out. Nevertheless, few evidences exploring the usage of buccal swab samples to study mitochondrial DNA epigenetics can be found in literature. Methods In this study, mitochondrial DNA from buccal swabs collected from a young Caucasian population (n = 69) have been used to examine potential correlation between mitochondrial DNA copy number and methylation with body composition (BMI, WHtR and bioimpedance measurements). Results A negative correlation between mitochondrial DNA copy number and BMI was measured in females (p = 0.028), but not in males. The mean percentage of D-loop methylation is significantly higher in overweight than in lean female subjects (p = 0.003), and a specific CpG located in the D-loop shows per se an association with impaired body composition (p = 0.004). Body composition impairment is predicted by a combined variable including mtDNA copy number and the D-loop methylation (AUC = 0.785; p = 0.009). Conclusions This study corroborates the hypothesis that mitochondrial DNA carries relevant information about body composition. However, wider investigations able to validate the usage of mtDNA methylation from buccal swabs as a biomarker are warranted.
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Affiliation(s)
- Laura Bordoni
- Unit of Molecular Biology, School of Pharmacy, University of Camerino, Via Gentile III da Varano, 62032, Camerino, MC, Italy
| | - Vanessa Smerilli
- Unit of Molecular Biology, School of Pharmacy, University of Camerino, Via Gentile III da Varano, 62032, Camerino, MC, Italy
| | - Cinzia Nasuti
- Unit of Molecular Biology, School of Pharmacy, University of Camerino, Via Gentile III da Varano, 62032, Camerino, MC, Italy
| | - Rosita Gabbianelli
- Unit of Molecular Biology, School of Pharmacy, University of Camerino, Via Gentile III da Varano, 62032, Camerino, MC, Italy.
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