The Use of the Bioelectrical Impedance Phase Angle to Assess the Risk of Sarcopenia in People Aged 50 and above in Poland

Limited predictive value of bioelectrical phase angle for the development of sarcopenia in older Europeans

BACKGROUND

Despite the emerging interest in phase angle (PhA), a non-invasive marker of cell hydration and nutritional status, no previous study has reported the prospective association between PhA and incident sarcopenia. Therefore, the aim of our study was to evaluate the association of baseline PhA in older subjects without sarcopenia with the development of new sarcopenia as outcome.

METHODS

Six-hundred ninety-six subjects without sarcopenia aged ≥75 years enrolled in an international multicenter observational study were included. Sarcopenia was assessed according to the revised EWGSOP2 criteria at baseline and in follow-up visits at 12 and 24 months. Muscle strength was assessed through the handgrip strength test using a hydraulic grip strength dynamometer, muscle mass was assessed by bioimpedance analysis (BIA) and appendicular skeletal muscle mass (ASMM) was estimated. Physical performance was assessed by Short Physical Performance Battery (SPPB).

RESULTS

Participants who developed sarcopenia were older, less educated, had higher prevalence of osteoporosis, and lower baseline cognitive function, SPPB, handgrip strength and ASMM than those without sarcopenia. Baseline PhA was significantly lower in subjects developing sarcopenia. Nevertheless, after adjusting for all potential covariates including baseline components of sarcopenia in multiple logistic regression, neither PhA as continuous variable nor different levels of PhA were any more significant predictors of sarcopenia.

CONCLUSIONS

As an indicator of cells function, PhA could be a potential useful early marker in identifying older people at risk of developing sarcopenia but its practical applicability remains uncertain with the present data.

Use of bioimpedance in prevention of sarcopenia in the elderly

OBJECTIVES

Physiological ageing is associated with major and progressive changes in body composition, particularly in the decline of fat-free mass, which puts older individuals at risk of geriatric syndromes such as sarcopenia and sarcopenic obesity. Bioimpedance analysis noninvasively allows the determination of body composition, thus being able to rapidly assess primary risk factors leading to sarcopenia prediction.

METHODS

We conducted a study of 180 probands, 120 females (66.7%) with a mean age of 76.23 (SD = 9.29) years and 60 males (33.3%) with a mean age of 74.01 (SD = 8.99) years in cooperation with facilities for the elderly and with the inpatient department of the clinics of J.A. Reimann Hospital in Prešov. Body height, body weight, hip circumference, and waist circumference were determined by the anthropometric method, from which the values of the body mass index and waist-to-hip ratio were calculated. Active body mass, total body water, extracellular body water, intracellular body water, cell mass, body mass fat, body fat index, fat-free mass index, impedance at frequencies of 50 kHz, resistance, reactance, and phase angle were determined using the Quadscan 4000 Touch bioimpedance instrument. Appendicular skeletal muscle mass (ASMM) and muscle mass (ASMM/Ht2) were calculated. The data obtained from anthropometric and bioimpedance measurements were processed in MS Excel 2000 and STATISTICA ver. 12. The difference of means in the studied groups was tested by the t-test.

RESULTS

Presarcopenia was diagnosed in 12 (6.66%) probands out of 180 probands, of which were 3 (5%) men and 9 women (7.5%). Phase angle, ASMM and ASMM/Ht2 values were significantly lower (p < 0.001) in men and women with presarcopenia.

CONCLUSION

By introducing bioimpedance measurements into practice, it is possible to obtain results in a non-invasive way revealing possible presarcopenia in the elderly.

The role of bioelectrical phase angle in patients with heart failure

The most challenging feature of heart failure (HF) still remains the evaluation of congestion. Residual congestion at discharge and the difficulties in perfectly dosing therapies in order to balance the hydration status of the patient are the most worrisome issues when dealing with HF.The use of bioimpedance vector analysis (BIVA) might promote a different approach in the general management of patients with HF. BIVA is a reliable, fast, bedside tool able to assess the congestion status. It proved to be helpful to physicians for diagnosing congestive status, managing therapies, and providing prognostic information in the setting of HF.Bioelectrical Phase Angle (PhA) - as derived from equations related to the parameters of BIVA - recently surged as a possible biomarker for patients with HF. Studies provided data about the application of PhA in the clinical management and in the overall risk stratification of HF patients.Basically, the use of PhA might be considered as a holistic evaluation of patients with HF which includes the need for a multiparametric approach able to effectively depict the clinical status of patients. There is no definite biomarker able to comprehensively describe and identify all the features of HF patient, but scores based on molecules/techniques able to explore the different pathogenetic mechanisms of HF are desirable.The aim of this review was to provide a comprehensive evaluation of literature related to PhA role in HF and the impact of this biomarker on clinical management and risk stratification of HF patients.

Bioelectrical impedance analysis in the BaSAlt cohort-study: the phase angle as an additional parameter for sarcopenia quantification among German nursing home residents?

PURPOSE

Sarcopenia is characterized by the loss of muscle mass, strength, and physical functioning. The bioelectrical impedance analysis (BIA) is a simplify method for the measurement of muscle quantity and quality. But there is a lack of evidence in the interpretation of the muscle quality parameter phase angle (PhA), which was recommended by the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). We hypothesize that the PhA shows differences between sarcopenia categorized groups and can be used as an additional parameter for sarcopenia quantification among residents of nursing homes (NH).

METHODS

Based on EWGSOP2 specifications, 78 residents from five German NH was categorized into sarcopenia groups. Group comparisons with Kruskal-Wallis tests, Dunn-Bonferroni post-hoc-Tests, and correlations with Spearman coefficients were conducted with the muscle quality parameter PhA.

RESULTS

Significant group differences by Kruskal-Wallis test for PhA was detected (H = 8.150, p = 0.017). The Dunn-Bonferroni post-hoc-Test showed significant results by group comparison for "confirmed/ severe sarcopenia" (4.1° [3.1-5.0]) with "no sarcopenia" (4.6° [3.7-11.2]; p =0 .049) and "probable sarcopenia" (4.7° [3.4-13.5]; p = 0.016), respectively.

CONCLUSIONS

There is a limitation for differentiation in preliminary stage of sarcopenia among multimorbid NH residents by PhA. Moreover, further research for specific cut-off-values and the individual sarcopenia progression monitoring by PhA are needed.

TRIAL REGISTRATION

No. AZ A2.5.4-096_aa (Date of approval: July 2019).

Phase angle derived from bioelectrical impedance analysis as a marker for predicting sarcopenia

Sarcopenia is commonly defined as the age-related loss of muscle mass and function and may be caused by several factors, such as genetics, environmental conditions, lifestyle, drug use, and, in particular, comorbidities. People with pre-existing conditions are more likely to develop sarcopenia and subsequently have a less favorable prognosis. Recently, phase angle (PhA), which is derived from bioelectrical impedance analysis (BIA), has received a great deal of attention, and numerous studies have been carried out to examine the relationship between PhA and sarcopenia in different conditions. Based on these studies, we expect that PhA could be used as a potential marker for sarcopenia in the future.

Patterns of Muscle-Related Risk Factors for Sarcopenia in Older Mexican Women

Early detriment in the muscle mass quantity, quality, and functionality, determined by calf circumference (CC), phase angle (PA), gait time (GT), and grip strength (GSt), may be considered a risk factor for sarcopenia. Patterns derived from these parameters could timely identify an early stage of this disease. Thus, the present work aims to identify those patterns of muscle-related parameters and their association with sarcopenia in a cohort of older Mexican women with neural network analysis. Methods: Information from the functional decline patterns at the end of life, related factors, and associated costs study was used. A self-organizing map was used to analyze the information. A SOM is an unsupervised machine learning technique that projects input variables on a low-dimensional hexagonal grid that can be effectively utilized to visualize and explore properties of the data allowing to cluster individuals with similar age, GT, GSt, CC, and PA. An unadjusted logistic regression model assessed the probability of having sarcopenia given a particular cluster. Results: 250 women were evaluated. Mean age was 68.54 ± 5.99, sarcopenia was present in 31 (12.4%). Clusters 1 and 2 had similar GT, GSt, and CC values. Moreover, in cluster 1, women were older with higher PA values (p < 0.001). From cluster 3 upward, there is a trend of worse scores for every variable. Moreover, 100% of the participants in cluster 6 have sarcopenia (p < 0.001). Women in clusters 4 and 5 were 19.29 and 90 respectively, times more likely to develop sarcopenia than those from cluster 2 (p < 0.01). Conclusions: The joint use of age, GSt, GT, CC, and PA is strongly associated with the probability women have of presenting sarcopenia.