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Yang J, Zhang J, Liu J, Liu G, Qian S. Bioelectrical impedance phase angle and the mortality in critically ill children. Front Nutr 2024; 11:1359814. [PMID: 39224183 PMCID: PMC11366603 DOI: 10.3389/fnut.2024.1359814] [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: 12/22/2023] [Accepted: 07/31/2024] [Indexed: 09/04/2024] Open
Abstract
Background Phase angle (PhA) is a variable obtained from bioelectrical impedance analysis (BIA). It is highly sensitive and specific and is commonly used in clinical nutrition assessment. Recently, PhA has shown promise in predicting clinical outcomes, especially as a new indicator of mortality, but its use in pediatric research is limited. This study aims to investigate the association between PhA measured at admission using BIA and PICU length of stay (LOS) and 60-day mortality in critically ill children and adolescents. Methods A consecutive series of pediatric patients in the PICU underwent BIA measurements within 72 h of admission. All patients met the inclusion and exclusion criteria. Patient demographics, anthropometric measurements, pediatric index of mortality 2 score (PIM-2), and laboratory exams were recorded. Kaplan-Meier (K-M) survival curves were constructed based on the critical PhA value to assess differences in survival status within the 60-day window. Multivariate cox regression model was employed to illustrate the relationship between PhA and 60-day mortality rates. The Youden's index method was used to identify the critical cut-off value for PhA in relation to mortality rates. ROC curves provided the area under the curve (AUC) and a 95% confidence interval (CI). Results A total of 205 pediatric patients (118 boys) were included, with a mean age of 9.2 years (±6.0). Survival curves indicated a cutoff value of 3.1°, with higher survival in patients with PhA ≥3.1° compared to those with PhA <3.1° (F = 10.51, p < 0.0001). The area under the ROC curve was 0.70, with a sensitivity of 0.65 and specificity of 0.72. Total hospital LOS was longer in the PhA <3.1° group compared to the PhA ≥3.1° group (p = 0.000). The PhA <3.1° group had a longer PICU LOS (adjusted for age and sex, HR 1.871, p = 0.000, log-rank test, p = 0.000). PhA and PIM-2 were two independently significant correlated variables (p < 0.05) for the 60-day mortality rate in this study. Conclusion Low PhA in patients is associated with longer PICU LOS and an increased risk of PICU patient mortality. PhA not only serves as an indicator for monitoring pediatric nutrition but also as a prognostic indicator for PICU patients.
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Affiliation(s)
- Jiongxian Yang
- Department of Health Care Center, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Jie Zhang
- Department of Pediatric Intensive Care Unit, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Jun Liu
- Department of Pediatric Intensive Care Unit, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Gang Liu
- Department of Pediatric Intensive Care Unit, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Suyun Qian
- Department of Pediatric Intensive Care Unit, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
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Santiago LN, Martins PC, Silva DAS. Utilization of bioelectrical impedance vector analysis (BIVA) in children and adolescents without diagnosed diseases: a systematic review. Physiol Meas 2024; 45:02TR02. [PMID: 38306664 DOI: 10.1088/1361-6579/ad252e] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 02/02/2024] [Indexed: 02/04/2024]
Abstract
Introduction. Bioelectrical impedance vector analysis (BIVA) emerges as a technique that utilizes raw parameters of bioelectrical impedance analysis and assumes the use of a reference population for information analysis.Objective. To summarize the reference values, main studies objectives, approaches, pre-test recommendations and technical characteristics of the devices employed in studies utilizing BIVA among children and adolescents without diagnosed diseases.Methods. A systematic search was conducted in nine electronic databases (CINAHL, LILACS, PubMed, SciELO, Scopus, SPORTDiscus, Science Direct, MEDLINE, and Web of Science). Studies with different designs which allowed extracting information regarding reference values of BIVA in children and adolescents without diagnosed diseases, aged 19 years or younger, were included. The systematic review followed PRISMA procedures and was registered in PROSPERO (registration: CRD42023391069).Results. After applying the eligibility criteria, 36 studies were included. Twenty studies (55.6%) analyzed body composition using BIVA, thirteen studies (36.1%) aimed to establish reference values for BIVA, and three studies (8.3%) investigated the association of physical performance with BIVA. There was heterogeneity regarding the reference populations employed by the studies. Fifteen studies used their own sample as a reference (41.6%), four studies used the adult population as a reference (11.1%), and five studies used reference values from athletes (13.9%).Conclusion. Nutricional status and body composition were the main studies objectives. References values were not always adequate or specific for the sample and population. Furthermore, there was no pattern of pre-test recommendations among the studies.
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Affiliation(s)
- Leandro Narciso Santiago
- Research Center in Kinanthropometry and Human Performance, Physical Education Department, Sports Center, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Priscila Custódio Martins
- Research Center in Kinanthropometry and Human Performance, Physical Education Department, Sports Center, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Diego Augusto Santos Silva
- Research Center in Kinanthropometry and Human Performance, Physical Education Department, Sports Center, Federal University of Santa Catarina, Florianopolis, SC, Brazil
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Imdad A, Rogner J, Sherwani RN, Sidhu J, Regan A, Haykal MR, Tsistinas O, Smith A, Chan XHS, Mayo-Wilson E, Bhutta ZA. Zinc supplementation for preventing mortality, morbidity, and growth failure in children aged 6 months to 12 years. Cochrane Database Syst Rev 2023; 3:CD009384. [PMID: 36994923 PMCID: PMC10061962 DOI: 10.1002/14651858.cd009384.pub3] [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] [Indexed: 03/31/2023]
Abstract
BACKGROUND Zinc deficiency is prevalent in low- and middle-income countries, and is considered a significant risk factor for morbidity, mortality, and linear growth failure. The effectiveness of preventive zinc supplementation in reducing prevalence of zinc deficiency needs to be assessed. OBJECTIVES To assess the effects of zinc supplementation for preventing mortality and morbidity, and for promoting growth, in children aged 6 months to 12 years. SEARCH METHODS A previous version of this review was published in 2014. In this update, we searched CENTRAL, MEDLINE, Embase, five other databases, and one trials register up to February 2022, together with reference checking and contact with study authors to identify additional studies. SELECTION CRITERIA Randomized controlled trials (RCTs) of preventive zinc supplementation in children aged 6 months to 12 years compared with no intervention, a placebo, or a waiting list control. We excluded hospitalized children and children with chronic diseases or conditions. We excluded food fortification or intake, sprinkles, and therapeutic interventions. DATA COLLECTION AND ANALYSIS Two review authors screened studies, extracted data, and assessed the risk of bias. We contacted study authors for missing information and used GRADE to assess the certainty of evidence. The primary outcomes of this review were all-cause mortality; and cause-specific mortality, due to all-cause diarrhea, lower respiratory tract infection (LRTI, including pneumonia), and malaria. We also collected information on a number of secondary outcomes, such as those related to diarrhea and LRTI morbidity, growth outcomes and serum levels of micronutrients, and adverse events. MAIN RESULTS We included 16 new studies in this review, resulting in a total of 96 RCTs with 219,584 eligible participants. The included studies were conducted in 34 countries; 87 of them in low- or middle-income countries. Most of the children included in this review were under five years of age. The intervention was delivered most commonly in the form of syrup as zinc sulfate, and the most common dose was between 10 mg and 15 mg daily. The median duration of follow-up was 26 weeks. We did not consider that the evidence for the key analyses of morbidity and mortality outcomes was affected by risk of bias. High-certainty evidence showed little to no difference in all-cause mortality with preventive zinc supplementation compared to no zinc (risk ratio (RR) 0.93, 95% confidence interval (CI) 0.84 to 1.03; 16 studies, 17 comparisons, 143,474 participants). Moderate-certainty evidence showed that preventive zinc supplementation compared to no zinc likely results in little to no difference in mortality due to all-cause diarrhea (RR 0.95, 95% CI 0.69 to 1.31; 4 studies, 132,321 participants); but probably reduces mortality due to LRTI (RR 0.86, 95% CI 0.64 to 1.15; 3 studies, 132,063 participants) and mortality due to malaria (RR 0.90, 95% CI 0.77 to 1.06; 2 studies, 42,818 participants); however, the confidence intervals around the summary estimates for these outcomes were wide, and we could not rule out a possibility of increased risk of mortality. Preventive zinc supplementation likely reduces the incidence of all-cause diarrhea (RR 0.91, 95% CI 0.90 to 0.93; 39 studies, 19,468 participants; moderate-certainty evidence) but results in little to no difference in morbidity due to LRTI (RR 1.01, 95% CI 0.95 to 1.08; 19 studies, 10,555 participants; high-certainty evidence) compared to no zinc. There was moderate-certainty evidence that preventive zinc supplementation likely leads to a slight increase in height (standardized mean difference (SMD) 0.12, 95% CI 0.09 to 0.14; 74 studies, 20,720 participants). Zinc supplementation was associated with an increase in the number of participants with at least one vomiting episode (RR 1.29, 95% CI 1.14 to 1.46; 5 studies, 35,192 participants; high-certainty evidence). We report a number of other outcomes, including the effect of zinc supplementation on weight and serum markers such as zinc, hemoglobin, iron, copper, etc. We also performed a number of subgroup analyses and there was a consistent finding for a number of outcomes that co-supplementation of zinc with iron decreased the beneficial effect of zinc. AUTHORS' CONCLUSIONS Even though we included 16 new studies in this update, the overall conclusions of the review remain unchanged. Zinc supplementation might help prevent episodes of diarrhea and improve growth slightly, particularly in children aged 6 months to 12 years of age. The benefits of preventive zinc supplementation may outweigh the harms in regions where the risk of zinc deficiency is relatively high.
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Affiliation(s)
- Aamer Imdad
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jaimie Rogner
- Departments of Medicine and Pediatrics, University of Rochester Medical Center, Rochester, NY, USA
| | - Rida N Sherwani
- Department of Pediatrics, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jasleen Sidhu
- Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Allison Regan
- Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Maya R Haykal
- Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Olivia Tsistinas
- Health Sciences Library, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Abigail Smith
- Health Sciences Library, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Xin Hui S Chan
- Pandemic Sciences Institute, University of Oxford, Oxford, UK
| | - Evan Mayo-Wilson
- Department of Epidemiology, UNC Gillings School of Global Public HealthMcGavran-Greenberg Hall, Chapel Hill, NC, USA
| | - Zulfiqar A Bhutta
- Centre for Global Child Health, The Hospital for SickKids, Toronto, Canada
- Center of Excellence for Women and Child Health, Aga Khan University, Karachi, Pakistan
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da Silva BR, Orsso CE, Gonzalez MC, Sicchieri JMF, Mialich MS, Jordao AA, Prado CM. Phase angle and cellular health: inflammation and oxidative damage. Rev Endocr Metab Disord 2022; 24:543-562. [PMID: 36474107 PMCID: PMC9735064 DOI: 10.1007/s11154-022-09775-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
Phase angle is a composite measure that combines two raw bioelectrical impedance analysis measures: resistance and reactance. Phase angle has been considered an indicator of cellular health, integrity, and hydration. As inflammation and oxidative stress can damage cellular structures, phase angle has potential utility in early detecting inflammatory and oxidative status. Herein, we aimed to critically review the current understanding on the determinants of phase angle and its relationship with markers of inflammation and oxidative stress. We also discussed the potential role of phase angle in detecting chronic inflammation and related adverse outcomes. Several factors have been identified as predictors of phase angle, including age, sex, extracellular to intracellular water ratio, and fat-free mass. In addition to these factors, body mass index (BMI) also seems to influence phase angle. Available data also show that lower phase angle values are correlated (negligible to high correlation coefficients) with higher c-reactive protein, tumour necrosis factor-α, interleukin-6, and interleukin-10 in studies involving the general and aging populations, as well as patients with chronic conditions. Although fewer studies have evaluated the relationship between phase angle and markers of oxidative stress, available data also suggest that phase angle has potential to be used as an indicator (for screening) of oxidative damage. Future studies including diverse populations and bioelectrical impedance devices are required to confirm the validity and accuracy of phase angle as a marker of inflammation and oxidative stress for clinical use.
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Affiliation(s)
- Bruna Ramos da Silva
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada
| | - Camila E Orsso
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada
| | - Maria Cristina Gonzalez
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Juliana Maria Faccioli Sicchieri
- Department of Health Sciences, Division of Nutrition and Metabolism, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Mirele Savegnago Mialich
- Department of Health Sciences, Division of Nutrition and Metabolism, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Alceu A Jordao
- Department of Health Sciences, Division of Nutrition and Metabolism, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Carla M Prado
- Department of Agricultural, Food & Nutritional Science, University of Alberta, Edmonton, Canada.
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Peng Z, Xu D, Li Y, Peng Y, Liu X. Phase Angle as a Comprehensive Tool for Nutritional Monitoring and Management in Patients with Crohn's Disease. Nutrients 2022; 14:nu14112260. [PMID: 35684060 PMCID: PMC9182801 DOI: 10.3390/nu14112260] [Citation(s) in RCA: 7] [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: 04/05/2022] [Revised: 05/25/2022] [Accepted: 05/26/2022] [Indexed: 02/05/2023] Open
Abstract
Background and Aims: Crohn’s disease (CD) is usually accompanied by malnutrition. CD-related malnutrition can increase morbidity, disability, mortality, and hospitalization costs. The purpose of this study was to find a reliable indicator for evaluating CD patients’ nutritional status. Methods: All data were retrospectively collected from Xiangya Hospital, Central South University between May 2021 and February 2022. All patients were evaluated for nutritional status using the Global Leadership Initiative on Malnutrition (GLIM) criteria. Body composition, resistance, and reactance were recorded by a body analyser, and the phase angle (PhA) was calculated simultaneously. The Mann−Whitney U test, chi-square test, Fisher’s exact test, and univariate and multivariate logistic regression analyses were used. A receiver operating characteristic (ROC) curve was built to evaluate the predictive value of differential variables for diagnosing malnutrition based on the GLIM criteria. Results: A total of 169 CD patients were enrolled, of which 74 (58.3%) males and 32 (76.2%) females were diagnosed with malnutrition; 34 (45.9%) males and 22 (68.8%) females were severely malnourished. Univariate analysis identified that as nutritional status deteriorated, body mass index, PhA, and levels of haemoglobin and albumin decreased, while platelet count, erythrocyte sedimentation rate, and levels of C-reactive protein and fibrinogen increased (p < 0.05). Logistic regression analysis revealed that the PhA was significantly independently associated with malnutrition (p < 0.05). The ROC curve analysis indicated that the optimal PhA cut-off levels of 6.11° and 5.55° could be used to predict malnutrition according to the GLIM criteria in males and females, respectively, with a PhA < 5.53° and < 5.12° indicating severe malnutrition in males and females, respectively. Conclusion: The PhA is a sensitive, noninvasive, portable, inexpensive tool that can be used to monitor and manage the nutritional status of CD patients.
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Affiliation(s)
- Ziheng Peng
- Department of Gastroenterology, Xiangya Hospital of Central South University, Changsha 410008, China; (Z.P.); (D.X.); (Y.L.)
| | - Duo Xu
- Department of Gastroenterology, Xiangya Hospital of Central South University, Changsha 410008, China; (Z.P.); (D.X.); (Y.L.)
| | - Yong Li
- Department of Gastroenterology, Xiangya Hospital of Central South University, Changsha 410008, China; (Z.P.); (D.X.); (Y.L.)
| | - Yu Peng
- Department of Gastroenterology, Xiangya Hospital of Central South University, Changsha 410008, China; (Z.P.); (D.X.); (Y.L.)
- Correspondence: (Y.P.); (X.L.)
| | - Xiaowei Liu
- Department of Gastroenterology, Xiangya Hospital of Central South University, Changsha 410008, China; (Z.P.); (D.X.); (Y.L.)
- Hunan International Scientific and Technological Cooperation Base of Artificial Intelligence Computer Aided Diagnosis and Treatment for Digestive Disease, Changsha 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha 410008, China
- Correspondence: (Y.P.); (X.L.)
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Gomes TLM, Peixoto MVM, de Azevedo ZMA, Fonseca VM, Ramos EG. Association of electrical bioimpedance vectors with the nutritional classification of vulnerable multiethnic children. Clin Nutr ESPEN 2021; 46:453-458. [PMID: 34857233 DOI: 10.1016/j.clnesp.2021.09.011] [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: 04/17/2020] [Revised: 05/06/2021] [Accepted: 09/15/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND & AIMS Monitoring growth and body composition in childhood is vital for early detection of health and nutrition problems during child development. The bioelectrical impedance vector analysis (BIVA) revealed its effectiveness as an indicator of nutritional status. This study aimed to measure the bioimpedance vectors of a sample of multiethnic children and evaluate the utility of BIVA for the classification of the nutritional status in a group of children with greater vulnerability, including in the presence of obesity. METHODS This is a cross-sectional study that analyzed the bioelectrical impedance of a sample of 321 children from public daycare centers, aged 1-4 years, using the RXc graph method (tetrapolar analysis at 50 kHz frequency). The 95%, 75%, and 50% tolerance ellipses were plotted by age group. The Z-scores of bioimpedance parameters (Xc/H-Z and R/H-Z) were calculated regarding age, which were used to build reference tolerance ellipses for a single group, regardless of age. Such ellipses were evaluated for their ability to recognize the pattern and classify the deviations, using individual vectors of obese children. RESULTS The mean impedance vectors showed progressively higher reactances and lower resistances with age. In the group of obese children, the individual vectors located outside the 95% baseline tolerance ellipse were 12.5%, 18.75%, and 11.1% of the cases for the WHZ, WAZ, and BMIZ criteria, respectively, all above the expected 5%, but much below expectations. This may be a problem with the obesity criteria used, as WHZ, WAZ, and BMIZ do not differentiate fat from lean mass. CONCLUSION Bioimpedance vector analysis reflects differences in the bioelectric patterns of children classified as obese. Provided the obesity criteria are constructed based on fat measurements, rather than lean mass, the use of tolerance ellipses in the BIVA chart is promising as a tool for monitoring nutritional status where measuring body composition is difficult, because constant tissue hydration cannot be assumed.
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Affiliation(s)
- Taisa Lisboa Montagner Gomes
- Department of Education and Research, Instituto Federal de Educação, Ciência e Tecnologia do Maranhão, São Luís, Brazil.
| | - Maria Virginia Marques Peixoto
- Analytical Methods Laboratory, Research Department, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Zina Maria Almeida de Azevedo
- Intensive Care Unit, Pediatrics Department, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Vania Matos Fonseca
- Clinical Research Unit, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
| | - Eloane Gonçalves Ramos
- Clinical Research Unit, Instituto Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brazil
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Zhou H, Yao W, Pan D, Sun G. Predicational ability of phase angle on protein energy wasting in kidney disease patients with renal replacement therapy: A cross-sectional study. Food Sci Nutr 2021; 9:3573-3579. [PMID: 34262718 PMCID: PMC8269568 DOI: 10.1002/fsn3.2310] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Revised: 04/05/2021] [Accepted: 04/12/2021] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To investigate the ability of phase angle (PA) and body composition for predicting protein energy wasting (PEW) in renal replacement therapy (RRT) patients. METHODS Renal replacement therapy (RRT) patients were enrolled in this study. Body composition was measured by direct segmental multi-frequency biolectrical impedance analysis method (DSM-BIA); phase angle (PA), fat-free mass (FFM), fat mass (FM), mid-arm circumference (MAC), WC (waist circumference), and ECW/TBW (extracellular water/total body water) were obtained. Biochemicals (serum albumin, triglyceride, and cholesterol) were tested. PEW patients were classified according to ISRNM (The International Society of Renal Nutrition and Metabolism) criteria. Cutoff value of PA and related variables was calculated by ROC analysis. The ability of body composition variables as indicators to predict PEW was evaluated. RESULTS Sixty-four patients were enrolled in this study. Thirty-three patients (52.6%) were males, and forty (62.5%) patients were diagnosed with PEW. The ROC curve showed that the optimal cutoff values of PA, FFMI (fat-free mass index), MAC, WC, and BMI for PEW risk were 4.45°, 16.71, 29.7 cm, 86.4 cm, and 21.1 kg/m2, respectively. These indicators showed significant association with PEW; meanwhile, the PA and MAC can be used as the predictors for PEW with OR 6.333 (95% CI, 1.956-20.505) and 3.267 (95% CI, 1.136-9.394), respectively. Both groups have a lower BUN/Cr ratio (<20). CONCLUSION In the RRT patients, over than 60% patients were diagnosed with PEW. PA, MAC, and other body composition can be used as the independent indicators for predicting PEW in renal replacement therapy kidney disease patients.
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Affiliation(s)
- Haiteng Zhou
- Key Laboratory of Environmental Medicine and Engineering Ministry of EducationDepartment of Nutrition and Food HygieneSchool of Public HealthSoutheast UniversityNanjingChina
| | | | - Da Pan
- Key Laboratory of Environmental Medicine and Engineering Ministry of EducationDepartment of Nutrition and Food HygieneSchool of Public HealthSoutheast UniversityNanjingChina
| | - Guiju Sun
- Key Laboratory of Environmental Medicine and Engineering Ministry of EducationDepartment of Nutrition and Food HygieneSchool of Public HealthSoutheast UniversityNanjingChina
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Regli IB, Turner R, Woyke S, Rauch S, Brugger H, Gatterer H. Bioelectrical Impedance Vector Analysis: A Valuable Tool to Monitor Daily Body Hydration Dynamics at Altitude. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:5455. [PMID: 34065211 PMCID: PMC8161038 DOI: 10.3390/ijerph18105455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 05/14/2021] [Accepted: 05/16/2021] [Indexed: 12/19/2022]
Abstract
Bioelectrical impedance vector analysis (BIVA) is a method used to estimate variation in body hydration. We assessed the potential of BIVA for monitoring daily body hydration fluctuations in nine healthy, normally active males under matching normoxic (NX) and hypobaric hypoxic (HH) experimental conditions. Furthermore, we aimed to investigate whether changes in BIVA may correspond with the development of acute mountain sickness (AMS). Subjects were exposed in a hypobaric chamber to both NX (corresponding to an altitude of 262 m) and HH conditions corresponding to an altitude of 3500 m during two four-day sojourns within which food, water intake and physical activity were controlled. Bioimpedance and body weight measurements were performed three times a day and medical symptoms were assessed every morning using the Lake Louise score (LLS). Total body water (TBW) was also assessed on the last day of both sojourns using the deuterium dilution technique. We detected circadian changes in vector length, indicating circadian body water variations that did not differ between NX and HH conditions (ANOVA effects: time: p = 0.018, eta2 = 0.149; interaction: p = 0.214, eta2 = 0.083; condition: p = 0.920, eta2 = 0.001). Even though none of the subjects developed AMS, four subjects showed clinical symptoms according to the LLS during the first 24 hours of HH conditions. These subjects showed a pronounced (Cohen's d: 1.09), yet not statistically significant (p = 0.206) decrease in phase angle 6 hours after exposure, which may indicate fluid shift from the intracellular to the extracellular compartment. At the end of each sojourn, vector length correlated with deuterium dilution TBW "gold standard" measurements (linear regression: NX: p = 0.002 and r2 = 0.756, HH: p < 0.001 and r2 = 0.84). BIVA can be considered a valuable method for monitoring body hydration changes at altitude. Whether such changes are related to the development of clinical symptoms associated with AMS, as indicated in the present investigation, must be confirmed in future studies.
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Affiliation(s)
- Ivo B. Regli
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy; (R.T.); (S.W.); (S.R.); (H.B.); (H.G.)
- Department of Anaesthesia and Intensive Care, “F. Tappeiner” Hospital, 39012 Merano, Italy
| | - Rachel Turner
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy; (R.T.); (S.W.); (S.R.); (H.B.); (H.G.)
| | - Simon Woyke
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy; (R.T.); (S.W.); (S.R.); (H.B.); (H.G.)
- Department of Anaesthesiology and Intensive Care, Medical University, 6020 Innsbruck, Austria
| | - Simon Rauch
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy; (R.T.); (S.W.); (S.R.); (H.B.); (H.G.)
- Department of Anaesthesia and Intensive Care, “F. Tappeiner” Hospital, 39012 Merano, Italy
| | - Hermann Brugger
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy; (R.T.); (S.W.); (S.R.); (H.B.); (H.G.)
- Department of Anaesthesiology and Intensive Care, Medical University, 6020 Innsbruck, Austria
| | - Hannes Gatterer
- Institute of Mountain Emergency Medicine, Eurac Research, 39100 Bolzano, Italy; (R.T.); (S.W.); (S.R.); (H.B.); (H.G.)
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Obayashi H, Ikuta Y, Fujishita H, Fukuhara K, Sakamitsu T, Ushio K, Kimura H, Adachi N. The relevance of whole or segmental body bioelectrical impedance phase angle and physical performance in adolescent athletes. Physiol Meas 2021; 42. [PMID: 33690189 DOI: 10.1088/1361-6579/abed35] [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: 12/14/2020] [Accepted: 03/09/2021] [Indexed: 12/11/2022]
Abstract
Objective. The physical condition of athletes can be assessed easily and quantitatively using objective indicators. Bioelectrical impedance measures the phase angle (PA), representing hydration and cell function, and is a potential clinical indicator of physical condition. This study aimed to investigate the association between PA and physical performance in adolescent athletes.Approach. Overall, 170 adolescent athletes underwent a sports medical check-up, including body composition measurements and physical performance tests. Whole-body and segmental PAs (arm and leg) were determined based on body composition values. Isometric grip power and knee isokinetic muscle strength were measured as parameters of muscle strength. Counter movement jump height and squat jump height were measured as jump parameters. Associations between PA and each muscle strength or jump parameters were analysed using Pearson product-moment correlation coefficient or Spearman's rank correlation coefficient.Main results. Whole-body and upper limb PAs were highly correlated with grip power (r= 0.70-0.80). Whole-body and lower limb PAs were correlated with knee isokinetic muscle strength (r= 0.43-0.59). Whole and all segmental PAs were correlated with counter movement jump height (r= 0.46-0.57) and squat jump height (r= 0.42-0.52).Significance. PA can be used to monitor physical condition and sports performance in adolescent athletes. Segmental PAs can help assess the condition of the corresponding body part.
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Affiliation(s)
- Hiromune Obayashi
- Hiroshima University Hospital Sports Medical Center, Hiroshima City, Hiroshima, Japan.,Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima City, Hiroshima, Japan
| | - Yasunari Ikuta
- Hiroshima University Hospital Sports Medical Center, Hiroshima City, Hiroshima, Japan.,Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan
| | - Hironori Fujishita
- Hiroshima University Hospital Sports Medical Center, Hiroshima City, Hiroshima, Japan.,Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima City, Hiroshima, Japan
| | - Koki Fukuhara
- Hiroshima University Hospital Sports Medical Center, Hiroshima City, Hiroshima, Japan.,Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima City, Hiroshima, Japan
| | - Tetsuhiko Sakamitsu
- Hiroshima University Hospital Sports Medical Center, Hiroshima City, Hiroshima, Japan.,Division of Rehabilitation, Department of Clinical Practice and Support, Hiroshima University Hospital, Hiroshima City, Hiroshima, Japan
| | - Kai Ushio
- Hiroshima University Hospital Sports Medical Center, Hiroshima City, Hiroshima, Japan.,Hiroshima University Hospital Department of Rehabilitation, Hiroshima City, Hiroshima, Japan
| | - Hiroaki Kimura
- Hiroshima University Hospital Sports Medical Center, Hiroshima City, Hiroshima, Japan.,Hiroshima University Hospital Department of Rehabilitation, Hiroshima City, Hiroshima, Japan
| | - Nobuo Adachi
- Hiroshima University Hospital Sports Medical Center, Hiroshima City, Hiroshima, Japan.,Department of Orthopaedic Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima City, Hiroshima, Japan
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Abstract
Dietary trace minerals are pivotal and hold a key role in numerous metabolic processes. Trace mineral deficiencies (except for iodine, iron, and zinc) do not often develop spontaneously in adults on ordinary diets; infants are more vulnerable because their growth is rapid and intake varies. Trace mineral imbalances can result from hereditary disorders (e.g., hemochromatosis, Wilson disease), kidney dialysis, parenteral nutrition, restrictive diets prescribed for people with inborn errors of metabolism, or various popular diet plans. The Special Issue "Dietary Trace Minerals" comprised 13 peer-reviewed papers on the most recent evidence regarding the dietary intake of trace minerals, as well as their effect toward the prevention and treatment of non-communicable diseases. Original contributions and literature reviews further demonstrated the crucial and central part that dietary trace minerals play in human health and development. This editorial provides a brief and concise overview that addresses and summarizes the content of the Dietary Trace Minerals Special Issue.
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