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Liu S, Zhang S, Cheng X, Wu D, Chen J, Liang W, Qian S, Zhang J, Jiang F. A meta-analysis on the impact of resistance training on phase angle in middle-aged and older individuals. Arch Gerontol Geriatr 2024; 119:105318. [PMID: 38194828 DOI: 10.1016/j.archger.2023.105318] [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: 10/04/2023] [Revised: 12/14/2023] [Accepted: 12/17/2023] [Indexed: 01/11/2024]
Abstract
PURPOSE To determine the impact of resistance training (RT) on phase angle (PhA) in middle-aged and older individuals via meta-analysis, explore effects in subgroups, and identify optimal RT protocol. MATERIALS AND METHODS We searched five databases using predefined criteria, assessed literature quality per Cochrane 5.1 Handbook, and used Revman 5.3 for effect size aggregation, bias assessment, sensitivity analysis, and subgroup analysis. RESULTS RT improved PhA in middle-aged and older individuals (d = 0.34, 95 % CI: 0.27-0.40, P < 0.05). Effective subgroups included Suspension (d = 0.62, 95 % CI: 0.33-0.90, P < 0.05), free-weights and machine (d = 0.36, 95 % CI: 0.28-0.45, P < 0.05), equipment training (d = 0.24, 95 % CI: 0.13-0.36, P < 0.05), and moderate-intensity RT (d = 0.34, 95 % CI: 0.27-0.42, P < 0.05). RT was conducted 2-3 times/week (d = 0.20, 95 % CI: 0.01-0.38, P < 0.05) or (d = 0.38, 95 % CI: 0.30-0.47, P < 0.05). PhA improved after 8 weeks (d = 0.37, 95 % CI: 0.23-0.51, P < 0.05), 12 weeks (d = 0.35, 95 % CI: 0.26-0.44, P < 0.05), and ≥ 24 weeks (d = 0.26, 95 % CI: 0.11-0.41, P < 0.05) of RT in aged and older individuals. Low- and high-intensity RT, elastic band training, and weekly exercises did not significantly improve PhA. CONCLUSIONS RT enhances PhA in middle-aged and older adults. For optimal results, we recommend 2-3 weekly sessions of free weights and machine training lasting at least 8 weeks.
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Affiliation(s)
- Siqi Liu
- School of Physical Education, Hunan Normal University, Changsha, 410012, China
| | - Siqing Zhang
- School of Physical Education, Huazhong University of Science and Technology, Wuhan, 430074, China
| | - Xuejing Cheng
- School of Physical Education, Hunan Normal University, Changsha, 410012, China
| | - Danting Wu
- Department of Physical Education, Tongji University, Shanghai, 200092, China
| | - Jiongxun Chen
- School of Physical Education, Hunan Normal University, Changsha, 410012, China
| | - Wenqi Liang
- School of Physical Education & Sports Science, South China Normal University, Guangzhou, 510006, China
| | - Siyu Qian
- School of Physical Education, Hunan Normal University, Changsha, 410012, China
| | - Jisheng Zhang
- School of Physical Education, Hunan Normal University, Changsha, 410012, China.
| | - Fanglin Jiang
- School of Physical Education, Hunan Normal University, Changsha, 410012, China.
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Gulin J, Ipavic E, Mastnak DM, Brecelj E, Edhemovic I, Kozjek NR. Phase angle as a prognostic indicator of surgical outcomes in patients with gastrointestinal cancer. Radiol Oncol 2023; 57:524-529. [PMID: 38038415 PMCID: PMC10690749 DOI: 10.2478/raon-2023-0060] [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: 08/03/2023] [Accepted: 09/30/2023] [Indexed: 12/02/2023] Open
Abstract
BACKGROUND In patients with gastrointestinal cancer with planned elective surgery, malnutrition increases the risk of adverse outcomes in the postoperative period. The phase angle, measured by the bioelectrical impedance analysis is an indicator of the metabolic and functional status of the patient. It may be an important prognostic indicator for the clinical outcome of post-surgical treatment in patients with gastrointestinal cancer. PATIENTS AND METHODS In this prospective study, 70 patients with gastrointestinal cancer had their phase angles measured by the bioelectrical impedance analysis before the surgery. During the first month after the surgery, we documented the postoperative complications from the patient's records and classified them according to the Clavien Dindo classification of surgical complications. The time of hospitalization was also recorded. The data was statistically analysed in SPSS. RESULTS We found a statistically significant difference (p = 0.036) in the average value of phase angles between the group of patients who had postoperative complications (phase angle 5.09°) and the group without postoperative complications (5.64°). We noted a correlating trend of decreasing phase angle values and increasing hospitalization time (Pe R = -0,40, p = 0,001). The phase angle cut-off value (5.5°) was calculated using the ROC curve method, predicting a higher risk of the postoperative complications (p = 0,037) in patients with lower phase angle. CONCLUSIONS Lower phase angle values before surgery were associated with more complications during the first month after surgery and longer hospitalization time. We found that a phase angle below than 5.5° could serve as a marker that predicts a greater risk of postoperative complications.
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Affiliation(s)
- Jana Gulin
- Medical Centre Ljubljana, Ljubljana, Slovenia
| | | | | | - Erik Brecelj
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | | | - Nada Rotovnik Kozjek
- Institute of Oncology Ljubljana, Ljubljana, Slovenia
- University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
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Zamberlan P, Mazzoni BP, Bonfim MAC, Vieira RR, Tumas R, Delgado AF. Body composition in pediatric patients. Nutr Clin Pract 2023; 38 Suppl 2:S84-S102. [PMID: 37721465 DOI: 10.1002/ncp.11061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 06/26/2023] [Accepted: 07/18/2023] [Indexed: 09/19/2023] Open
Abstract
Undernutrition is highly prevalent in children who are critically ill and is associated with increased morbidity and mortality, including a higher risk of infection due to transitory immunological disorders, inadequate wound healing, reduced gut function, longer dependency on mechanical ventilation, and longer hospital stays compared with eutrophic children who are critically ill. Nutrition care studies have proposed that early interventions targeting nutrition assessment can prevent or minimize the complications of undernutrition. Stress promotes an acute inflammatory response mediated by cytokines, resulting in increased basal metabolism and nitrogen excretion and leading to muscle loss and changes in body composition. Therefore, the inclusion of body composition assessment is important in the evaluation of these patients because, in addition to the nutrition aspect, body composition seems to predict clinical prognosis. Several techniques can be used to assess body composition, such as arm measurements, calf circumference, grip strength, bioelectrical impedance analysis, and imaging examinations, including computed tomography and dual-energy x-ray absorptiometry. This review of available evidence suggests that arm measurements seem to be well-established in assessing body composition in children who are critically ill, and that bioelectrical impedance analysis with phase angle, handgrip strength, calf circumference and ultrasound seem to be promising in this evaluation. However, further robust studies based on scientific evidence are necessary.
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Affiliation(s)
- Patrícia Zamberlan
- Instituto da Criança e do Adolescente/Division of Nutrition, Support Team, Universidade de São Paulo Hospital das Clínicas, São Paulo, Brazil
| | - Beatriz P Mazzoni
- Instituto da Criança e do Adolescente/Division of Nutrition, Universidade de São Paulo Hospital das Clínicas, São Paulo, Brazil
| | - Maria A C Bonfim
- Instituto da Criança e do Adolescente/Division of Nutrition, Universidade de São Paulo Hospital das Clínicas, São Paulo, Brazil
| | - Rafaela R Vieira
- Instituto da Criança e do Adolescente/Division of Nutrition, Universidade de São Paulo Hospital das Clínicas, São Paulo, Brazil
| | - Rosana Tumas
- Instituto da Criança e do Adolescente/Nutrology Unit, Universidade de São Paulo Hospital das Clínicas, São Paulo, Brazil
| | - Artur F Delgado
- Department of Pediatrics - Medical School, Universidade de São Paulo, São Paulo, Brazil
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Graybeal AJ, Tinsley GM, Brandner CF, Aultman R. Raw bioelectrical impedance measurements are not different between White and Black adults when matched for sex, age, BMI, and other physical characteristics. Nutr Res 2023; 112:1-10. [PMID: 36933277 PMCID: PMC10079621 DOI: 10.1016/j.nutres.2023.02.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 02/20/2023] [Accepted: 02/20/2023] [Indexed: 03/18/2023]
Abstract
Raw bioelectrical impedance measurements are often used as a prognosticator of health status because of their association with disease states and malnutrition. Although studies consistently show the effect of physical characteristics on bioelectrical impedance, few investigations describe the effect of race, particularly for Black adults, and many bioelectrical impedance standards were produced from primarily White adults almost 2 decades ago. Therefore, this study sought to evaluate the racial differences in bioelectrical impedance measurements using bioimpedance spectroscopy between non-Hispanic White and non-Hispanic Black adults matched for age, sex, and body mass index. We hypothesized that Black adults would have a lower phase angle from higher resistance and lower reactance compared with White adults. One hundred non-Hispanic White (n = 50) and non-Hispanic Black (n = 50) males (n = 34) and females (n = 66) matched for sex, age, and body mass index completed this cross-sectional study. Participants underwent several anthropometric assessments, including height, weight, waist circumference, hip circumference, bioimpedance spectroscopy, and dual-energy X-ray absorptiometry. Bioelectrical impedance measures of resistance, reactance, phase angle, and impedance were all collected at frequencies of 5, 50, and 250 kHz and bioelectrical impedance vector analysis was performed using 50-kHz data. There were no significant differences for any anthropometric variable between Black and White participants in the total sample or by sex groups. In addition, there were no significant racial differences for any bioelectrical impedance assessment, including bioelectrical impedance vector analysis. Differences in bioelectrical impedance are likely not a function of race between Black and White adults and concerns regarding its utility should not be based on this characteristic.
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Affiliation(s)
- Austin J Graybeal
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS 39406, USA.
| | - Grant M Tinsley
- Department of Kinesiology & Sport Management, Texas Tech University, Lubbock, TX 79409, USA
| | - Caleb F Brandner
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS 39406, USA
| | - Ryan Aultman
- School of Kinesiology & Nutrition, College of Education and Human Sciences, University of Southern Mississippi, Hattiesburg, MS 39406, USA
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Jiang N, Zhang J, Cheng S, Liang B. The Role of Standardized Phase Angle in the Assessment of Nutritional Status and Clinical Outcomes in Cancer Patients: A Systematic Review of the Literature. Nutrients 2022; 15:nu15010050. [PMID: 36615707 PMCID: PMC9824322 DOI: 10.3390/nu15010050] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 12/10/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
Compared with the phase angle (PA), the predictive ability of the standardized phase angle (SPA) in assessing nutritional status and clinical outcomes in cancer patients remains uncertain. This review aimed to assess (1) the relationship between SPA and nutritional status and clinical outcomes (including complications and survival) in cancer patients; (2) the predictive ability of SPA alone and in comparison with the predictive ability of PA; and (3) the cut-off value of SPA in cancer patients. Studies that addressed the relationship of SPA use to nutritional status, complications, and survival in cancer patients were searched and identified from six electronic databases (PubMed, Medline, CINAHL, Embase, Web of Science, and the Cochrane Library). The included studies were considered to meet the following criteria: English studies with original data that reflected the effects of SPA on nutritional status and clinical outcomes (including complications and survival) and reported a cut-off value of SPA in cancer patients aged ≥18. Thirteen studies that included a total of 2787 participants were evaluated. Five studies assessed the relationship between SPA and nutritional status, and four of them reported a positive relationship between SPA and nutritional status in cancer patients, even considering SPA as a predictor. Twelve studies assessed the relationship between SPA and clinical outcomes in cancer patients. Two-thirds of the studies that evaluated complications reported the predictive ability of SPA; 30% of survival studies reported a positive relationship, 40% reported SPA as a predictor, and 30% reported no relationship. The standard cut-off value for SPA has not yet been determined. Data from the selected studies suggest that SPA might be a predictor of nutritional status. Further studies are needed to determine the value of SPA in predicting nutritional status and clinical outcomes in cancer patients.
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Affiliation(s)
| | | | | | - Bing Liang
- Correspondence: ; Tel.: +86-138-4311-4648
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Fernández-Jiménez R, Dalla-Rovere L, García-Olivares M, Abuín-Fernández J, Sánchez-Torralvo FJ, Doulatram-Gamgaram VK, Hernández-Sanchez AM, García-Almeida JM. Phase Angle and Handgrip Strength as a Predictor of Disease-Related Malnutrition in Admitted Patients: 12-Month Mortality. Nutrients 2022; 14:1851. [PMID: 35565818 PMCID: PMC9105999 DOI: 10.3390/nu14091851] [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: 03/15/2022] [Revised: 04/17/2022] [Accepted: 04/26/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Phase Angle (PhA) value measured by bioelectrical impedance analysis (BIA) could be considered a good marker of the patient’s cell mass and cellular damage. Various studies have shown that the value of PhA is associated with an increased nutritional risk in several pathologies. However, not many studies have focused on the use of PhA as a screening tool in admitted patients. The aim of this study is to evaluate the prognostic value of PhA to determine disease-related malnutrition (DRM) and the risk that this entails for mortality and length of stay (LOS). Methods: 570 patients admitted to the hospital for different causes were included in this retrospective observational study. Patients’ nutritional risk was assessed by screening tests such as the Malnutrition Universal Screening tool (MUST) and Subjective Global Assessment (SGA), in addition to non-invasive functional techniques, such as BIA and handgrip strength (HGS), 24−48 h after admission. After performing an SGA as the gold standard to assess malnutrition, PhA and SPhA values were used to determine DRM. Furthermore, both samples: malnutrition status (MS) and non-malnutrition status (NMS) were compared, with SphA-Malnutrition corresponding to a diagnosis of malnutrition. Statistical analysis of the sample was conducted with JAMOVI version 2.2.2. Results: Patients with MS had lower PhA and SPhA than patients with NMS (p < 0.001). The ROC curve analysis (AUC = 0.81) showed a cut-off point for MS for PhA = 5.4° (sensitivity 77.51% and specificity 74.07%) and AUC = 0.776 with a cut-off point for SPhA = −0.3 (sensitivity 81.74% and specificity 63.53%). Handgrip strength (HGS) was also observed to be a good predictor in hospitalized patients. Carrying out a comparative analysis between MS and NMS, length of stay (LOS) was 9.0 days in MS vs. 5.0 days in NMS patients (OR 1.07 (1.04−1.09, p < 0.001)). A low SPhA-malnutrition value (SPhA < −0.3) was significantly associated with a higher mortality hazards ratio (HR 7.87, 95% CI 2.56−24.24, p < 0.001). Conclusion: PhA, SPhA and HGS are shown to be good prognostic markers of DRM, LOS and mortality and could therefore be useful screening tools to complement the nutritional assessment of admitted patients.
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Affiliation(s)
- Rocío Fernández-Jiménez
- Departmento de Endocrinologia y Nutrición, Quironsalud Málaga Hospital Av. Imperio Argentina, 29004 Málaga, Spain; (L.D.-R.); (M.G.-O.); (J.A.-F.); (J.M.G.-A.)
- Unidad de Gestion Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria de Málaga, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; (F.J.S.-T.); (V.K.D.-G.)
| | - Lara Dalla-Rovere
- Departmento de Endocrinologia y Nutrición, Quironsalud Málaga Hospital Av. Imperio Argentina, 29004 Málaga, Spain; (L.D.-R.); (M.G.-O.); (J.A.-F.); (J.M.G.-A.)
| | - María García-Olivares
- Departmento de Endocrinologia y Nutrición, Quironsalud Málaga Hospital Av. Imperio Argentina, 29004 Málaga, Spain; (L.D.-R.); (M.G.-O.); (J.A.-F.); (J.M.G.-A.)
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; (F.J.S.-T.); (V.K.D.-G.)
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
| | - José Abuín-Fernández
- Departmento de Endocrinologia y Nutrición, Quironsalud Málaga Hospital Av. Imperio Argentina, 29004 Málaga, Spain; (L.D.-R.); (M.G.-O.); (J.A.-F.); (J.M.G.-A.)
| | - Francisco José Sánchez-Torralvo
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; (F.J.S.-T.); (V.K.D.-G.)
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Departamento de Medicina y Dermatología, Facultad de Medicina, University of Malaga, 29010 Málaga, Spain
| | - Viyey Kishore Doulatram-Gamgaram
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; (F.J.S.-T.); (V.K.D.-G.)
- Unidad de Gestión Clínica de Endocrinología y Nutrición, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain
- Departamento de Medicina y Dermatología, Facultad de Medicina, University of Malaga, 29010 Málaga, Spain
| | | | - José Manuel García-Almeida
- Departmento de Endocrinologia y Nutrición, Quironsalud Málaga Hospital Av. Imperio Argentina, 29004 Málaga, Spain; (L.D.-R.); (M.G.-O.); (J.A.-F.); (J.M.G.-A.)
- Unidad de Gestion Clínica de Endocrinología y Nutrición, Hospital Universitario Virgen de la Victoria de Málaga, 29010 Málaga, Spain
- Instituto de Investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; (F.J.S.-T.); (V.K.D.-G.)
- Departamento de Medicina y Dermatología, Facultad de Medicina, University of Malaga, 29010 Málaga, Spain
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Andrade GKPD, Carvalho JB, Nascimento LAD, Rodrigues ALCC, Severine AN. NUTRITIONAL ASSESSMENT TEAM: BODY COMPOSITION ASSESSMENT PROTOCOL IN HOSPITALIZED PATIENTS. CLINICAL NUTRITION OPEN SCIENCE 2022. [DOI: 10.1016/j.nutos.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Fu L, Ren Z, Liu X, Wu N, Zhao K, Luo G, Yang H, Zhang Y, Yan T, Liu Y, Zhang T. Reference Data of Phase Angle Using Bioelectrical Impedance Analysis in Overweight and Obese Chinese. Front Endocrinol (Lausanne) 2022; 13:924199. [PMID: 35903275 PMCID: PMC9319044 DOI: 10.3389/fendo.2022.924199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 06/17/2022] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Phase angle (PhA) is a ratio of reactance and resistance {arctangent (reactance (Xc)/resistance (R)) × (180°/π)}, which can be obtained by bioelectrical impedance analysis (BIA). PhA indicates cellular health and integrity, and it is also considered as a prognostic tool in medical disorders and an indicator of nutritional status (especially of muscle quality) in patients with obesity. However, PhA has limited usefulness in clinical practice because of a lackness of reference values for Chinese overweight and obese populations. The main aim of this study was to show PhA reference data in different age and BMI groups by sex. In addition, we also study the association of age, sex, and BMI on PhA. METHODS A total of 1729 overweight and obese participants were included in this study. PhA and body composition were measured using segmental multifrequency BIA. Differences in mean values for variables were tested by one-way analysis of variance. Multiple regression analysis was used to assess the associations of PhA with age, sex and BMI. RESULTS Multiple regression analysis showed that age, sex and BMI were significant (P < 0.05) independent influence factors of PhA in Chinese overweight and obese adults when age and BMI were continues variables. The mean PhA value for all participants was 5.5°. Mean BMI, age, weight, height and 50kHz-PhA were significantly higher (P < 0.001) in male participants than female ones. In age groups and BMI groups, mean 50kHz-PhA was significantly higher (P < 0.005) in male participants than female ones. When age groups and BMI groups were categorical variables, multiple regression analysis showed that different age groups (46-55 years and ≥ 56 years) had a significantly lower (P < 0.005) PhA as compared with the baseline group (18-25 years) and different BMI groups (≥ 28 kg/m2) had a significantly higher (P < 0.05) PhA as compared with the baseline group (24-27.9 kg/m2). CONCLUSION PhA differed according to age, sex and BMI. Reference data in this study can be taken into consideration when deriving the reference values for overweight and obese Chinese populations.
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Affiliation(s)
- Luo Fu
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Zhengyun Ren
- College of Medicine, Southwest Jiaotong University, Chengdu, China
| | - Xiaoxiao Liu
- College of Medicine, Southwest Jiaotong University, Chengdu, China
| | - Nianwei Wu
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
- Medical Research Center, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Kang Zhao
- College of Medicine, Southwest Jiaotong University, Chengdu, China
| | - Guangping Luo
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
- Medical Research Center, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Huawu Yang
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Yuanchuan Zhang
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Tong Yan
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Yanjun Liu
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
| | - Tongtong Zhang
- Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
- Medical Research Center, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu, China
- *Correspondence: Tongtong Zhang,
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Fernandes SA, Rossoni C, Koch VW, Imbrizi M, Evangelista-Poderoso R, Pinto LP, Magro DO. Phase angle through electrical bioimpedance as a predictor of cellularity in inflammatory bowel disease. Artif Intell Gastroenterol 2021; 2:111-123. [DOI: 10.35712/aig.v2.i4.111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 06/19/2021] [Accepted: 07/26/2021] [Indexed: 02/06/2023] Open
Abstract
It is estimated in Western industrialized countries that inflammatory bowel disease (IBD) has a prevalence of 1 for every 200 inhabitants. In the past, the fat mass disproportionate increase in relation to the fat-free mass was considered uncommon in patients with IBD, due to the observation of the disease being more common with weight loss and malnutrition. However, more in-depth investigations demonstrate that the fat/lean mass disproportion stands out both in prevalence in patients with new diagnoses of ulcerative colitis or Crohn's disease as well as a factor of poor prognosis to the natural evolution of the disease or to the therapeutic response. Another important aspect associated with obesity in IBD is the increased risk of drug clearance [including anti-tumor necrosis factor (TNF) and anti-integrin agents], resulting in short half-life and low trough drug concentrations, since the levels of TNF secreted by adipocytes sequester anti-TNF agents, which could result in suboptimal response to biologics. In view of these characteristic aspects of the inflammatory process of IBD, the identification of cellular functioning is necessary, which can be associated with the staging of the underlying disease, biochemical parameters, and body composition, helping as an indicator for a more accurate clinical and nutritional conduct.
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Affiliation(s)
- Sabrina A Fernandes
- Postgraduate Program in Hepatology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre 90050-170, Brazil
| | - Carina Rossoni
- Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon, Lisbon 1649-028, Portugal
| | - Vivian W Koch
- Gastroenterology Department, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 90020-090, Brazil
- Gastroenterology Department, Grupo Hospitalar Conceição, Porto Alegre 91350-250, Brazil
| | - Marcello Imbrizi
- Coloproctology Department, State University of Campinas (UNICAMP-SP), São Paulo 13056-405, Brazil
| | | | - Letícia Pereira Pinto
- Postgraduate Program in Hepatology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre 90050-170, Brazil
| | - Daniéla Oliveira Magro
- Department of Surgery, State University of Campinas (UNICAMP-SP) and Faculty of Medical Sciences (FCM), São Paulo 13056-405, Brazil
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Huang Y, Ge Y, Li F, Zhang C, Zhang Z, Xu N, Wang R, Wu S, Geng X, Quan Y, Ren H. Elucidating the relationship between nutrition indices and coronary artery calcification in patients undergoing maintenance hemodialysis. Ther Apher Dial 2021; 26:71-84. [PMID: 34038022 DOI: 10.1111/1744-9987.13693] [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: 04/03/2020] [Revised: 05/20/2021] [Accepted: 05/23/2021] [Indexed: 12/13/2022]
Abstract
Cardiovascular diseases (CVD) are common in maintenance hemodialysis (MHD) patients, and vascular calcification is associated with the incidence of CVD. Malnourished MHD patients are particularly prone to CVD events. Thus far, there is no clear explanation for the relationship of nutrition status with vascular calcification; therefore, we investigated the relationship between malnutrition and vascular calcification. One hundred thirty-one patients underwent laboratory testing, assessment of vascular calcification, modified quantitative subjective global assessment (MQSGA), bioelectrical impedance analysis (BIA), and anthropometric measurements. The patients were divided into two groups based on the presence or absence of coronary artery calcification (CAC), and nutritional statuses were compared between the two groups. The MQSGA score was higher in the CAC group (mean 10.9 ± 1.81) than in the no-CAC group (mean 10.2 ± 1.51); in addition, the mean phase angle (PA) value was significantly lower in the CAC group than in the no-CAC group. Stratification according to CAC score showed that age, Kt/V, incidence of valve calcification, incidence of abdominal aortic calcification, MQSGA score, and blood cell mass were related to the severity of CAC. In addition, quartile analysis revealed that MQSGA score and PA value were related to the incidence and severity of vascular calcification. Binary regression analysis showed that MQSGA score, age, hemoglobin level, and high-density lipoprotein level were independent risk factors for dialysis-related CAC. Patients on MHD who exhibited malnutrition were more likely to have vascular calcification, especially CAC. Namely, the higher the MQSGA score, the lower the PA, and the more likely the occurrence of CAC.
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Affiliation(s)
- Yingzi Huang
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yongchun Ge
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Furong Li
- Department of Nephrology, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Chuanzhen Zhang
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Zhaoyong Zhang
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Na Xu
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Rui Wang
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Shun Wu
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Xin Geng
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Yongqiang Quan
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China
| | - Hongqi Ren
- Department of Nephrology, the Affiliated Huaihai Hospital of Xuzhou Medical University, Xuzhou, China.,National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
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11
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Differences in body composition between metabolically healthy and unhealthy midlife women with respect to obesity status. ANTHROPOLOGICAL REVIEW 2021. [DOI: 10.2478/anre-2021-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Abstract
Body composition (BC) characteristics across metabolic health-by-body mass index categories were examined. Metabolic health (MH) was defined by five biomarkers: waist circumference, blood pressure, levels of triglycerides, high density lipoprotein cholesterol, and fasting glucose. Potential differences in BC characteristics between metabolically healthy obese (MH-O) and metabolically unhealthy obese (MUH-O) women, and between MH normal weight (MH-NW) and MUH normal weight (MUH-NW) women were explored in 276 Slovak midlife women (39-65 years). Body composition parameters were measured with bioimpedance analyzer (BIA 101, Akern, S. r. l.). A simple comparison of the BC data between the subgroups showed significant differences in resistance (Rz, ohm) (p=0.035), muscle mass (MM, kg) (p=0.044), and total body water (TBW, kg) (p=0.047) between MH-O and MUH-O women. However, we did not observe any significant differences in BC characteristics between MH-NW and MUHNW. Specific logistic regression models were used to determine differences in BC characteristics between various obesity phenotypes, with controlling for age, menopausal status, smoking status and sport activity. Our results indicated that increasing age and decreasing Rz were statistically significantly associated with an increased likelihood of exhibiting MUH-O (p=0.031 for age; p=0.032 for Rz). Moreover, other logistic models which included age, menopausal status, biochemical variables and life style factors such as covariates, showed that increasing alanine aminotransferase (ALT) and uric acid (UA) were statistically significantly associated with an increased likelihood of exhibiting MUH-O (p=0.023 for ALT, p=0.010 for UA). In conclusion, MUH-O and MH-O cardiometabolic profiles are characterized by differences in the value of resistance and plasma levels of ALT and UA.
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12
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Roccamatisi L, Gianotti L, Paiella S, Casciani F, De Pastena M, Caccialanza R, Bassi C, Sandini M. Preoperative standardized phase angle at bioimpedance vector analysis predicts the outbreak of antimicrobial-resistant infections after major abdominal oncologic surgery: A prospective trial. Nutrition 2021; 86:111184. [PMID: 33676330 DOI: 10.1016/j.nut.2021.111184] [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] [Received: 06/22/2020] [Revised: 11/30/2020] [Accepted: 01/21/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Infectious morbidity is the most common and costly among all surgery-related complications, and infections by multidrug-resistant microorganisms (MDR) are associated with poor outcomes. Derangements of body composition is a recognized risk factor for infections. The aim of this study was to investigate the potential association between specific traits of body composition and the risk of having MDR-related infections. METHODS This was a prospective study with patients scheduled for major abdominal surgery for gastrointestinal cancer. Bioimpedance vector analysis (BIVA), a reliable tool for body composition assessment, was performed the day before the operation. Postoperative complications were collected focusing on resistance patterns and site of infection. Patterns of resistance were compared with BIVA parameters. RESULTS Data from 182 patients suffering from pancreatic (n = 76, 41.7%), rectal (n = 38, 20.9%), gastric (n = 31, 17%), or hepatic (n = 37, 20.3%) malignancy were collected. Overall complications occurred in 108 patients (59%), and in 45 patients (28%) bacterial infections were proven at culture. Of these, 15 (8%) were multidrug-sensitive (MDS), 38 MDR, and 2 extended drug-resistant (XDR) infections. The standardized phase angle measured (SPA) at BIVA was significantly lower in the MDR/XDR infections (-0.02 ± 1.20) than for no infection/MDS (0.56 ± 1.53; P = 0.029). A multivariate analysis showed that SPA was the only independent variable for MDR/XDR infections with an odds ratio of 3.057 (95% confidence interval, 1.354-6903; P = 0.007). The predictive ability of SPA revealed an area under the receiver operating characteristic curve of 0.662, with an optimal threshold of -0.3. CONCLUSIONS In surgical cancer patients, preoperative value of SPA lower than -0.3 is associated with the outbreak of MDR bacterial infections.
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Affiliation(s)
- Linda Roccamatisi
- School of Medicine and Surgery, University of Milano-Bicocca and Department of Surgery, San Gerardo Hospital, Monza, Italy Monza, Italy
| | - Luca Gianotti
- School of Medicine and Surgery, University of Milano-Bicocca and Department of Surgery, San Gerardo Hospital, Monza, Italy Monza, Italy.
| | - Salvatore Paiella
- Unit of General and Pancreatic Surgery, The Pancreas Institute, Policlinico GB Rossi, University of Verona Hospital Trust, Verona, Italy
| | - Fabio Casciani
- Unit of General and Pancreatic Surgery, The Pancreas Institute, Policlinico GB Rossi, University of Verona Hospital Trust, Verona, Italy
| | - Matteo De Pastena
- Unit of General and Pancreatic Surgery, The Pancreas Institute, Policlinico GB Rossi, University of Verona Hospital Trust, Verona, Italy
| | - Riccardo Caccialanza
- Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
| | - Claudio Bassi
- Unit of General and Pancreatic Surgery, The Pancreas Institute, Policlinico GB Rossi, University of Verona Hospital Trust, Verona, Italy
| | - Marta Sandini
- School of Medicine and Surgery, University of Milano-Bicocca and Department of Surgery, San Gerardo Hospital, Monza, Italy Monza, Italy; Department of General Visceral and Transplantation Surgery, Heidelberg University Hospital, Heidelberg, Germany
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13
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Ribeiro AS, Schoenfeld BJ, Dos Santos L, Nunes JP, Tomeleri CM, Cunha PM, Sardinha LB, Cyrino ES. Resistance Training Improves a Cellular Health Parameter in Obese Older Women: A Randomized Controlled Trial. J Strength Cond Res 2021; 34:2996-3002. [PMID: 30273288 DOI: 10.1519/jsc.0000000000002773] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Ribeiro, AS, Schoenfeld, BJ, dos Santos, L, Nunes, JP, Tomeleri, CM, Cunha, PM, Sardinha, LB, and Cyrino, ES. Resistance training improves a cellular health parameter in obese older women: a randomized controlled trial. J Strength Cond Res 34(10): 2996-3002, 2020-Phase angle (PhA) is a viable indicator of cellular health, with higher values reflecting better cellularity, cell membrane integrity, and cell function. Adaptive responses to resistance training (RT) on PhA may be important in obese older people. The main purpose of the present study was to investigate the effects of 8 weeks of RT on PhA in obese older women. Thirty-three obese older women (68.1 ± 5.7 years, 71.6 ± 10.1 kg, 154.5 ± 6.7 cm, 30.0 ± 4.1 kg·m, and 45.0 ± 6.0% body fat) were randomly allocated into 1 of 2 groups: a training group that performed the RT program (TG, n = 18) or a nonexercise control group (CG, n = 15). The whole-body RT consisted of an 8-week RT program involving 8 exercises performed for 3 sets of 8-12 repetitions 3 times a week. Anthropometric, body fat and fat-free mass, PhA, total body water (TBW), intracellular water (ICW), and extracellular water compartments were performed at before and after training. After the intervention period, the TG presented greater increases (p < 0.05) than CG for fat-free mass (TG = +1.3% and CG = -0.3%), TBW (TG = +2.0% and CG = -1.7%), ICW (TG = +3.1% and CG = -1.9%), and PhA (TG = +3.4% and CG = -1.4%), and lower values for percentage of body fat (TG = -1.3% and CG = +0.9%) and bioimpedance resistance (TG = -4.6% and CG = +2.3%). Our results suggest that 8 weeks of RT improves PhA-a cellular health parameter-in obese older women.
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Affiliation(s)
- Alex S Ribeiro
- Center for Research in Health Sciences, University of Northern Parana, Londrina, Brazil
| | - Brad J Schoenfeld
- Exercise Science Department, CUNY Lehman College, Bronx, New York, NY
| | - Leandro Dos Santos
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil; and
| | - João Pedro Nunes
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil; and
| | - Crisieli M Tomeleri
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil; and
| | - Paolo M Cunha
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil; and
| | - Luis B Sardinha
- Exercise and Health Laboratory, CIPER, Faculty of Human Kinetics, University of Lisbon, Lisbon, Portugal
| | - Edilson S Cyrino
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil; and
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14
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Watanabe T, Ishida N, Takaoka M, Tsujimoto K, Kondo K, Isoda R, Yukawa T, Tokunaga N, Ishida A, Fukazawa T, Morita I, Yoshida H, Kuinose M, Yamatsuji T. Bioelectrical impedance analysis for perioperative water management in adult cardiovascular valve disease surgery. Surg Today 2020; 51:1061-1067. [PMID: 33259014 PMCID: PMC8141485 DOI: 10.1007/s00595-020-02184-3] [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: 04/18/2020] [Accepted: 10/27/2020] [Indexed: 11/03/2022]
Abstract
PURPOSE Bioelectrical impedance analysis (BIA) has been used recently to measure the body water of patients with acute heart failure. We used BIA in this study to better understand, and possibly identify a predictive marker for, perioperative water behavior in cardiac surgery patients. METHODS We measured body water and studied its behavior in 44 patients undergoing surgery for cardiac valvular disease at our hospital. Measurements included the levels of extracellular water (ECW), intracellular water (ICW), and total body water, the edema index (EI), and the ratio of ECW to total body water. The first measured EI was defined as the "preoperative EI" and the maximum as the "peak EI". RESULTS A negative correlation was found between the preoperative EI and the preoperative estimated glomerular filtration rate (eGFR) (R = 0.644, p < 0.001). Positive correlations were found between the peak EI and the ICU stay (R = 0.625, p < 0.001), the peak EI and the ventilation time (R = 0.366, p < 0.01), and the preoperative EI and the ICU stay (R = 0.464, p = 0.026). CONCLUSION The EI is possibly a predictive marker for perioperative water management in cardiac surgery.
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Affiliation(s)
- Tatsuya Watanabe
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan
| | - Naomasa Ishida
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan
| | - Munenori Takaoka
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan
| | - Kotone Tsujimoto
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan
| | - Kensuke Kondo
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan
| | - Ryutaro Isoda
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan
| | - Takuro Yukawa
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan
| | - Noriyuki Tokunaga
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan
| | - Atsuhisa Ishida
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan
| | - Takuya Fukazawa
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan
| | - Ichiro Morita
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan
| | - Hideo Yoshida
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan
| | - Masahiko Kuinose
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan
| | - Tomoki Yamatsuji
- Department of General Surgery, Kawasaki Medical School General Medical Center, 2-6-1 Nakasange, Kita-Ku, Okayama-Shi, Okayama, Japan.
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15
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Oliveira KS, Oliveira LR, Fernandes SA, Coral GP. MALNUTRITION IN CIRRHOSIS: ASSOCIATION WITH ETIOLOGY AND HEPATOCELLULAR DYSFUNCTION. ARQUIVOS DE GASTROENTEROLOGIA 2020; 57:375-380. [PMID: 33331472 DOI: 10.1590/s0004-2803.202000000-71] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 07/12/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND The protein-energy malnutrition alters the prognosis of patients with cirrhosis. Its prevalence may vary according to the etiology of liver disease, it´s severity and the evaluation of the method applied. The infection by the hepatitis C virus (HCV) and alcoholism are the main etiologies of cirrhosis and result in a significant morbidity and mortality. OBJECTIVE To evaluate the nutritional status of patients with cirrhosis according the liver disease etiology and severity. METHODS It is a prospective study, in which the sample was for convenience and consisted of patients with cirrhosis, infected by HCV or alcoholic etiology. The nutritional status evaluation was carried out through anthropometry, food consumption, bioelectrical impedance (BIA) and subjective global assessment (SGA). The anthropometric data evaluated were weight, height, body mass index (BMI), triceps skinfold (TSF), circumference of the arm (CA), non-dominant handshake strength (FAM) and the adductor pollicis muscle thickness (APM). Patients were classified according to the severity of liver disease, using the Child-Pugh and Model for End-stage Liver Diseases (MELD) scores. RESULTS Ninety patients with cirrhosis were evaluated, 47 with HCV and 43 with alcoholic etiology. The prevalence of protein-calorie malnutrition ranged from 10.9% to 54.3% in the HCV group and from 4.7% to 20.9% in the alcoholic group, depending on the method used for evaluation. The group with HCV infection presented a higher malnutrition prevalence in comparison to the alcoholic in the following evaluations: TSF (P<0.001), phase angle (PA) (P=0.016) and SGA (P=0.010). PA values were lower in patients with viral cirrhosis (5.68±1.05) when compared to those with alcoholic etiology (6.61±2.31) (P=0.016). When all patients were analyzed, regardless of etiology, an inversely correlation was observed among Child-Pugh score and PA values (P=0.018). CONCLUSION HCV cirrhosis showed worse nutritional parameters in comparison to alcoholic etiology; however, the PA was associated with worse liver function in both etiologies.
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Affiliation(s)
- Kalinca S Oliveira
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Programa de Pós-Graduação em Hepatologia, Porto Alegre, RS, Brasil
| | | | | | - Gabriela P Coral
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Programa de Pós-Graduação em Hepatologia, Porto Alegre, RS, Brasil
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Devarasu N, Sudha GF. Dual-frequency bioelectrical phase angle to estimate the platelet count for the prognosis of dengue fever in Indian children. BIOMED ENG-BIOMED TE 2020; 65:417-428. [DOI: 10.1515/bmt-2018-0203] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 08/30/2019] [Indexed: 11/15/2022]
Abstract
Abstract
A noninvasive investigation to ascertain the platelet (PLT) count was conducted on 44 hospitalized dengue hemorrhagic fever (DHF) subjects, male and female aged between 3 and 14 years using bioelectrical phase angle (BPhA). Among the 44 subjects, 30 subjects were confirmed to be non-structural protein-1 (NS1) positive at the time of admission, whose blood investigations such as hematocrit (HCT) level, PLT count, aspartate aminotransferase (AST) level and alanine aminotransferase (ALT) level were performed for the classification of risk as low-risk (LR) and high-risk (HR) DHF. It was found that the BPhA of the body reflects a linear correlation with the PLT count. To provide a better and more accurate estimate of PLT, a dual-frequency method is proposed to calculate the phase angle of the total body. The resistance at 5 kHz and reactance at 100 kHz were used to estimate the phase angle of the total body. The statistical analysis identified that the PLT count estimated using the proposed dual-frequency method shows a good correlation with the blood investigation results. In addition, statistical analysis of the proposed method on other fever subjects indicated a significant difference with DHF.
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Affiliation(s)
- Neelamegam Devarasu
- Department of Electronics and Communication Engineering , Pondicherry Engineering College , Puducherry 605014 , India
| | - Gnanou Florence Sudha
- Department of Electronics and Communication Engineering , Pondicherry Engineering College , Puducherry 605014 , India
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17
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PEKER A, AKAR H, TANRISEV M. Son Dönem Böbrek Yetmezliği Hastalarinda Serum Kreatin Kinaz (Ck) Düzeyi Malnutrisyon Parametresi Olabilir Mi? ACTA MEDICA ALANYA 2020. [DOI: 10.30565/medalanya.679570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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18
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Yasui-Yamada S, Oiwa Y, Saito Y, Aotani N, Matsubara A, Matsuura S, Tanimura M, Tani-Suzuki Y, Kashihara H, Nishi M, Shimada M, Hamada Y. Impact of phase angle on postoperative prognosis in patients with gastrointestinal and hepatobiliary-pancreatic cancer. Nutrition 2020; 79-80:110891. [PMID: 32731162 DOI: 10.1016/j.nut.2020.110891] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 04/13/2020] [Accepted: 05/27/2020] [Indexed: 01/06/2023]
Abstract
OBJECTIVE Phase angle (PhA), by bioelectrical impedance analysis, has been used in patients with several diseases; however, its prognostic value in patients with gastrointestinal (GI) and hepatobiliary-pancreatic (HBP) cancer is unclear. The aim of the present study was to investigate the effects of PhA on postoperative short- outcomes and long-term survival in these patients. METHODS This retrospective study reviewed data from 501 patients with GI and HBP cancers who underwent first resection surgery. The data were divided into the following groups according to the preoperative PhA quartile values by sex: high-PhA group with the highest quartile (Q4), normal-PhA group with middle quartiles (Q3 and Q2), and low-PhA group with the lowest quartile (Q1). Preoperative nutritional statuses, postoperative short-term outcomes during hospitalization, and 5-y survival between three groups were compared. Cox proportional hazard models were used to evaluate the prognostic effect of PhA. RESULTS PhA positively correlated with body weight, skeletal muscle mass, and handgrip strength, and negatively correlated with age and levels of C-reactive protein. The low-PhA group showed a higher prevalence of malnutrition (48%) than normal-PhA (25%), and high-PhA groups (9%; P < 0.001). The incidence of postoperative severe complications was 10% for all patients (14% in low-PhA, 12% in normal-PhA, and 4% in high-PhA; P = 0.018). The incidence of prolonged stays in a postoperative high-care or intensive care unit was 8% in all patients (16% in low-PhA, 8% in normal-PhA, and 2% in high-PhA; P < 0.001). The 5-y survival rate was 74% in all patients (68% in low-PhA, 74% in normal-PhA, and 79% in high-PhA; P < 0.001). The multivariate analysis demonstrated that a low-PhA group was an independent risk factor for mortality (hazard ratio, 1.99; 95% confidence interval, 1.05-3.90; P = 0.034). CONCLUSION PhA is a useful short-term and long-term postoperative prognostic marker for patients with GI and HBP cancers.
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Affiliation(s)
- Sonoko Yasui-Yamada
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan; Department of Nutrition, Tokushima University Hospital, Japan.
| | - Yu Oiwa
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Yu Saito
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan; Department of Digestive Surgery and Transplantation, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Nozomi Aotani
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Atsumi Matsubara
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Sayaka Matsuura
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Mayu Tanimura
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Yoshiko Tani-Suzuki
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan; Department of Nutrition, Tokushima University Hospital, Japan
| | - Hideya Kashihara
- Department of Nutrition, Tokushima University Hospital, Japan; Department of Digestive Surgery and Transplantation, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Masaaki Nishi
- Department of Digestive Surgery and Transplantation, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Mitsuo Shimada
- Department of Digestive Surgery and Transplantation, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan
| | - Yasuhiro Hamada
- Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School, Japan; Department of Nutrition, Tokushima University Hospital, Japan
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A Randomized, Double-Blind, Placebo Controlled Trial to Determine the Effectiveness a Polyphenolic Extract ( Hibiscus sabdariffa and Lippia citriodora) in the Reduction of Body Fat Mass in Healthy Subjects. Foods 2020; 9:foods9010055. [PMID: 31935957 PMCID: PMC7022485 DOI: 10.3390/foods9010055] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Revised: 12/23/2019] [Accepted: 12/27/2019] [Indexed: 12/16/2022] Open
Abstract
The location and quantity of body fat determine the health risks, limiting people with obesity. Recently, polyphenols have attracted the attention of the scientific community because of their potential use for the reduction of obesity. A proprietary formula comprised of a blend of Lippia citriodora and Hibiscus sabdariffa has been recognized for its high content of polyphenols, powerful antioxidant molecules that may prevent weight gain and could be helpful for the treatment of obesity, as proven previously by in vivo models. The aim of the present study is to determine if the supplementation with Lippia citriodora and Hibiscus sabdariffa is useful for the treatment of obesity and/or weight control in subjects without a controlled diet. The intake of the extract for 84 days reduced body weight, the body mass index, and the fat mass measured with both bioimpedance and densitometry. This decrease in fat mass was observed to a greater extent, being significant, in the fat mass of the trunk (chest and torso).
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Al-Kalaldeh M, Suleiman K, Al-Kalaldeh O. Prognostic Performance of NUTRIC Score in Quantifying Malnutrition Risk in the Critically Ill in Congruence With the Bioelectrical Impedance Analysis. Nutr Clin Pract 2019; 35:559-566. [PMID: 31713274 DOI: 10.1002/ncp.10440] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND There is still no concrete guidance for assessing malnutrition risk in the critically ill. Nutrition Risk in the Critically Ill (NUTRIC) score is undertaken cautiously compared with other validated tools such as bioelectrical impedance analysis (BIA). This study aimed to assess the malnutrition risk in the critically ill using NUTRIC score and assess its congruency with the BIA. METHODS In this cross-section observational study, intensive care unit (ICU) patients from various etiologies were assessed using the earlier tools in addition to other prognostic markers (Acute Physiologic Assessment and Chronic Health Evaluation II [APACHE II] and Sequential Organ Failure Assessment [SOFA] scores), caloric attainment, and feeding complications. RESULTS Of a total 411 assessed patients, 313 (76.2%) were enterally fed, and 318 (77.4%) were mechanically ventilated. Mean age was 60.7 years, and the median of the assessment since admission was the 12th day. Of those enterally fed patients, 57.9% attained the caloric requirements. Both APACHE II and SOFA scores were compatible in ascertaining ICU mortality at a moderate level (17.88 and 7.17, respectively). The NUTRIC score and phase angle (PA) measured by BIA revealed no differences in the malnutrition risk between patients with and without enteral nutrition. However, regression indicated that the NUTRIC score has explained only 1.1% of the variance of PA after controlling other covariates (β = -0.222, P = .009, confidence interval = -0.31 to -0.05). CONCLUSIONS NUTRIC score has a limited prediction to the urgency of aggressive nutrition therapy within the early period of ICU admission.
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Affiliation(s)
| | - Khaled Suleiman
- Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
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HOPANCI BIÇAKLI D, ÇEHRELİ R, ÖZVEREN A, MESERİ R, USLU R, UYAR M, KARABULUT B, AKÇİÇEK F. Evaluation of sarcopenia, sarcopenic obesity, and phase angle in geriatric gastrointestinal cancer patients: before and after chemotherapy. Turk J Med Sci 2019; 49:583-588. [PMID: 30997793 PMCID: PMC7018239 DOI: 10.3906/sag-1808-114] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Background/aim The purpose of this study was to determine sarcopenia, sarcopenic obesity and phase angle (PA) and the influence of chemotherapy (CT) on anthropometric measurements and and the PA in in geriatric patients with gastrointestinal (GI) cancer. Material and methods The anthropometric measurements, calf circumference (CC), upper midarm circumference (UMAC), and hand grip strength (HGS), have been measured to understand muscle function of 153 patients (mean age of 70.5 ± 5.6 years, 28.8% female, 71.2% male). Sarcopenia and PA measurements have been evaluated by bioelectrical impedance analyses. The same evaluations were checked again after 1 cycle of CT (min: 4, max: 6 weeks). Results Patient population consisted of colorectal (51,6%), gastric (26.8%), pancreas (11.8%), liver (7.2%), and biliary tract cancer (2%). UMAC (28.5 ± 4.4 before, 28.1 ± 4.9, P = 0.034 after CT), and HGS measurements (27.5 ± 8.6 before, 26.8 ± 8.8 after CT, P = 0.007) have significantly decreased after CT. CC measurement < 31 cm at first visit was seen in 13.1% of patients, but the ratio raised to 20.3% after CT (χ², P = 0.003). Severe sarcopenia was determined in 33% of all patients, and 30.0% of them have been considered as sarcopenic obese. Conclusion Sarcopenia and sarcopenic obesity were prevalent in this group patients. The CT caused a decrease in muscle functions, UMAC, and CC. Patients should be followed up carefully for sarcopenia, sarcopenic obesity, and nutritional aspect and it would be proper to intervene before sarcopenia has not occurred yet.
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Affiliation(s)
- Derya HOPANCI BIÇAKLI
- Department of Medical Oncology, School of Medicine, Ege University, İzmirTurkey
- * To whom correspondence should be addressed. E-mail:
| | - Rüksan ÇEHRELİ
- Department of Preventive Oncology, Institute of Oncology, 9 Eylül University, İzmirTurkey
| | - Ahmet ÖZVEREN
- Department of Medical Oncology, School of Medicine, Ege University, İzmirTurkey
| | - Reci MESERİ
- Department of Nutrition and Dietetics, School of Health, Ege University, İzmirTurkey
| | - Rüçhan USLU
- Department of Medical Oncology, School of Medicine, Ege University, İzmirTurkey
| | - Mehmet UYAR
- Department of Anesthesia and Critical Care, School of Medicine, Ege University, İzmirTurkey
| | - Bülent KARABULUT
- Department of Medical Oncology, School of Medicine, Ege University, İzmirTurkey
| | - Fehmi AKÇİÇEK
- Department of Geriatric, School of Medicine, Ege University, İzmirTurkey
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22
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Is phase angle an appropriate indicator of malnutrition in different disease states? A systematic review. Clin Nutr ESPEN 2018; 29:1-14. [PMID: 30661671 DOI: 10.1016/j.clnesp.2018.10.010] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 09/04/2018] [Accepted: 10/17/2018] [Indexed: 01/04/2023]
Abstract
BACKGROUND & AIMS Subjective Global Assessment (SGA) classifies malnutrition severity via a simple bedside assessment. Phase angle (PhA) is an indicator of cell integrity and has been suggested to be indicator of nutritional status. OBJECTIVE To explore the relationship between PhA and SGA. METHODS Relevant studies published through October 31, 2017 were identified using 7 electronic databases. Articles were included for review if they included comparison data between SGA and PhA within adult disease populations. Evidence quality was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines and methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. RESULTS 33 articles within four disease states (liver, hospitalization, oncology and renal) met inclusion criteria for review. Results were limited by restricting the database search to articles published in English only, and by the inherent difficulty of comparing 2 methods which are both influenced by the operator. CONCLUSION Based on GRADE guidelines, evidence quality received a grade of Low. Based on QUADAS-2, 61% of studies had high risk of bias in the index test (PhA), while all other domains had low risk. It is not possible to conclude that PhA is an accurate independent indicator of malnutrition. PROSPERO no. CRD42016050876.
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23
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Zamberlan P, Feferbaum R, Doria Filho U, Brunow de Carvalho W, Figueiredo Delgado A. Bioelectrical Impedance Phase Angle and Morbidity and Mortality in Critically Ill Children. Nutr Clin Pract 2018; 34:163-171. [DOI: 10.1002/ncp.10201] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Patrícia Zamberlan
- Division of Nutrition; Faculty of Medicine; Hospital das Clinicas Instituto da Crianca; University of São Paulo; São Paulo Brazil
| | - Rubens Feferbaum
- Division of Neonatology; Department of Pediatric; Faculty of Medicine; Hospital das Clinicas Instituto da Crianca; University of São Paulo; São Paulo Brazil
| | - Ulysses Doria Filho
- Department of Pediatric; Faculty of Medicine; Hospital das Clinicas Instituto da Crianca; University of São Paulo; São Paulo Brazil
| | | | - Artur Figueiredo Delgado
- Pediatric Intensive Care; Department of Pediatric; Faculty of Medicine; Hospital das Clinicas Instituto da Crianca; University of São Paulo; São Paulo Brazil
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24
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Ribeiro AS, Nascimento MA, Schoenfeld BJ, Nunes JP, Aguiar AF, Cavalcante EF, Silva AM, Sardinha LB, Fleck SJ, Cyrino ES. Effects of Single Set Resistance Training With Different Frequencies on a Cellular Health Indicator in Older Women. J Aging Phys Act 2018; 26:537-543. [PMID: 29182426 DOI: 10.1123/japa.2017-0258] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2023]
Abstract
The main purpose of this study was to compare the effects of resistance training (RT) performed two versus three times per week on phase angle (a cellular health indicator) in older women. A total of 39 women (69.1 ± 5.5 years) were randomly assigned to perform a RT program two (G2X) or three (G3X) days per week for 12 weeks. The RT was a whole-body program (eight exercises, one set, 10-15 repetitions). Phase angle, resistance, reactance, and total body water were assessed by bioimpedance spectroscopy. Intracellular water, reactance, and phase angle increased significantly in G2X (2.1%, 3.0%, and 5.6%, respectively) and G3X (5.0%, 6.9%, and 10.3%, respectively) from pretraining to posttraining, with no significant difference between groups. Bioimpedance resistance decreased similarly in both groups (G2X = -1.7% vs. G3X = -3.2%). We conclude that a single set RT program with a frequency of 2 days per week may be sufficient to promote an improvement in cellular health in older women.
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25
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Tomeleri CM, Ribeiro AS, Cavaglieri CR, Deminice R, Schoenfeld BJ, Schiavoni D, Dos Santos L, de Souza MF, Antunes M, Venturini D, Barbosa DS, Sardinha LB, Cyrino ES. Correlations between resistance training-induced changes on phase angle and biochemical markers in older women. Scand J Med Sci Sports 2018; 28:2173-2182. [PMID: 29858504 DOI: 10.1111/sms.13232] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/28/2018] [Indexed: 01/02/2023]
Abstract
The main purpose of this study was to investigate the effects of 12 weeks of resistance training (RT) on phase angle (PhA), inflammatory and oxidative stress biomarkers, and to evaluate whether these RT-induced adaptations are related to PhA changes. Fifty-one older women (70.6 ± 5.1 years; 26.9 ± 4.2 kg/m2 ) were randomly allocated into a training group (TG) that performed 12-week RT or a nonexercising control group (CG). The PhA (Xitron), body composition (DXA), and blood sample measurements (after a 12 hours fast) were performed before and after the intervention. The TG showed a significant (P < .05) increase in PhA (TG: +7.4±5.9% vs CG: -3.6 ± 8.8%), and interleukin-10 (IL-10; TG: +51.8 ± 71.1% vs CG: -46.6 ± 38.0%), and a decrease in tumor necrosis factor alpha (TNF-α; TG: -15.2 ± 11.1% vs CG: +6.9±17.7%), interleukin-6 (IL-6; TG: -17.9 ± 17.8% vs CG: +6.1 ± 24.8%), and C-reactive protein (CRP; TG: -24.1 ± 19.9% vs CG: +43.8 ± 31.1%). Moreover, TG upregulated catalase (TG: +11.4 ± 15.0% vs CG: -6.7 ± 10.2%). Changes in TNF-α (r = -.71), CRP (r = -.65), lower advanced oxidation protein products (r = -.55), and catalase (r = +.73) after RT were correlated with changes in PhA (P < .05). These results suggest that RT improves PhA, inflammatory and oxidative stress biomarkers, and the changes in inflammatory and oxidative damage markers are correlated with changes in PhA.
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Affiliation(s)
- C M Tomeleri
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil.,Exercise Physiology Laboratory, Faculty of Physical Education, University of Campinas-Unicamp, Campinas, Brazil
| | - A S Ribeiro
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil.,Center for Research in Health Sciences, University of Northern Parana, Londrina, Brazil
| | - C R Cavaglieri
- Exercise Physiology Laboratory, Faculty of Physical Education, University of Campinas-Unicamp, Campinas, Brazil
| | - R Deminice
- Department of Physical Education, Faculty of Physical Education and Sport, State University of Londrina, Londrina, PR, Brazil
| | - B J Schoenfeld
- Exercise Science Department, CUNY Lehman College, Bronx, New York
| | - D Schiavoni
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil
| | - L Dos Santos
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil
| | - M F de Souza
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil.,Department of Physical Education, Federal University of Vale do São Francisco, Petrolina, Brazil
| | - M Antunes
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil
| | - D Venturini
- Clinical Analyses Laboratory, Londrina State University, Londrina, Brazil
| | - D S Barbosa
- Clinical Analyses Laboratory, Londrina State University, Londrina, Brazil
| | - L B Sardinha
- Exercise and Health Laboratory, Faculdade Motricidade Humana, CIPER, Universidade de Lisboa, Lisbon, Portugal
| | - E S Cyrino
- Metabolism, Nutrition, and Exercise Laboratory, Londrina State University, Londrina, Brazil.,Department of Physical Education, Faculty of Physical Education and Sport, State University of Londrina, Londrina, PR, Brazil
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26
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Assessment of Nutritional Status of Critically Ill Patients Using the Malnutrition Universal Screening Tool and Phase Angle. TOP CLIN NUTR 2018. [DOI: 10.1097/tin.0000000000000136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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27
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Santana NDM, Pinho CPS, da Silva CP, Dos Santos NF, Mendes RML. Phase Angle as a Sarcopenia Marker in Hospitalized Elderly Patients. Nutr Clin Pract 2018; 33:232-237. [PMID: 29397040 DOI: 10.1002/ncp.10016] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 09/15/2017] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Phase angle (PhA) has been proposed as a parameter to predict clinical outcomes and mortality for various diseases. Several studies have considered it an important nutrition assessment tool. However, the usefulness of this parameter as a sarcopenia marker has not yet been evaluated. This study was developed to evaluate the performance of PhA as a sarcopenia marker in hospitalized elderly patients. MATERIALS AND METHODS This was a cross-sectional study involving elderly patients admitted to a hospital in northeastern Brazil. The PhA was obtained from resistance and reactance measurements by bioelectrical impedance. Sarcopenia was defined as a decrease in muscle mass associated with a reduced muscle strength or physical performance. RESULTS The sample consisted of 148 patients with a mean age of 71.6 (±7.6) years and a 62.8% prevalence of sarcopenia. The average PhA was 5.9 ± 2.0°, similar for men and women (5.9 ± 2.3 vs 5.9 ± 1.8; P = .946). In men, sarcopenic patients had a lower average PhA (5.6 ± 2.3°) when compared with patients without this condition (6.8 ± 1.9°; P = .024). When comparing the value of PhA regarding the degree of sarcopenia, it was found that patients from both sexes with severe sarcopenia had lower averages. The PhA had a low predictive capacity in relation to the diagnostic components of sarcopenia (physical performance, muscle mass, and strength). CONCLUSION PhA was an inaccurate marker to identify sarcopenia and presented low predictive capacity to explain muscle mass, muscle strength, and functional capacity, components involved in the diagnosis of sarcopenia.
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Galluzzo M, D'Adamio S, Pastorino R, Andreoli A, Servoli S, Bianchi L, Talamonti M. Effect of anti IL-12/23 on body composition: results of bioelectrical impedance analysis in Caucasian psoriatic patients. Expert Opin Biol Ther 2017; 18:229-235. [PMID: 29252034 DOI: 10.1080/14712598.2018.1419183] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Bioelectrical impedance analysis (BIA) is an inexpensive, non-invasive and fast method to assess body composition. Little is known of the interaction between anti IL 12/23 treatment and body composition. The aim of this study was to evaluate 6- and 12-month changes in body weight, Body Mass Index (BMI) and body composition assessed by BIA in psoriatic patients treated with anti-IL-12/23. RESEARCH DESIGN AND METHODS Demographic and clinical data were collected for each enrolled patient. Physical examination, anthropometric assessment, Psoriasis Area and Severity Index (PASI) assessment and body composition by BIA (single-frequency 50 kHz), were assessed at baseline and at 6 and 12 months of treatment. RESULTS A significant decrease in body weight, compared to baseline, in BMI, Fat Mass at month 6 and a significant increase at month 12 for body cellular mass (BCM) and Phase Angle (PhA) were observed. In addition, a significant increase was found for intracellular water. CONCLUSION At baseline, psoriatic patients showed a lower BCM and a lower mean PhA score. During ustekinumab treatment, the mean PhA and BCM scores increased with an improvement in psoriatic disease. Thus, ustekinumab can be an effective drug for improving not only psoriasis but also the general clinical status of patients.
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Affiliation(s)
- Marco Galluzzo
- a Department of Dermatology , University of Rome 'Tor Vergata ,' Rome , Italy
| | - Simone D'Adamio
- a Department of Dermatology , University of Rome 'Tor Vergata ,' Rome , Italy
| | - Roberta Pastorino
- b Section of Hygiene , Institute of Public Health, Catholic University of the Sacred Heart , Rome , Italy
| | - Angela Andreoli
- c Department of System Medicine, Human Physiology and Nutrition Unit , University of Rome 'Tor Vergata ,' Rome , Italy
| | - Stella Servoli
- a Department of Dermatology , University of Rome 'Tor Vergata ,' Rome , Italy
| | - Luca Bianchi
- a Department of Dermatology , University of Rome 'Tor Vergata ,' Rome , Italy
| | - Marina Talamonti
- a Department of Dermatology , University of Rome 'Tor Vergata ,' Rome , Italy
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29
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Schulz KH, Patra S, Spielmann H, Klapdor S, Schlüter K, van Eckert S. Physical condition, nutritional status, fatigue, and quality of life in oncological out-patients. SAGE Open Med 2017; 5:2050312117743674. [PMID: 29318010 PMCID: PMC5753892 DOI: 10.1177/2050312117743674] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Accepted: 10/29/2017] [Indexed: 12/22/2022] Open
Abstract
Objective: Early detection of limited physical activity and nutritional deficiencies in cancer survivors could contribute to early treatment and preservation of quality of life. The aim of this study is to describe the association of physical condition and nutritional status with fatigue and quality of life in oncological out-patients. Methods: Data in this descriptive study was collected on bioelectrical impedance analysis, postural stability (stability index), body mass index, Karnofsky Index, quality of life (Short-Form 36-Item Health Survey) and fatigue (multidimensional fatigue inventory-20) in a consecutive sample of 203 oncological out-patients. Phase angle was calculated from bioelectrical impedance analysis. Values were intercorrelated and compared to appropriate standard values. Results: Phase angle and stability index outcomes were far below the values of a healthy population of similar age (p < 0.001). Quality of life was significantly lower than in the normal population (p < 0.001), and the level of fatigue was significantly higher (p < 0.001). Phase angle correlated with Karnofsky Index (p = 0.002) and Short-Form 36-Item Health Survey Summary physical function (p < 0.001). Furthermore, multidimensional fatigue inventory-20 scales ‘physical fatigue’ and ‘reduced activity’ were significantly associated with phase angle (p = 0.04, p = 0.005). Stability indices correlated with Short-Form 36-Item Health Survey physical function. Conclusion: The physical condition and the nutritional status are key components determining the individual quality of life of oncological out-patients. These variables also showed an association with the manifestation of fatigue. Results highlight the need for interdisciplinary cooperation to detect physical, nutritional and psychological deficiencies in oncological out-patients.
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Affiliation(s)
- Karl-Heinz Schulz
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Universitäres Kompetenzzentrum für Sport- und Bewegungsmedizin (Athleticum), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Patra
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Universitäres Kompetenzzentrum für Sport- und Bewegungsmedizin (Athleticum), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | - Hannah Spielmann
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Universitäres Kompetenzzentrum für Sport- und Bewegungsmedizin (Athleticum), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany
| | | | - Kathrin Schlüter
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Universitäres Kompetenzzentrum für Sport- und Bewegungsmedizin (Athleticum), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Abteilung Medizinische Onkologie, Nationales Centrum für Tumorerkrankungen (NCT), Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - Sandra van Eckert
- Institut und Poliklinik für Medizinische Psychologie, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Universitäres Kompetenzzentrum für Sport- und Bewegungsmedizin (Athleticum), Universitätsklinikum Hamburg-Eppendorf, Hamburg, Germany.,Fakultät für Gesundheitswissenschaften, Technische Universität Brandenburg, Cottbus, Germany
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Abstract
Screening and assessment imply different processes, with the former indicating risk factors for a deprived nutrition condition and the latter providing the nutrition diagnosis. Both should be routinely performed at hospital admission according to recommended guidelines; however, this is not the reality worldwide, and undernutrition remains highly prevalent in the hospital setting. Therefore, the objective of the current review is to delve into the principles leading to nutrition status deficiencies and how they should be addressed by screening and assessment. A critical appraisal for the reasons associated with the misunderstanding between screening and assessing is proposed without further discussing the many available screening tools while approaching some of the assessment instruments.
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Affiliation(s)
- Maria Isabel Toulson Davisson Correia
- School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,Nutritional Therapy Team, Instituto Alfa de Gastroenterologia, Hospital das Clínicas-Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
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31
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Genetic variation in the promoter region of the TNF rs1800629 gene is not associated with adiposity index, but AA genotype is more likely to have low cellular membrane integrity. Meta Gene 2017. [DOI: 10.1016/j.mgene.2017.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
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32
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Body composition of Fanconi anemia patients after hematopoietic stem cell transplantation. Rev Bras Hematol Hemoter 2017; 39:318-324. [PMID: 29150103 PMCID: PMC5693275 DOI: 10.1016/j.bjhh.2017.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/26/2017] [Accepted: 06/09/2017] [Indexed: 12/22/2022] Open
Abstract
Introduction Fanconi anemia is a rare genetic disease linked to bone marrow failure; a possible treatment is hematopoietic stem cell transplantation. Changes in the nutritional status of Fanconi anemia patients are not very well known. This study aimed to characterize body composition of adult, children and adolescent patients with Fanconi anemia who were submitted to hematopoietic stem cell transplantation or not. Methods This cross-sectional study enrolled 63 patients (29 adults and 34 children and adolescents). Body composition was assessed based on diverse methods, including triceps skin fold, arm circumference, arm muscle area and bioelectrical impedance analysis, as there is no established consensus for this population. Body mass index was also considered as reference according to age. Results Almost half (48.3%) of the transplanted adult patients were underweight considering body mass index whereas eutrophic status was observed in 66.7% of the children and adolescents submitted to hematopoietic stem cell transplantation and in 80% of those who were not. At least 50% of all groups displayed muscle mass depletion. Half of the transplanted children and adolescents presented short/very short stature for age. Conclusion All patients presented low muscle stores, underweight was common in adults, and short stature was common in children and adolescents. More studies are needed to detect whether muscle mass loss measured at the early stages of treatment results in higher risk of mortality, considering the importance of muscle mass as an essential body component to prevent mortality related to infectious and non-infectious diseases and the malnutrition inherent to Fanconi anemia.
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Phase Angle Bioelectrical Impedance Analysis (BIA) as a Biomarker Tool for Liver Disease. BIOMARKERS IN DISEASE: METHODS, DISCOVERIES AND APPLICATIONS 2017. [DOI: 10.1007/978-94-007-7675-3_43] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Alves FD, Souza GC, Clausell N, Biolo A. Prognostic role of phase angle in hospitalized patients with acute decompensated heart failure. Clin Nutr 2016; 35:1530-1534. [DOI: 10.1016/j.clnu.2016.04.007] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 04/04/2016] [Accepted: 04/04/2016] [Indexed: 12/30/2022]
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Ringaitiene D, Gineityte D, Vicka V, Zvirblis T, Norkiene I, Sipylaite J, Irnius A, Ivaskevicius J. Malnutrition assessed by phase angle determines outcomes in low-risk cardiac surgery patients. Clin Nutr 2016; 35:1328-1332. [DOI: 10.1016/j.clnu.2016.02.010] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 01/30/2016] [Accepted: 02/13/2016] [Indexed: 01/10/2023]
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36
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Klek S, Forbes A, Gabe S, Holst M, Wanten G, Irtun Ø, Damink SO, Panisic-Sekeljic M, Pelaez RB, Pironi L, Blaser AR, Rasmussen HH, Schneider SM, Thibault R, Visschers RG, Shaffer J. Management of acute intestinal failure: A position paper from the European Society for Clinical Nutrition and Metabolism (ESPEN) Special Interest Group. Clin Nutr 2016; 35:1209-1218. [DOI: 10.1016/j.clnu.2016.04.009] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2015] [Revised: 03/31/2016] [Accepted: 04/06/2016] [Indexed: 01/22/2023]
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Małecka-Massalska T, Mlak R, Smoleń A, Brzozowska A, Surtel W, Morshed K. Capacitance of Membrane As a Prognostic Indicator of Survival in Head and Neck Cancer. PLoS One 2016; 11:e0165809. [PMID: 27802349 PMCID: PMC5089769 DOI: 10.1371/journal.pone.0165809] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Accepted: 10/18/2016] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Evaluation of prognostic value of capacitance of membrane (Cm), parameter measured by bioelectrical impedance (BIA) as an alternative to known clinical factors in patients with Head and Neck Cancer (HNC). METHODS A cohort of 75 stage IIIB and IV HNC patients treated in Department of Otolaryngology, Head and Neck Surgery, Medical University of Lublin, Poland were prospectively evaluated. Cm measurements were performed in all patients using a bioelectrical impedance analyzer that was set on a frequency of 50 kHz. Results of Cm measurements were presented in nF. Survival differences were estimated using Kaplan-Meier method. RESULTS Significantly higher Cm median was noted in well-nourished(n = 45) compared to malnourished (n = 30) patients (1.41 vs 1.01 respectively; p = 0.0009). Established in ROC curves analysis cut-off value (0.743) was characterized by 98% specificity and 37% sensitivity in the detection of malnutrition. Median overall survival (mOS) in the cohort was 32months. At the time of analysis deaths were recorded in 47 cases (62.7%). In patients who had Cm below the level of 0.743 risk of OS shortening was significantly higher than in other patients (12.1 and 43.4 months respectively; HR = 8.47, 95%CI: 2.91-24.66; χ2 = 15.38, p = 0.0001). CONCLUSION Cm is a strong, independent prognostic factor in head and neck cancer.
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Affiliation(s)
| | - Radosław Mlak
- Human Physiology Department, Medical University of Lublin, Lublin, Poland
| | - Agata Smoleń
- Department of Epidemiology and Methodology of Clinical Research, Medical University of Lublin, Lublin, Poland
| | - Anna Brzozowska
- Oncology Department, Medical University of Lublin, Lublin, Poland
| | - Wojciech Surtel
- Institute of Electronics and Information Technology, Technical University of Lublin, Lublin, Poland
| | - Kamal Morshed
- Department of Epidemiology and Methodology of Clinical Research, Medical University of Lublin, Lublin, Poland
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Władysiuk MS, Mlak R, Morshed K, Surtel W, Brzozowska A, Małecka-Massalska T. Bioelectrical impedance phase angle as a prognostic indicator of survival in head-and-neck cancer. ACTA ACUST UNITED AC 2016; 23:e481-e487. [PMID: 27803609 DOI: 10.3747/co.23.3181] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Phase angle could be an alternative to subjective global assessment for the assessment of nutrition status in patients with head-and-neck cancer. METHODS We prospectively evaluated a cohort of 75 stage iiib and iv head-and-neck patients treated at the Otolaryngology Department, Head and Neck Surgery, Medical University of Lublin, Poland. Bioelectrical impedance analysis was performed in all patients using an analyzer that operated at 50 kHz. The phase angle was calculated as reactance divided by resistance (Xc/R) and expressed in degrees. The Kaplan-Meier method was used to calculate survival. RESULTS Median overall survival in the cohort was 32.0 months. At the time of analysis, 47 deaths had been recorded in the cohort (62.7%). The risk of shortened overall survival was significantly higher in patients whose phase angle was less than 4.733 degrees than in the remaining patients (19.6 months vs. 45 months, p = 0.0489; chi-square: 3.88; hazard ratio: 1.8856; 95% confidence interval: 1.0031 to 3.5446). CONCLUSIONS Phase angle might be prognostic of survival in patients with advanced head-and-neck cancer. Further investigation in a larger population is required to confirm our results.
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Affiliation(s)
- M S Władysiuk
- HTA Consulting, Cracow, Medical University of Lublin, Lublin, Poland
| | - R Mlak
- Human Physiology Department, Medical University of Lublin, Lublin, Poland
| | - K Morshed
- Epidemiology Department, Medical University of Lublin, Poland
| | - W Surtel
- Electronics Department, Lublin University of Technology, Lublin, Poland
| | - A Brzozowska
- Oncology Department, Medical University of Lublin, Lublin, Poland
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Earthman CP. Body Composition Tools for Assessment of Adult Malnutrition at the Bedside: A Tutorial on Research Considerations and Clinical Applications. JPEN J Parenter Enteral Nutr 2016; 39:787-822. [PMID: 26287016 DOI: 10.1177/0148607115595227] [Citation(s) in RCA: 143] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Because of the key role played by the body's lean tissue reserves (of which skeletal muscle is a major component) in the response to injury and illness, its maintenance is of central importance to nutrition status. With the recent development of the Academy of Nutrition and Dietetics/American Society for Parenteral and Enteral Nutrition diagnostic framework for malnutrition, the loss of muscle mass has been recognized as one of the defining criteria. Objective methods to evaluate muscle loss in individuals with acute and chronic illness are needed. Bioimpedance and ultrasound techniques are currently the best options for the clinical setting; however, additional research is needed to investigate how best to optimize measurements and minimize error and to establish if these techniques (and which specific approaches) can uniquely contribute to the assessment of malnutrition, beyond more subjective evaluation methods. In this tutorial, key concepts and statistical methods used in the validation of bedside methods to assess lean tissue compartments are discussed. Body composition assessment methods that are most widely available for practice and research in the clinical setting are presented, and clinical cases are used to illustrate how the clinician might use bioimpedance and/or ultrasound as a tool to assess nutrition status at the bedside. Future research needs regarding malnutrition assessment are identified.
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Affiliation(s)
- Carrie P Earthman
- Department of Food Science and Nutrition, University of Minnesota-Twin Cities, St Paul, Minnesota
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Siddiqui NI, Khan SA, Shoeb M, Bose S. Anthropometric Predictors of Bio-Impedance Analysis (BIA) Phase Angle in Healthy Adults. J Clin Diagn Res 2016; 10:CC01-4. [PMID: 27504280 DOI: 10.7860/jcdr/2016/17229.7976] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2015] [Accepted: 02/04/2016] [Indexed: 02/03/2023]
Abstract
INTRODUCTION Phase Angle (PhA) is a ratio of whole body reactance and resistance obtained from Bioelectrical Impedance Analysis (BIA). It indicates cellular health and integrity and is considered as prognostic tool in medical disorders. In spite of prognostic potentials of PhA, it has limited usefulness in clinical practice and in population studies because of non-availability of normal population reference limits for comparison. Moreover, it is influenced by various factors like age, sex, race and body composition (i.e. body fat, muscle mass, visceral fat, body cell mass, total body water, etc). AIM The aim of this study was to evaluate predictors of phase angle which will be useful in formulation of reference values for Indian population. MATERIALS AND METHODS BIA was performed by Tanita Body Composition Analyser on healthy adults aged 17-24 years. The inbuilt software measured the phase angle by the formula: Phase angle (PhA) = Reactance (xc)/Resistance (R)* (180/π). Phase angle values were compared across categories of age, sex, weight, height, Body Mass Index (BMI), total fat, visceral fat and muscle mass. RESULTS Mean value of phase angle was found to be 5.65. Phase angle was significantly (p< 0.001) higher in male than in female. Phase angle was significantly predicted from height (p< 0.001), weight (p< 0.002), muscle mass (p< 0.002) and visceral fat (p< 0.02) in multiple regression models. CONCLUSION Phase angle differs across anthropometric and body composition categories. Thus height, weight and muscle mass should also be taken into consideration while deriving population specific reference limits of phase angle.
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Affiliation(s)
- Nazeem Ishrat Siddiqui
- Professor, Department of Physiology, Sri Aurobindo Medical College and Post Graduate Institute , Indore, Madhya Pradesh, India
| | - Sarfaraz Alam Khan
- Associate Professor, Department of Pharmacology, CIMS Bilaspur, Chhattisgarh, India
| | - Mohammad Shoeb
- Assistant Professor, Department of Biotechnology, SSMV , Bhilai, Chhattisgarh, India
| | - Sukhwant Bose
- Director Professor, Department of Physiology and Director Medical Education, Sri Aurobindo Medical College and Post Graduate Institute , Indore, Madhya Pradesh, India
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Pileggi VN, Scalize ARH, Camelo Junior JS. Phase angle and World Health Organization criteria for the assessment of nutritional status in children with osteogenesis imperfecta. REVISTA PAULISTA DE PEDIATRIA 2016; 34:484-488. [PMID: 27102998 DOI: 10.1016/j.rpped.2016.02.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2015] [Revised: 02/15/2016] [Accepted: 02/28/2016] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To compare the phase angle of patients with osteogenesis imperfecta treated at a tertiary university hospital with patients in a control group of healthy children, and to assess the nutritional status of these patients through the body mass index proposed by the World Health Organization. METHODS Cross-sectional study carried out in a university hospital that included seven patients with osteogenesis imperfecta and a control group of 17 healthy children of the same gender and age. Weight and height were measured and bioelectrical impedance was performed. Subsequently, the phase angle was calculated based on resistance and reactance values. RESULTS The phase angle of the group of children with osteogenesis imperfecta was significantly lower than that of the control group (p<0.05). The body mass index criterion for age of the World Health Organization showed no difference between groups. CONCLUSIONS Children with osteogenesis imperfecta have a nutritional risk detected by the phase angle, which is a useful tool for nutritional screening. The calculation result could help in the diet therapy of patients with osteogenesis imperfecta.
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Affiliation(s)
- Vicky Nogueira Pileggi
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brasil
| | | | - José Simon Camelo Junior
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (FMRP-USP), Ribeirão Preto, SP, Brasil.
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Gonzalez MC, Barbosa-Silva TG, Bielemann RM, Gallagher D, Heymsfield SB. Phase angle and its determinants in healthy subjects: influence of body composition. Am J Clin Nutr 2016; 103:712-6. [PMID: 26843156 PMCID: PMC6546229 DOI: 10.3945/ajcn.115.116772] [Citation(s) in RCA: 206] [Impact Index Per Article: 25.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2015] [Accepted: 11/16/2015] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The phase angle (PA) has been used as a prognostic marker in several clinical situations. Nevertheless, its biological meaning is not completely understood. OBJECTIVE We verified how body-composition components could explain the PA. DESIGN The trial was a cross-sectional study involving 1442 participants (women: 58.5%; Caucasian: 40.2%) from body-composition studies. Labeled tritium dilution and total-body potassium were used to estimate total-body water (TBW) and intracellular water (ICW), respectively. Extracellular water (ECW) and the ECW:ICW ratio were estimated from the difference and the ratio of these values. Fat-free mass (FFM) and fat mass (FM) were estimated with the use of dual-energy X-ray absorptiometry, underwater weighing (UWW), and TBW. The PA was estimated with the use of a single-frequency bioelectrical impedance analysis system. Correlations between the PA and all body-composition variables were evaluated. A multivariate linear regression analysis was performed to adjust for the effects of body-composition variables on the PA variability. All analyses were performed separately by sex. RESULTS Compared with men, women exhibited significantly larger ECW:ICW ratios and FM. The highest positive correlation was shown between the PA and FFM obtained with the use of UWW (both sexes). The highest negative correlation was shown between the PA and ECW:ICW ratios for both sexes. Age, race, height, ECW:ICW, and FFM from UWW were significant PA determinants in a multivariate linear regression model. Even after adjustment for all significant covariates, the explained PA variance was low (adjusted R(2) = 0.539 and 0.421 in men and women, respectively). The greatest impact on the total PA prediction in both men and women were age, FFM, and height. CONCLUSIONS Age is the most significant PA predictor in men and women followed by FFM and height. The ECW:ICW contribution may explain the association of the PA observed in the clinical setting and in people who are obese.
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Affiliation(s)
- Maria Cristina Gonzalez
- Post-graduation Program on Health and Behavior, Catholic University of Pelotas, Pelotas, Brazil;
| | | | - Renata M Bielemann
- Post-graduation Program in Epidemiology, Federal University of Pelotas, Pelotas, Brazil
| | - Dympna Gallagher
- The New York Obesity Nutrition Research Center, St. Luke's-Roosevelt Hospital Center, College of Physicians and Surgeons, Columbia University, New York, NY; and
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Moreno MV, Ribbe E, Coux MN, Chauvet P, Dissa A, Ly O. Nouvel outil de détection de la dénutrition chez l’enfant. NUTR CLIN METAB 2016. [DOI: 10.1016/j.nupar.2016.01.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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de França NA, Callegari A, Gondo FF, Corrente JE, Mclellan KC, Burini RC, de Oliveira EP. Higher dietary quality and muscle mass decrease the odds of low phase angle in bioelectrical impedance analysis in Brazilian individuals. Nutr Diet 2016. [DOI: 10.1111/1747-0080.12267] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Natasha A.G. de França
- Centre for Exercise Metabolism and Nutrition (CeMENutri), Department of Public Health; Botucatu School of Medicine (UNESP); Botucatu, Sao Paulo State Brazil
- Department of Nutrition; School of Public Health, Sao Paulo University; Sao Paulo, Sao Paulo State Brazil
| | - Aliucha Callegari
- Centre for Exercise Metabolism and Nutrition (CeMENutri), Department of Public Health; Botucatu School of Medicine (UNESP); Botucatu, Sao Paulo State Brazil
| | - Fernanda F. Gondo
- Centre for Exercise Metabolism and Nutrition (CeMENutri), Department of Public Health; Botucatu School of Medicine (UNESP); Botucatu, Sao Paulo State Brazil
| | - José E. Corrente
- Department of Bioestatistic; Bioscience Institute (UNESP); Botucatu, Sao Paulo State Brazil
| | - Kátia C.P. Mclellan
- Centre for Exercise Metabolism and Nutrition (CeMENutri), Department of Public Health; Botucatu School of Medicine (UNESP); Botucatu, Sao Paulo State Brazil
| | - Roberto C. Burini
- Centre for Exercise Metabolism and Nutrition (CeMENutri), Department of Public Health; Botucatu School of Medicine (UNESP); Botucatu, Sao Paulo State Brazil
| | - Erick P. de Oliveira
- Centre for Exercise Metabolism and Nutrition (CeMENutri), Department of Public Health; Botucatu School of Medicine (UNESP); Botucatu, Sao Paulo State Brazil
- School of Medicine; Federal University of Uberlandia; Uberlandia, Minas Gerais State Brazil
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Pileggi VN, Monteiro JP, Margutti AVB, Camelo JS. Prevalence of child malnutrition at a university hospital using the World Health Organization criteria and bioelectrical impedance data. Braz J Med Biol Res 2016; 49:S0100-879X2016000300705. [PMID: 26840712 PMCID: PMC4763819 DOI: 10.1590/1414-431x20155012] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2015] [Accepted: 09/14/2015] [Indexed: 11/26/2022] Open
Abstract
Malnutrition constitutes a major public health concern worldwide and serves as an
indicator of hospitalized patients’ prognosis. Although various methods with which to
conduct nutritional assessments exist, large hospitals seldom employ them to diagnose
malnutrition. The aim of this study was to understand the prevalence of child
malnutrition at the University Hospital of the Ribeirão Preto Medical School,
University of São, Brazil. A cross-sectional descriptive study was conducted to
compare the nutritional status of 292 hospitalized children with that of a healthy
control group (n=234). Information regarding patients’ weight, height, and
bioelectrical impedance (i.e., bioelectrical impedance vector analysis) was obtained,
and the phase angle was calculated. Using the World Health Organization (WHO)
criteria, 35.27% of the patients presented with malnutrition; specifically, 16.10%
had undernutrition and 19.17% were overweight. Classification according to the
bioelectrical impedance results of nutritional status was more sensitive than the WHO
criteria: of the 55.45% of patients with malnutrition, 51.25% exhibited
undernutrition and 4.20% were overweight. After applying the WHO criteria in the
unpaired control group (n=234), we observed that 100.00% of the subjects were
eutrophic; however, 23.34% of the controls were malnourished according to impedance
analysis. The phase angle was significantly lower in the hospitalized group than in
the control group (P<0.05). Therefore, this study suggests that a protocol to
obtain patients’ weight and height must be followed, and bioimpedance data must be
examined upon hospital admission of all children.
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Affiliation(s)
- V N Pileggi
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - J P Monteiro
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - A V B Margutti
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
| | - J S Camelo
- Departamento de Puericultura e Pediatria, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brasil
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Marroni CA, Miranda D, Boemeke L, Fernandes SA. Phase Angle Bioelectrical Impedance Analysis (BIA) as a Biomarker Tool for Liver Disease. BIOMARKERS IN DISEASE: METHODS, DISCOVERIES AND APPLICATIONS 2016:1-18. [DOI: 10.1007/978-94-007-7742-2_43-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/06/2023]
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Lopes MMGD, de Brito NJN, de Medeiros Rocha ÉD, França MC, de Almeida MDG, Brandão-Neto J. Nutritional assessment methods for zinc supplementation in prepubertal non-zinc-deficient children. Food Nutr Res 2015; 59:29733. [PMID: 26507491 PMCID: PMC4623288 DOI: 10.3402/fnr.v59.29733] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2015] [Revised: 10/01/2015] [Accepted: 10/01/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Zinc is an essential nutrient that is required for numerous metabolic functions, and zinc deficiency results in growth retardation, cell-mediated immune dysfunction, and cognitive impairment. OBJECTIVE This study evaluated nutritional assessment methods for zinc supplementation in prepubertal non-zinc-deficient children. DESIGN We performed a randomised, controlled, triple-blind study. The children were divided into a control group (10% sorbitol, n=31) and an experimental group (10 mg Zn/day, n=31) for 3 months. Anthropometric and dietary assessments as well as bioelectrical measurements were performed in all children. RESULTS Our study showed (1) an increased body mass index for age and an increased phase angle in the experimental group; (2) a positive correlation between nutritional assessment parameters in both groups; (3) increased soft tissue, and mainly fat-free mass, in the body composition of the experimental group, as determined using bioelectrical impedance vector analysis; (4) increased consumption of all nutrients, including zinc, in the experimental group; and (5) an increased serum zinc concentration in both groups (p<0.0001). CONCLUSIONS Given that a reference for body composition analysis does not exist for intervention studies, longitudinal studies are needed to investigate vector migration during zinc supplementation. These results reinforce the importance of employing multiple techniques to assess the nutritional status of populations.
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Affiliation(s)
| | | | | | | | | | - José Brandão-Neto
- Department of Internal Medicine, Federal University of Rio Grande do Norte, Natal, Brazil;
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Waitzberg DL, Correia MI. Strategies for High-Quality Nutrition Therapy in Brazil. JPEN J Parenter Enteral Nutr 2015; 40:73-82. [DOI: 10.1177/0148607115596159] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 06/11/2015] [Indexed: 12/20/2022]
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49
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Małecka-Massalska T, Mlak R, Smolen A, Morshed K. Bioelectrical impedance phase angle and subjective global assessment in detecting malnutrition among newly diagnosed head and neck cancer patients. Eur Arch Otorhinolaryngol 2015; 273:1299-305. [DOI: 10.1007/s00405-015-3626-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2015] [Accepted: 04/05/2015] [Indexed: 10/23/2022]
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Soares V, Avelar ISD, Andrade SRDS, Vieira MF, Silva MS. Body composition of chronic renal patients: anthropometry and bioimpedance vector analysis. Rev Lat Am Enfermagem 2015; 21:1240-7. [PMID: 24402340 DOI: 10.1590/0104-1169.3060.2360] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Accepted: 08/21/2013] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE to compare the body composition of patients undergoing hemodialysis with that of healthy individuals using different methods. METHOD cross-sectional study assessing male individuals using anthropometric markers, electrical bioimpedance and vector analysis. RESULTS the healthy individuals presented larger triceps skinfold and arm circumference (p<0.001). The bioimpedance variables also presented significant higher values in this group. Significant difference was found in the confidence interval of the vector analysis performed for both the patients and healthy individuals (p<0.0001). The tolerance intervals showed that 55.20% of the patients were dehydrated, 10.30% presented visible edema, and 34.50% were within normal levels of hydration. Bioimpedance and vector analysis revealed that 52% of the patients presented decreased cell mass while 14.00% presented increased cell mass. CONCLUSIONS the differences in the body composition of patients and healthy individuals were revealed through bioimpedance and vector analysis but not through their measures of arm circumference and arm muscle area.
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Affiliation(s)
- Viviane Soares
- Faculdade de Medicina, Universidade Federal de Goiás, GoiâniaGO, Brazil
| | | | | | - Marcus Fraga Vieira
- Faculdade de Educação Física, Universidade Federal de Goiás, GoiâniaGO, Brazil
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