Association between phase angle of bioelectrical impedance analysis and nutritional parameters in older adults
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Abstract
Introduction: Phase angle (PhA) is a Bioelectrical impedance analysis (BIA) parameter representing an indicator of cellular health and has been suggested as a biomarker of nutritional status. Objective: To evaluate the association between PhA and nutritional parameters in older adults. Methods: A cross-sectional study was conducted with community-dwelling older adults. Body mass index (BMI), arm muscle circumference (AMC), calf circumference (CC), body fat percentage (BF%), appendicular skeletal muscle mass (ASMM), serum albumin, mini-nutritional assessment (MNA), and PhA were assessed. Kolmogorov–Smirnov test, Spearman's correlation coefficient, chi-square test, and Poisson regression models were performed. Results: 144 participants were included in the study, and most of them were female, aged ≥80 years, and underweight. Most older adults with lower PhA were women, aged range 80–89 years, and with reduced ASMM (p<0.05). PhA presented a significant correlation with age (r=–0.417; p<0.001), ASMM (r=0.427; p<0.001), AMC (r=0.195; p=0.019) and BF% (r=–0.223; p=0.007). Older adults with lower PhA present reduced ASMM (PR: 1.25; 95%CI: 1.04–1.50), and hypoalbuminemia (PR: 1.50; 95%CI: 1.11–2.03). Conclusion: PhA is related to commonly nutritional indicators used in clinical practice and could be an important biomarker of muscle mass reserves in community-living older adults of both sexes.
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Tomeleri CM, Cavalcante EF, Antunes M, Nabuco HCG, Souza MF, Teixeira DC, et al. Phase Angle Is Moderately Associated With Muscle Quality and Functional Capacity, Independent of Age and Body Composition in Older Women. J Geriatr Phys Ther. 2019;42(4):281-6. https://doi.org/10.1519/JPT.0000000000000161
Kubo Y, Noritake K, Nakashima D, Fujii K, Yamada K. Relationship between nutritional status and phase angle as a noninvasive method to predict malnutrition by sex in older inpatients. Nagoya J Med Sci. 2021;83(1):31-40. https://doi.org/10.18999/nagjms.83.1.31
Kołodziej M, Ignasiak Z. Changes in the bioelectrical impedance parameters estimating appendicular skeletal muscle mass in healthy older persons. Aging Clin Exp Res. 2020;32(10):1939-45. https://doi.org/10.1007/s40520-019-01413-1
Lukaski HC, Kyle UG, Kondrup J. Assessment of adult malnutrition and prognosis with bioelectrical impedance analysis. Curr Opin Clin Nutr Metab Care. 2017;20(5):330-9. https://doi.org/10.1097/MCO.0000000000000387
Santana NM, Pinho CPS, Silva CP, Santos NF, Mendes RML. Phase Angle as a Sarcopenia Marker in Hospitalized Elderly Patients. Nutr Clin Pract. 2018;33(2):232-7. https://doi.org/10.1002/ncp.10016
Kilic MK, Kizilarslanoglu MC, Arik G, Bolayir B, Kara O, Dogan Varan H, et al. Association of Bioelectrical Impedance Analysis-Derived Phase Angle and Sarcopenia in Older Adults. Nutr Clin Pract. 2017;32(1):1039. http://doi.org/10.1177/0884533616664503
Marino LV, Ramos LFAO, Chiarello PG. Nutritional status according to the stages of Alzheimer’s disease. Aging Clin Exp Res. 2015;27(4):507-13. http://doi.org/10.1007/s40520-014-0302-3
Kyle UG, Genton L, Pichard C. Low phase angle determined by bioelectrical impedance analysis is associated with malnutrition and nutritional risk at hospital admission. Clin Nutr. 2013;32(2):294-9. http://dx.doi.org/10.1016/j.clnu.2012.08.001
Lohman TG, Roche AF, Martorell R. Anthropometric standardization reference manual. Human Kinetics Books. Champaign: Human Kinetics Books, 1988.
Organização Pan-Americana da Saúde (OPAS). Organização Mundial da Saúde (OMS). Relatório do Comitê Assessor de Pesquisas em Saúde. Washington: OPAS/OMS, 2001.
Frisancho AR. New norms of upper limb fat and muscle areas for assessment of nutritional status. Am J Clin Nutr. 1981;34(11):2540-5. https://doi.org/10.1093/ajcn/34.11.2540
Kuczmarski MF, Kuczmarski RJ, Najjar M. Descriptive anthropometric reference data for older Americans. J Am Diet Assoc. 2000;100(1):59-66. https://doi.org/10.1016/S0002-8223(00)00021–3
Barbosa-Silva TG, Bielemann RM, Gonzalez MC, Menezes AMB. Prevalence of sarcopenia among community-dwelling elderly of a medium-sized South American city: results of the COMO VAI ? study. J Cachexia Sarcopenia Muscle. 2016;7(2):136-43. https://doi.org/10.1002/jcsm.12049
Guigoz Y. The Mini-Nutritional Assessment (MNA) review of the literature -What does it tell us? J Nutr Health Aging. 2006;10(6):466-85.
Alcock NW. Pruebas de laboratorio para valorar el estado nutricional. In: Shils M, Olson J, Shike M, Ross C. Nutrición en Salud y Enfermedad. México: McGraw Hill Interamericana, 2002; p. 1057-71.
Kyle UG, Bosaeus I, De Lorenzo AD, Deurenberg P, Elia M, Gómez JM, et al. Bioelectrical impedance analysis-part II: utilization in clinical practice. Clin Nutr. 2004;23(6):1430-53. https://doi.org/10.1016/j.clnu.2004.09.012
Morais KBD, Franco FS, Lucas CG, Montini TA, Martins MV, Tinoco ALA. Correlação entre índices antropométricos e ângulo de fase de mulheres idosas. Rev Digital. 2012;17(175).
Barbosa-Silva MCG, Barros AJD. Bioelectrical impedance analysis in clinical practice: A new perspective on its use beyond body composition equations. Curr Opin Clin Nutr Metab Care. 2005;8(3):311-7. http://doi.org/10.1097/01.mco.0000165011.69943.39
Gonzalez MC, Orlandi SP, Santos LP, Barros AJD. Body composition using bioelectrical impedance: Development and validation of a predictive equation for fat-free mass in a middle-income country. Clin Nutr. 2019;38(5):2175-9. https://doi.org/10.1016/j.clnu.2018.09.012
Morrow Junior JR. Medida e avaliação do desempenho humano. 2nd ed. Porto Alegre: Artmed, 2003.
Sergi G, De Rui M, Veronese N, Bolzetta F, Berton L, Carraro S, et al. Assessing appendicular skeletal muscle mass with bioelectrical impedance analysis in free-living Caucasian older adults. Clin Nutr. 2015;34(4):667-73. http://dx.doi.org/10.1016/j.clnu.2014.07.010
Studenski SA, Peters KW, Alley DE, Cawthon PM, McLean RR, Harris TB, et al. The FNIH sarcopenia project: Rationale, study description, conference recommendations, and final estimates. J Gerontol A Biol Sci Med Sci. 2014;69(5):547-58. http://doi.org/10.1093/gerona/glu010
Scheunemann L, Wazlawik E, Bastos JL, Cardinal TR, Nakazora LM. Concordancia y asociación entre el ángulo de fase y los parámetros de evaluación del estado nutricional en pacientes quirúrgicos. Nutr Hosp. 2011;26(3):480-7.
Varan HD, Bolayir B, Kara O, Arik G, Kizilarslanoglu MC, Kilic MK, et al. Phase angle assessment by bioelectrical impedance analysis and its predictive value for malnutrition risk in hospitalized geriatric patients. Aging Clin Exp Res. 2016;28(6):1121-6. http://doi.org/10.1007/s40520-015-0528-8
Yamada M, Kimura Y, Ishiyama D, Nishio N, Otobe Y, Tanaka T, et al. Phase Angle is a Useful indicator for Muscle Function in Older Adults. J Nutr Heal Aging. 2019;23(3):251-5. http://doi.org/10.1007/s12603-018-1151-0
Reljic D, Zarafat D, Jensen B, Herrmann HJ, Neurath MF, Konturek PC, et al. Phase angle and vector analysis from multifrequency segmental bioelectrical impedance analysis: new reference data for older adults. J Physiol Pharmacol. 2020;71(4). http://doi.org/10.26402/jpp.2020.4.04
Basile C, Della-Morte D, Cacciatore F, Gargiulo G, Galizia G, Roselli M, et al. Phase angle as a bioelectrical marker to identify elderly patients at risk of sarcopenia. Exp Gerontol. 2014;58:43-6. http://dx.doi.org/10.1016/j.exger.2014.07.009
Lukaski HC, Kyle UG, Kondrup J. Assessment of adult malnutrition and prognosis with bioelectrical impedance analysis: Phase angle and impedance ratio. Curr Opin Clin Nutr Metab Care. 2017;20(5):330-9. http://doi.org/10.1097/MCO.0000000000000387