Association between phase angle and height-to-age index classifications of children under five years of age

Macêna, Mateus de Lima; Júnior, André Eduardo da Silva; Praxedes, Dafiny Rodrigues Silva; Leite, Fernanda Maria de B.; Neto, Luiz Gonzaga Ribeiro Silva; Pureza, Isabele Rejane de Oliveira Maranhão; Florêncio, Telma Maria de Menezes Toledo; Bueno, Nassib Bezerra

doi:10.1016/j.clnesp.2021.05.013

Cited by 3 publications

(4 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…We observed this trend in studies comparing patients with SAM to HC, where the observed mean PhA in the SAM group was lower (2.1°-2.8°) compared with HC (3.8°-4.3°) ( 32 , 34 , 36 ). However, these values are different from that reported by Macena et al ( 38 ), who observed no differences in PhA between the population with chronic malnutrition (HAZ <2) or risk of chronic malnutrition (HAZ <-1 and > −2) and those with adequate HAZ. This phenomenon can be explained by the fact that in chronic malnutrition, there could be an adaptive response to energy restriction that, when there are periods of energy availability, could favor fat storage to the detriment of its use ( 53 ).…”

Section: Discussioncontrasting

confidence: 99%

“…When stratifying the SAM group, the mean ± SD PhA was 2.8° ± 1.2° for the non-edematous group and 2.3° ± 1.0° for the edematous group. Macena et al ( 38 ) evaluated children at risk or in chronic malnutrition (3 ± 0.78 years old) based on HAZ and stratified as: adequate (HAZ >-1), risk of stunting (HAZ <−1 and >-2), or stunted = (HAZ <2). The overall mean ± SD PhA was 4.4° ± 0.6°, and there was no significant difference between the adequate HAZ group (PhA = 4.2° ± 0.7°) and the at-risk HAZ (PhA = 4.5° ± 0.7°) and stunted HAZ (PhA° = 4.4 ± 0.6°) groups ( p = 0.19).…”

Section: Resultsmentioning

confidence: 99%

“…In children with SAM, Bourdon et al ( 34 ) found that 45.9% had severe wasting and 54% had edematous SAM. Macena et al ( 38 ) reported that in a population with risk of malnutrition, 37% had stunting and 38% had a risk of stunting. Nagano et al ( 39 ) included malnourished patients and reported that according to the percentage of ideal body weight (%IBW), 70% of the children had mild malnutrition and 30% had moderate malnutrition; according to the percentage of arm muscle circumference (%AMC), 10% had severe malnutrition, 20% had moderate malnutrition, and 70% had mild malnutrition.…”

Section: Resultsmentioning

confidence: 99%

“…Among the included studies, nine reported results from the supine position, and three reported results from the lying position, the horizontal position, and the lying in the supine position; however, in three of them, the position of measurement was not reported ( 24 , 33 , 44 ). Of the 15 studies we included, six studies reported the formula they used to calculate PhA ( 21 , 28 , 30 , 36 , 38 , 39 ). Four of the studies did not report the formula ( 20 , 27 , 33 , 43 ), but they used the same bioimpedance model reported by Małecka-Massalska et al ( 48 ), who presented the formula in a Supplementary Table .…”

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

Association between phase angle and the nutritional status in pediatric populations: a systematic review

Franco-Oliva,

Ávila-Nava,

Rodríguez-Aguilar

et al. 2023

Front. Nutr.

View full text Add to dashboard Cite

Background and aimsMalnutrition is prevalent in pediatric populations with any disease, and it is also related to changes in body composition. In addition, recent studies have documented relationships between these changes and phase angle (PhA), an important parameter of functional nutritional assessment. PhA could be a new marker of nutritional status. Many studies have generated information about the association between PhA and malnutrition in various pathologies, although the vast majority of this information is from adult populations. In this systematic review, we answered the following question: What is the association between PhA and the nutritional status in pediatric populations?MethodsWe performed a systematic search of the Medline/PubMed and Latin American and Caribbean Health Sciences Literature databases (LILACS) databases for studies published up to October 2022. The inclusion criteria were pediatric subjects, which reported the relationship between PhA and the nutritional status with any objective nutritional indicator, and PhA was measured by electric impedance and reported at 50 kHz. We synthesized data from the studies that reported cutoff analysis of PhA with receiver operating characteristic (ROC) curves, mean PhA values presented by nutritional status strata, and correlations between PhA and nutritional status indicators. We assessed the risk of bias by using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies and the Quality Assessment for Diagnostic Accuracy Studies.ResultsOf the 126 studies we identified, 15 met the inclusion criteria. The included studies reported the association between PhA and objective indicators of nutritional status, including weight-for-age z-score (WAZ) <-1 standard deviation (SD) for malnutrition, height-for-age z-score (HAZ) for malnutrition-stunting, body mass index (BMI) for the starvation state, body mass index z-score (BMIz) and BMI for malnutrition, mid-upper arm circumference (MUAC) <11 cm for severe acute malnutrition (SAM), and fat-free mass index z-score (FFMIz) <-2 z-score for moderate malnutrition, among others. The report of these associations between PhA and nutritional status was based on cutoff points generated with ROC curve analysis or comparison of mean PhA values, which were reported stratified by the presence or absence of malnutrition, and correlations between PhA and anthropometric indicators for the evaluation of the nutritional status in the pediatric population. It was difficult to compare the studies due to the heterogeneity of the bioelectrical impedance analysis models used, how PhA was reported (standardized, percentiles, or degrees), and the anthropometric indicators used to diagnose malnutrition.ConclusionThe early identification of malnutrition is relevant to establish the correct nutritional treatment; PhA appears to be a sensitive indicator of nutritional status and is easy to obtain. Although the results of this review are inadequate to establish PhA cutoff points associated with malnutrition in pediatric populations, in most of the studies, there was an association between PhA and objective indicators of nutritional status.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42022362413, identifier: PROSPERO 2022 CRD42022362413.

show abstract

Section: Discussioncontrasting

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Association between phase angle and the nutritional status in pediatric populations: a systematic review

Franco-Oliva,

Ávila-Nava,

Rodríguez-Aguilar

et al. 2023

Front. Nutr.

View full text Add to dashboard Cite

show abstract

Associations of bioelectrical impedance and anthropometric variables among populations and within the full spectrum of malnutrition

Marini,

Stagi,

Cabras

et al. 2024

Nutrition

View full text Add to dashboard Cite

Bioelectrical impedance phase angle and the mortality in critically ill children

Yang,

Zhang,

Liu

et al. 2024

Front. Nutr.

View full text Add to dashboard Cite

BackgroundPhase angle (PhA) is a variable obtained from bioelectrical impedance analysis (BIA). It is highly sensitive and specific and is commonly used in clinical nutrition assessment. Recently, PhA has shown promise in predicting clinical outcomes, especially as a new indicator of mortality, but its use in pediatric research is limited. This study aims to investigate the association between PhA measured at admission using BIA and PICU length of stay (LOS) and 60-day mortality in critically ill children and adolescents.MethodsA consecutive series of pediatric patients in the PICU underwent BIA measurements within 72 h of admission. All patients met the inclusion and exclusion criteria. Patient demographics, anthropometric measurements, pediatric index of mortality 2 score (PIM-2), and laboratory exams were recorded. Kaplan–Meier (K–M) survival curves were constructed based on the critical PhA value to assess differences in survival status within the 60-day window. Multivariate cox regression model was employed to illustrate the relationship between PhA and 60-day mortality rates. The Youden’s index method was used to identify the critical cut-off value for PhA in relation to mortality rates. ROC curves provided the area under the curve (AUC) and a 95% confidence interval (CI).ResultsA total of 205 pediatric patients (118 boys) were included, with a mean age of 9.2 years (±6.0). Survival curves indicated a cutoff value of 3.1°, with higher survival in patients with PhA ≥3.1° compared to those with PhA <3.1° (F = 10.51, p < 0.0001). The area under the ROC curve was 0.70, with a sensitivity of 0.65 and specificity of 0.72. Total hospital LOS was longer in the PhA <3.1° group compared to the PhA ≥3.1° group (p = 0.000). The PhA <3.1° group had a longer PICU LOS (adjusted for age and sex, HR 1.871, p = 0.000, log-rank test, p = 0.000). PhA and PIM-2 were two independently significant correlated variables (p < 0.05) for the 60-day mortality rate in this study.ConclusionLow PhA in patients is associated with longer PICU LOS and an increased risk of PICU patient mortality. PhA not only serves as an indicator for monitoring pediatric nutrition but also as a prognostic indicator for PICU patients.

show abstract

Association between phase angle and height-to-age index classifications of children under five years of age

Cited by 3 publications

References 22 publications

Association between phase angle and the nutritional status in pediatric populations: a systematic review

Association between phase angle and the nutritional status in pediatric populations: a systematic review

Associations of bioelectrical impedance and anthropometric variables among populations and within the full spectrum of malnutrition

Bioelectrical impedance phase angle and the mortality in critically ill children

Contact Info

Product

Resources

About