Bioelectrical Impedance Analysis (BIA)- Derived Phase Angle in Children and Adolescents: A Systematic Review

Abstract

Phase angle (PhA), a directly-measured bioelectrical impedance analysis variable, is suggested to be a proxy of body cell mass as well as extracellular/intracellular water ratio, and is related to cellular integrity and functions. The aim of this systematic review was to evaluate PhA in healthy youths in relation to sex, age, weight status, physical fitness, and sports activities. A systematic literature search (preferred reporting items for systematic reviews and meta-analyses criteria) until January 2022 was performed using PubMed, Embase, Scopus, and Web of Science regarding studies on PhA in healthy children and adolescents 4–18 years of age. Quality was assessed according to the National Institute of Health. After removing duplicates and studies not fulfilling the inclusion criteria, 22 cross-sectional and 1 longitudinal were considered appropriate. As for quality, 14 articles were rated fair and 9 good. Ten studies found that PhA increases with age: the increase was more marked after puberty, whereas changes in younger subjects are by far less defined. A clear sex difference was found in adolescents, likely due to pubertal development. Limited evidence suggests that PhA increases in participants with very high BMI. Limited data were reported on physically active youths without convincing findings. Positive associations of PhA with physical fitness and fat-free mass were found in few studies. In conclusion, partial and limited evidence suggests that changes in PhA over the first 2 decades of life reflect modification in body composition and fat-free mass composition. Further studies are needed for confirming PhA as a relevant marker of nutritional status in youths.

The Efficacy of Pulmonary Rehabilitation in Patients with Idiopathic Pulmonary Fibrosis

“…Isokinetic knee flexion and extension were tested at a velocity of 60 °/s and 120 °/s using an isokinetic dynamometer (BIODEX System 4 ProTM; BIODEX, Natcon Drive Shirley, NY, USA) [ 19 ]. A bioelectrical impedance analyzer (InBody S10; Biospace, Seoul, Korea) was used to measure SMM and phase angle (PhA) [ 20 ].…”

Body composition in pediatric patients

“…PA is not a measure of body composition per se; however, it can be considered an index of the extracellular water (ECW)/intracellular water ratio, body cellular mass, and cellular integrity in healthy and ill participants, and is directly associated with muscle strength. It varies depending on age and sex and is related to FFM 72 …”

“…It varies depending on age and sex and is related to FFM. 72 Few studies have reported clinical outcomes related to body composition in sick children, especially children who are critically ill. Shime et al 73 investigated perioperative changes in BIA in 107 pediatric patients (aged 3 days to 17 years) after heart surgery and concluded that measurement of the relative changes postoperatively, which reflect perioperative alterations in body composition, provided a quantitative estimation of critical illness in these patients.…”

Phase angle as a prognostic indicator in critically ill children: A systematic review

“…PhA is related to cellular functions and integrity and is suggested to be a proxy of extracellular/intracellular water ratio as well as body cell mass 5 . By definition, the PhA is directly associated to reactance and inversely associated to resistance.…”

“…3,4 PhA is related to cellular functions and integrity and is suggested to be a proxy of extracellular/intracellular water ratio as well as body cell mass. 5 By definition, the PhA is directly associated to reactance and inversely associated to resistance. Higher PhA values appear to be consistent with greater amounts of intact skeletal muscle cell membranes and body cell mass, whereas low values suggest cell death or decreased integrity of cell membranes.…”