Bioelectrical impedance phase angle relates to function, disease severity and prognosis in stable chronic obstructive pulmonary disease

Maddocks, Matthew; Kon, Samantha S.C.; Jones, Sarah E.; Canavan, Jane L.; Nolan, Claire M.; Higginson, Irene J; Gao, Wei; Polkey, Michael I.; Man, William D.‐C.

doi:10.1016/j.clnu.2014.12.020

Cited by 75 publications

(60 citation statements)

References 37 publications

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“…DEXA is thus considered a valid, reliable, safe and noninvasive technique for assessment of fat-free mass in COPD (2,50). It is however more expensive and often less easily accessible than BIA in clinical settings (48). Body composition assessment with either method provides clinically relevant information.…”

Section: Measurements Of Muscle Mass and Body Compositionmentioning

confidence: 99%

“…BIA is a noninvasive, inexpensive, time efficient and valid technique that, like DEXA, requires no active collaboration from the patient (47,48). By measuring body electrical impedance, which varies according to water content of various tissues, BIA provides valid information on the distribution of fat mass and fat-free mass (48)(49)(50). Because BIA results are influenced by total body water, it is recommended to perform the measurement under the same fluid balance conditions at the same time of the day, especially when longitudinal assessment is to be performed.…”

Section: Measurements Of Muscle Mass and Body Compositionmentioning

confidence: 99%

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Why and How Limb Muscle Mass and Function Should Be Measured in Patients with Chronic Obstructive Pulmonary Disease

2015

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Impaired limb muscle function is a common occurrence in patients with chronic obstructive pulmonary disease (COPD), and it negatively influences exercise tolerance, quality of life, and even survival. Assessment of limb muscle mass and function in COPD is highly encouraged; it should include the quadriceps muscle, but other lower and upper limb muscles may also be evaluated to provide valuable information. Quantification of muscle mass as well as assessment of muscle strength and endurance are suggested. Bioelectrical impedance and dual-energy X-ray absorption can be realistically used in the clinical environment to monitor body composition. Although sophisticated computerized dynamometers provide the most accurate assessment, simple exercise and testing equipment are valid alternatives and they should help in implementing limb muscle function assessment in clinical settings. Isometric measurements, using strain-gauges or hand-held dynamometers, should be favored for their simplicity, availability, and quality of information provided. This perspective provides a rationale for the evaluation of limb muscle mass and function in COPD in routine clinical practice. In addition, measurement techniques used to assess limb muscle mass, strength, endurance, and fatigue in various clinical settings are discussed.

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Section: Measurements Of Muscle Mass and Body Compositionmentioning

confidence: 99%

Section: Measurements Of Muscle Mass and Body Compositionmentioning

confidence: 99%

Why and How Limb Muscle Mass and Function Should Be Measured in Patients with Chronic Obstructive Pulmonary Disease

2015

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“…Key Words: spirometer software, community-based spirometry, userfriendliness Swinburne University Of Technology, 2 The Alfred Hospital, 3 Monash University Introduction/Aim. Exercise oscillatory ventilation (EOV) is an oscillatory breathing pattern observed during exercise and is common in subjects with heart failure.…”

Section: Referencementioning

confidence: 99%

“…In the healthy population, PA typically ranges between 5 and 7 C and varies accordingly with age, gender and BMI [1]. A larger PA suggests greater cell quantity and/or cellular health, while a smaller phase angle suggests cellular loss or reduced cellular integrity [2].…”

Section: Melbourne Healthmentioning

confidence: 99%

Abstracts

2020

Respirology

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“…While DXA offers a more accurate assessment of lean mass than bioelectrical impedance analysis, it may not be readily available in practice, particularly within settings where sarcopenia is relevant (nursing homes, critical care). In contrast, the EWGSOP criteria are more pragmatic and accept use of bioelectrical impedance analysis, a measure we routinely use in practice 7. Finally, when deciding between absolute and normalised cut points, FNIH data were inconsistent across genders; body mass index adjustment did not affect relationships between sarcopenia domains in men, but markedly improved the fit of models in women 5.…”

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confidence: 99%

Sarcopenia definitions: where to draw the line? Response to Scarlata et al

Maddocks

Jones

Kon

et al. 2015

Thorax

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We thank Scarlata et al 1 for their interest in our study 2 in which we demonstrated a 15% prevalence in stable COPD by European Working Group on Sarcopenia in Older People (EWGSOP) criteria. 3 Professor Scarlata and colleagues acknowledge these are the most commonly adopted sarcopenia criteria. Consequently, prevalence estimates in other populations 4 allow us to compare our findings beyond respiratory medicine. Towards the end of recruitment, The Foundation for the National Institutes of Health (FNIH) Sarcopenia Project published their findings. 5 We acknowledge the strength of the FNIH criteria, with cut points derived from a large pool of patient-level data. Nonetheless, the project team had to make difficult decisions around data harmonisation and handling, and by group's own admission the criteria are a 'work in progress' to be evolved and refined. 6Professor Scarlata and colleagues suggest the FNIH employ gait speed as an end point rather than a parameter of muscle function. However, low gait speed (<0.8 m/s) was the principal criterion for mobility disability, from which grip strength and then appendicular lean mass cut points were derived. In this respect, we view gait speed as an intrinsic component of the FNIH operationalisation. 5With regards to lean mass assessment, the FNIH elected only to accept dual-energy X-ray absorptiometry (DXA) measurements and in doing so excluded over half of their data set (14 603/26 625 cases). While DXA offers a more accurate assessment of lean mass than bioelectrical impedance analysis, it may not be readily available in practice, particularly within settings where sarcopenia is relevant (nursing homes, critical care). In contrast, the EWGSOP criteria are more pragmatic and accept use of bioelectrical impedance analysis, a measure we routinely use in practice.7 Finally, when deciding between absolute and normalised cut points, FNIH data were inconsistent across genders; body mass index adjustment did not affect relationships between sarcopenia domains in men, but markedly improved the fit of models in women. 5 Further, for all combinations of FNIH-defined low strength and mass, there were no significant associations with survival among women. 6 This contrasts with recent studies in which EWGSOP-defined sarcopenia carried a twofold mortality risk. 8 We are unable to offer a sarcopenia prevalence by FNIH criteria owing to lack of DXA measures in our cohort. However, 2119 patients within the FNIH data set had a COPD diagnosis and disease-specific publications may emerge. 5 We agree that multiple definitions may hinder efforts to treat sarcopenia. However, we are encouraged that a consistent phenotype is emerging in which a lean mass criterion is combined with one or more markers of physical function. This is important and exciting given the effectiveness of exercise, and nutritional and pharmacological interventions on functional end points. We observed a modest whole-group effect on all EWGSOP sarcopenia domains following pulmonary rehabilitation.2 To this end, patients ...

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Bioelectrical impedance phase angle relates to function, disease severity and prognosis in stable chronic obstructive pulmonary disease

Abstract: Phase angle relates to markers of function, disease severity and prognosis in patients with COPD. As a directly measured variable, phase angle offers more useful information than fat-free mass indices.

Cited by 75 publications

References 37 publications

Why and How Limb Muscle Mass and Function Should Be Measured in Patients with Chronic Obstructive Pulmonary Disease

Why and How Limb Muscle Mass and Function Should Be Measured in Patients with Chronic Obstructive Pulmonary Disease

Abstracts

Sarcopenia definitions: where to draw the line? Response to Scarlata et al

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