Phase Angle as a Sarcopenia Marker in Hospitalized Elderly Patients

Santana, Natália de Moraes; Pinho, Cláudia Porto Sabino; Silva, Cristiane Pereira da; Santos, Natália Fernandes dos; Mendes, Roberta Maria Lins

doi:10.1002/ncp.10016

Cited by 31 publications

(22 citation statements)

References 27 publications

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“…In addition, the relationships of PhA with the different components of sarcopenia were assessed in eight papers [25,26,31,32,34e36,38] by linear correlation analysis. On the whole, a weak/moderate association was found with SM in six studies [25,27,31,32,34,35], with HGS in six studies [25,27,32,34,35,38] and with GS in three studies [35,36,38]. Thus, low PhA was a marker for both sarcopenia and impairment of its components.…”

Section: Discussionmentioning

confidence: 90%

“…Similar results were also obtained in patients with COPD (À12.5%) or cirrhosis (À22.4%), hospitalized patients (À25.7%), free living/hospitalized patients (À24.5%) and kidney transplant recipients (À10.4%), whereas only a small difference was observed in cancer patients (À4.9%). On the other hand, difference was smaller for non-severe sarcopenic [23,25] and negligible for pre-sarcopenic subjects/patients, the latter being those with just a reduced muscle mass and no muscle impairment [25,35,38]. In addition, using logistic regression analysis, another study [32] showed that sarcopenic patients were 5.6 times more likely to have low PhA values.…”

Section: Discussionmentioning

confidence: 97%

“…As far community-dwelling and hospitalized elderly patients (overall prevalence of sarcopenia 15.2%) were concerned, Kilic et al (2017) indicated that there was a declining trend of PhA as follows (median values): 4.97 in non-sarcopenic, 4.60 in pre-sarcopenic, 4.45 in non-severe sarcopenic and 3.75 in severe sarcopenic patients [25]. In another study (148 hospitalized elderly patients) mean PhA was lower in sarcopenic than non-sarcopenic male patients (À17.6%), whereas no significant difference was found in females (À4.9%) [35] PhA was decreased in severe sarcopenia in both men (À25.7%) and women (À11.4%), but not in pre-sarcopenic patients.…”

Section: From Sarcopenia To Phase Anglementioning

confidence: 89%

“…In the first study on elderly patients, those with low PhA had lower SM, SMI and HGS [25], while in the second one there was a weak/moderate correlation of PhA with ASM/h 2 , HGS and GS in both genders [35].…”

Section: Relationships Between Pha and Different Components Of Sarcopmentioning

confidence: 93%

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Bioelectrical impedance analysis (BIA) -derived phase angle in sarcopenia: A systematic review

et al. 2021

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Background & aims: Bioelectrical impedance analysis-derived phase angle (PhA) has been gaining attention in the clinical evaluation of nutritional status because it is thought to be a proxy of water distribution and body cell mass; it is also associated to muscle strength and is an effective predictor of different clinical outcomes. Since an association may be expected between PhA and sarcopenia (defined by low skeletal muscle mass and impaired muscle function), the aim of this systematic review was to evaluate: a) changes in PhA due to sarcopenia; b) prevalence of sarcopenia according to PhA values; c) derivation of phase angle cutoffs for detecting sarcopenia; d) sarcopenia and PhA as predictors of clinical outcomes. Methods: A systematic research on electronic databases (PubMed, Embase, Scopus and Web of Science) from inception to January 31st, 2020 was performed according to PRISMA checklist. Using PICOS strategy, "P" corresponded to participants of any age, gender or ethnicity, "I" designated diagnosis of sarcopenia, "C" indicated subjects without sarcopenia, "O" corresponded to PhA, and "S" selected all study types. Methodological quality was assessed using the National Institute of Health (NIH) quality assessment tool. Results: Through the initial literature search and after removing duplicates and excluding papers by screening titles and abstracts, 79 potentially relevant studies were examined. Thirteen studies (7668 subjects) met the inclusion criteria. The overall risk of bias was low. Sarcopenia was associated with a significant lower PhA in seven studies out of eight, while five studies out of six reported a high prevalence of sarcopenia was in patients with low PhA. Different cutoff point values from 4.05 to 5.05 have been derived for the identification of sarcopenia. PhA and sarcopenia were independent predictors of survival in cancer patients and geriatric hospitalized patients. Conclusions: Data from the selected papers demonstrate that PhA is decreased in sarcopenic subjects and the prevalence of sarcopenia is higher in subjects with low PhA. Further studies are needed to determine to what extent PhA may be valuable in detecting low muscle quality and/or identifying sarcopenia.

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Section: Discussionmentioning

confidence: 90%

Section: Discussionmentioning

confidence: 97%

Section: From Sarcopenia To Phase Anglementioning

confidence: 89%

Section: Relationships Between Pha and Different Components Of Sarcopmentioning

confidence: 93%

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Bioelectrical impedance analysis (BIA) -derived phase angle in sarcopenia: A systematic review

et al. 2021

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“…In fact, the PhA correlated positively with SMI and anterior thigh MTH in both sexes in the present study. The PhA has been reported to correlate with various functional indicators [ 31 ] as well as nutritional status, frailty, and sarcopenia [ 32 , 33 , 34 ]. In our study using 412 hospitalized patients with CVD, the PhA correlated positively with hand grip strength, knee extension strength, and SPPB score in both sexes.…”

Section: Discussionmentioning

confidence: 99%

Phase Angle as an Indicator of Sarcopenia, Malnutrition, and Cachexia in Inpatients with Cardiovascular Diseases

Hirose

Nakajima

Nozawa

et al. 2020

JCM

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Malnutrition is associated with sarcopenia, cachexia, and prognosis. We investigated the usefulness of phase angle (PhA) as a marker of sarcopenia, cachexia, and malnutrition in 412 hospitalized patients with cardiovascular disease. We analyzed body composition with bioelectrical impedance analysis, and nutritional status such as controlling nutritional status (CONUT) score. Both skeletal muscle mass index (SMI) and PhA correlated with age, grip strength and knee extension strength (p < 0.0001) in both sexes. The SMI value correlated with CONUT score, Hb, and Alb in males. Phase angle also correlated with CONUT score, Hb, and Alb in males, and more strongly associated with these nutritional aspects. In females, PhA was correlated with Hb and Alb (p < 0.001). In both sexes, sarcopenia incidence was 31.6% and 32.4%; PhA cut-off in patients with sarcopenia was 4.55° and 4.25°; and cachexia incidence was 11.5% and 14.1%, respectively. The PhA cut-off in males with cachexia was 4.15°. Multivariate regression analysis showed that grip strength and brain natriuretic peptide (BNP) were independent determinants of SMI, whereas grip strength, BNP, and Hb were independent determinants of PhA. Thus, PhA appears to be a useful marker for sarcopenia, malnutrition, and cachexia in hospitalized patients with cardiovascular disease.

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Future lines of research on phase angle: Strengths and limitations

Guerrero

García-García

Talluri³

et al. 2023

Rev Endocr Metab Disord

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Bioelectrical impedance analysis (BIA) is the most widely used technique in body composition analysis. When we focus the use of phase sensitive BIA on its raw parameters Resistance (R), Reactance (Xc) and Phase Angle (PhA), we eliminate the bias of using predictive equations based on reference models. In particular PhA, have demonstrated their prognostic utility in multiple aspects of health and disease. In recent years, as a strong association between prognostic and diagnostic factors has been observed, scientific interest in the utility of PhA has increased. In the different fields of knowledge in biomedical research, there are different ways of assessing the impact of a scientific-technical aspect such as PhA. Single frequency with phase detection bioimpedance analysis (SF-BIA) using a 50 kHz single frequency device and tetrapolar wrist-ankle electrode placement is the most widely used bioimpedance approach for characterization of whole-body composition. However, the incorporation of vector representation of raw bioelectrical parameters and direct mathematical calculations without the need for regression equations for the analysis of body compartments has been one of the most important aspects for the development of research in this area. These results provide new evidence for the validity of phase-sensitive bioelectrical measurements as biomarkers of fluid and nutritional status. To enable the development of clinical research that provides consistent results, it is essential to establish appropriate standardization of PhA measurement techniques. Standardization of test protocols will facilitate the diagnosis and assessment of the risk associated with reduced PhA and the evaluation of changes in response to therapeutic interventions. In this paper, we describe and overview the value of PhA in biomedical research, technical and instrumental aspects of PhA research, analysis of Areas of clinical research (cancer patients, digestive and liver diseases, critical and surgical patients, Respiratory, infectious, and COVID-19, obesity and metabolic diseases, Heart and kidney failure, Malnutrition and sarcopenia), characterisation of the different research outcomes, Morphofunctional assessment in disease-related malnutrition and other metabolic disorders: validation of PhA with reference clinical practice techniques, strengths and limitations. Based on the detailed study of the measurement technique, some of the key issues to be considered in future PhA research. On the other hand, it is important to assess the clinical conditions and the phenotype of the patients, as well as to establish a disease-specific clinical profile. The appropriate selection of the most critical outcomes is another fundamental aspect of research.

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Phase Angle as a Sarcopenia Marker in Hospitalized Elderly Patients

Abstract: 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.

Cited by 31 publications

References 27 publications

Bioelectrical impedance analysis (BIA) -derived phase angle in sarcopenia: A systematic review

Bioelectrical impedance analysis (BIA) -derived phase angle in sarcopenia: A systematic review

Phase Angle as an Indicator of Sarcopenia, Malnutrition, and Cachexia in Inpatients with Cardiovascular Diseases

Future lines of research on phase angle: Strengths and limitations

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