Phase angle as an index of physiological status: validating bioelectrical assessments of hydration and cell mass in health and disease

Lukaski, Henry C.; Talluri, Antonio

doi:10.1007/s11154-022-09764-3

Cited by 17 publications

(18 citation statements)

References 35 publications

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“…In the human body, for example, PhA typically ranges from 1º to 12º, with the R and Xc contributions varying according to a set of biological factors that will be later discussed. Although the biological meaning of PhA is not fully understood, this raw BIA parameter has been used as a non-invasive nutritional and health assessment tool to characterize the cellular health and intra-and extracellular fluids [22], which are, respectively, the major biological determinants of Xc and R in the human body [18]. The available literature suggests that lower PhA, consistent of reduced Xc, are attributable to reduced body cell mass (BCM) and to compromised selective permeability function of the cell, which are, in turn, related to lower levels of muscle strength, quality of life, and increased rates of hospitalization and mortality [23,24].…”

Section: In Vivo Biological Tissue Measurementmentioning

confidence: 99%

“…The available literature suggests that lower PhA, consistent of reduced Xc, are attributable to reduced body cell mass (BCM) and to compromised selective permeability function of the cell, which are, in turn, related to lower levels of muscle strength, quality of life, and increased rates of hospitalization and mortality [23,24]. On the other hand, higher levels of PhA are conceptually associated with increased levels of BCM, which is mainly composed of skeletal muscle mass (SMM), and directly linked to an improved cell membrane health [22]. With researchers having this information at hand, a growing body of evidence has been demonstrating a close and positive effect of sports performance, physical activity, and general health on PhA [25,26].…”

Section: In Vivo Biological Tissue Measurementmentioning

confidence: 99%

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Phase angle, muscle tissue, and resistance training

Sardinha

Rosa

2023

Rev Endocr Metab Disord

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The biophysical response of the human body to electric current is widely appreciated as a barometer of fluid distribution and cell function. From distinct raw bioelectrical impedance (BIA) variables assessed in the field of body composition, phase angle (PhA) has been repeatedly indicated as a functional marker of the cell’s health and mass. Although resistance training (RT) programs have demonstrated to be effective to improve PhA, with varying degrees of change depending on other raw BIA variables, there is still limited research explaining the biological mechanisms behind these changes. Here, we aim to provide the rationale for the responsiveness of PhA determinants to RT, as well as to summarize all available evidence addressing the effect of varied RT programs on PhA of different age groups. Available data led us to conclude that RT modulates the cell volume by increasing the levels of intracellular glycogen and water, thus triggering structural and functional changes in different cell organelles. These alterations lead, respectively, to shifts in the resistive path of the electric current (resistance, R) and capacitive properties of the human body (reactance, Xc), which ultimately impact PhA, considering that it is the angular transformation of the ratio between Xc and R. Evidence drawn from experimental research suggests that RT is highly effective for enhancing PhA, especially when adopting high-intensity, volume, and duration RT programs combining other types of exercise. Still, additional research exploring the effects of RT on whole-body and regional BIA variables of alternative population groups is recommended for further knowledge development.

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Section: In Vivo Biological Tissue Measurementmentioning

confidence: 99%

Section: In Vivo Biological Tissue Measurementmentioning

confidence: 99%

Phase angle, muscle tissue, and resistance training

Sardinha

Rosa

2023

Rev Endocr Metab Disord

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“…It is necessary to know the bioelectrical bases that establish the passage of the current through the organism, evaluating the voltage drop as a function of body R, and therefore of the volume of water and hydration, up to the measurement of the circuit capacitance evaluated through the Total body Parallel Xc evaluates the cell and the integrity of cell membranes. This global model makes it possible, expressed jointly through the PhA, to evaluate changes in cell membranes and the hydration status of the organism [4].…”

Section: Introductionmentioning

confidence: 99%

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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“…For the biomedical and clinical researcher, the terms BIA and PhA can be vague. Lukaski and Talluri [ 11 ] concisely describe a simple conceptual framework for bioelectrical impedance analysis (BIA) that associates bioelectrical measurements and empirical models with hydration and body cell mass. They provide evidence from diverse experimental models and clinical findings to develop valid interpretations of the BI measurements of resistance (R), Xc and PhA for fluid distribution and cell membrane integrity.…”

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confidence: 99%