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

Abstract

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.

Low-Intensity Resistance Training with Moderate Blood Flow Restriction Appears Safe and Increases Skeletal Muscle Strength and Size in Cardiovascular Surgery Patients: A Pilot Study

“…Each patient completed two trials and the higher value was used in the analysis. MVIC of the knee extensors was determined with a digital handheld dynamometer (μTas MT-1, ANIMA Co., Ltd., Tokyo, Japan) as described previously [ 1 , 30 , 31 ]. Patients were seated in a chair with the trunk vertical, the hip and knee joints flexed 90°, and arms folded across the chest.…”

“…Body composition: A multi-frequency bioelectrical impedance analyzer (BIA) (InBody S10 Biospace devise, Biospace Co., Ltd., Korea/Model JMW140) was used according to the manufacturer’s recommendations [ 1 , 31 ]. Thirty impedance measurements were obtained at 1, 5, 50, 250, 500, and 1000 kHz over the right and left arms and legs and the trunk.…”

“…Muscle size: Muscle thickness of thigh (MTH) was measured at the midpoint of the thigh length (between the greater trochanter and the lateral femoral condyle) with a real-time linear electronic scanner using a 10 MHz scanning head and ultrasound probe (L4-12t-RS Probe, GE Healthcare, Tokyo, Japan) and ultrasound (LOGIQ e, GE Healthcare, Tokyo, Japan) [ 1 , 30 , 31 , 33 ]. The scanning head was coated with a water-soluble transmission gel to provide acoustic contact without depressing the dermal surface.…”

Phase Angle as an Easy Diagnostic Tool of Meta-Inflammation for the Nutritionist

“…Previous clinical studies reported that PhA might represent a screening tool for the identification of inflammation in patients with obesity [ 19 ], polycystic ovary syndrome [ 20 ], hypovitaminosis D [ 21 ], hidradenitis suppurativa [ 22 ], psoriasis [ 23 ], cancer [ 24 , 25 ], and type 2 diabetes [ 26 ]. Furthermore, PhA also appears to be a useful biomarker for cachexia, sarcopenia, and malnutrition in hospitalized individuals with cardiovascular disease [ 27 ]. In addition, PhA is an important independent predictor of mortality [ 28 , 29 ].…”

Preoperative Serum GDF-15, Endothelin-1 Levels, and Intraoperative Factors as Short-Term Operative Risks for Patients Undergoing Cardiovascular Surgery

“…The STS score is widely used in cardiovascular surgery mortality risk assessment [ 1 , 2 , 32 , 33 ]. The present study showed that the STS score correlated with eGFR, BNP Alb, and Hb, reflecting organ dysfunction or nutritional status [ 34 ], and correlated with ICU stay period and postoperative admission days. However, the STS score was not significantly different between patients with and without AKI, and it was not an independent factor of AKI in our present study.…”