Phase Angle: Could Be an Easy Tool to Detect Low-Grade Systemic Inflammation in Adults Affected by Prader–Willi Syndrome?

Barrea, Luigi; Pugliese, Gabriella; Alteriis, Giulia de; Colao, Annamaria; Savastano, Silvia; Muscogiuri, Giovanna

doi:10.3390/nu12072065

Cited by 24 publications

(20 citation statements)

References 73 publications

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“…The authors reported that, after controlling for potential covariates, such as age and number of diseases, PhA exhibited a negative association with all inflammatory biomarkers, particularly CRP [ 30 ]. The results of these two studies corroborate the findings of our two previous studies [ 23 , 31 ]. In the first study, conducted in 180 adult patients with psoriasis, an inflammatory skin disease that is associated with increased CRP levels, we reported the first evidence that psoriatic patients presented lower PhAs compared to controls, with a novel negative association between PhA and CRP levels independent of BMI [ 23 ].…”

Section: Discussionsupporting

confidence: 92%

“…In the first study, conducted in 180 adult patients with psoriasis, an inflammatory skin disease that is associated with increased CRP levels, we reported the first evidence that psoriatic patients presented lower PhAs compared to controls, with a novel negative association between PhA and CRP levels independent of BMI [ 23 ]. More recently, we also confirmed the negative association between PhA and CRP after adjustment for sex, BMI, and WC in patients with Prader–Willi syndrome, which is associated with a high prevalence of metabolic dysfunction and meta-inflammation [ 31 ]. Given the obsessive–compulsive characteristics of this syndrome, which are commonly associated with poor compliance with blood sampling, the usefulness of PhA as a non-invasive marker of inflammation was strongly suggested in these patients.…”

Section: Discussionsupporting

confidence: 73%

“…The associations between PhA and oxidative stress and inflammatory biomarkers, including CRP, have been previously investigated in a group of older females, among which there was a negative association between PhA and CRP levels regardless of common modifiable and non-modifiable risk factors, such as age and body composition [ 30 ]. Very recently, we reported that PhA was inversely associated with CRP levels in adults affected by Prader–Willi syndrome, the most common genetic cause of obesity [ 31 ].…”

Section: Introductionmentioning

confidence: 99%

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

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Phase angle (PhA), a noninvasive bioimpedance marker, is a useful tool for nutritional screening in several diseases. C-reactive protein (CRP), a strong risk factor for metabolic and cardiovascular diseases, is a commonly used biomarker of meta-inflammation. As both PhA and CRP are influenced by age, BMI, and nutritional status, and exhibit a clear sex dimorphism, we examined the association between PhA and CRP levels in 1855 subjects (680 males and 1175 females), aged 18–59 years, with BMIs ranging from 19.5 to 69.4 kg/m2, stratified according to sex. PhA values and CRP levels were significantly lower in females than males (p < 0.001), while the adherence to the Mediterranean diet (MD) was lower in males compared to females (p < 0.001). After adjusting for age, physical activity, BMI, waist circumference, and adherence to the MD, PhA remained negatively associated with CRP levels in both genders (p < 0.001). In the ROC analysis, PhA ≤ 5.5° in males and ≤5.4° in females were the threshold values predicting increased hs-CRP levels. These results suggested that PhA might represent a valid predictor of CRP levels in both sexes regardless of body weight and adherence to the MD, which avoids the collection of blood sampling and expensive biochemical assays.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 73%

Section: Introductionmentioning

confidence: 99%

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

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“…Second, the follow-up period of 30 min for detecting a response was inadequate for evaluating block efficacy. Third, we did not measure the nutrition status and pro-inflammatory or inflammatory markers in each patient; CRP (C-reactive protein) and TNF-α (tumor necrosis factor) are known to be related with cell plasma membrane instability [ 35 , 36 ]. Fourth, we did not enroll a sham group to compare with the PA values of patients who did not receive blocks.…”

Section: Discussionmentioning

confidence: 99%

Predictive Value of the Phase Angle for Analgesic Efficacy in Lumbosacral Transforaminal Block

Kim

Park

Sim

et al. 2021

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The mechanism of low back and leg pain involves mixed neuropathic and nociceptive components. Spinal neuropathic pain is related to increased levels of inflammatory cytokines and disrupted and increased permeability of the blood–spinal cord barrier, originally composed of tight junctions of capillary endothelial cells surrounded by lamina. The phase angle (PA) estimates cell membrane integrity using bioelectrical impedance analysis. We evaluated the predictive value of the PA for analgesic efficacy in lumbosacral transforaminal block. We retrospectively collected data from 120 patients receiving transforaminal blocks for lumbosacral radicular pain and assessed the PA before and 5 min following the block. Responders (group R) and non-responders (group N) were defined by ≥50% and <50% pain reduction, respectively, on a numerical rating scale, 30 min following the block; clinical data and the PA were compared. Among the 109 included patients, 50 (45.9%) and 59 (54.1%) had ≥50% and <50% pain reduction, respectively. In group N, the PA change ratio showed 88.1% specificity, 32.0% sensitivity, and 62.4% accuracy; a ratio of <0.087 at 5 min following the block predicted non-response. A PA change ratio of <0.087 at 5 min following lumbar transforaminal blocks predicted non-responders with high specificity.

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“…Body composition was assessed using a BIA phase-sensitive system by a certified clinical nutrition specialist with 5 years of experience in the assessment of body composition with the BIA-method (800-µA current at a frequency single frequency of 50 kHz, BIA 101, RJL Akern Bioresearch, Florence, Italy) [ 55 ], as previously reported [ 56 – 58 ]. The BIA analysis was performed according to the European Society of Parental and Enteral Nutrition (ESPEN) [ 40 ].…”

Section: Methodsmentioning

confidence: 99%

Phase angle and Mediterranean diet in patients with acne: Two easy tools for assessing the clinical severity of disease

et al. 2021

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Background Acne is a chronic, inflammatory and debilitating skin disorder. Dietary factors and nutritional status are among the exacerbating factors of acne. Phase angle (PhA), a direct measure of Bioelectrical Impedance Analysis (BIA), represents an indicator of the chronic inflammatory state. The Mediterranean diet (MD) is a healthy dietary pattern that can exert anti-inflammatory effects in several inflammatory diseases. We aimed to investigate the difference in PhA and adherence to the MD and their associations with the severity of acne in a sample of naïve treatment patients with acne compared to control group. Materials In this cross-sectional, case–control, observational study, we enrolled 51 patients with acne and 51 control individuals. Body composition was evaluated by a BIA phase-sensitive system (50 kHz BIA 101 RJL, Akern Bioresearch, Florence, Italy, Akern). For adherence to the MD, we have used the PREvención con DIeta MEDiterránea (PREDIMED) questionnaire. The clinical severity of acne was assessed by using the global acne grading system (GAGS), a quantitative scoring system to assess acne severity. Results Patients with acne had a worse body composition, in particular smaller PhA (p = 0.003), and a lower adherence to the MD (p < 0.001) than the control group, in spite of no differences in gender, age and BMI between the two groups. Stratifying patients with acne according to GAGS categories, both PhA (p = 0.006) and PREDIMED score (p = 0.007) decreased significantly in severe acne than mild/moderate acne. The GAGS score was negative correlations with PhA (r = − 0.478, p < 0.001) and PREDIMED score (r = − 0.504, p < 0.001). The results of the multivariate analysis showed PhA and PREDIMED score were the major determinants of GAGS score (p < 0.001). The receiver operator characteristic (ROC) analysis reporting a value of PhA of ≤ 6.1° and a PREDIMED score of ≤ 9 identified patients with acne with the highest clinical severity of the disease. Conclusions Novel correlations were reported between PhA and the degree of adherence to the MD with acne severity. Of interest, PhA and PREDIMED scores might represent possible markers of the severity of acne in a clinical setting. This study highlights how a cooperation between dermatologist and nutritionists might provide a combination key in the complex management of acne patients.

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Phase Angle: Could Be an Easy Tool to Detect Low-Grade Systemic Inflammation in Adults Affected by Prader–Willi Syndrome?

Cited by 24 publications

References 73 publications

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

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

Predictive Value of the Phase Angle for Analgesic Efficacy in Lumbosacral Transforaminal Block

Phase angle and Mediterranean diet in patients with acne: Two easy tools for assessing the clinical severity of disease

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