Phase angle from bioelectrical impedance analysis remains an independent predictive marker in HIV-infected patients in the era of highly active antiretroviral treatment

Schwenk, Achim; Beisenherz, Alexander; Römer, Katja; Kremer, Gisela; Salzberger, Bernd; Elia, Marinos

doi:10.1093/ajcn/72.2.496

Cited by 247 publications

(199 citation statements)

References 29 publications

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“…Among HIV-infected individuals, the phase angle has been inversely related to the risk of death (Ott et al, 1995;Schwenk et al, 2000), although a precise mechanism is not known yet. In this study, the average phase angle in both HIV-positive and -negative subjects was lower than the means reported among healthy adults (Ellis, 2000).…”

Section: Discussionmentioning

confidence: 99%

“…A few cross-sectional studies examined the impact of HIV infection on body composition of adults with TB and yielded divergent results; BCM was found to be lower in coinfected men from Malawi (Van Lettow et al, 2004), but not in patients from Uganda (Shah et al, 2001) or Burundi (Niyongabo et al, 1994(Niyongabo et al, , 1999. In Malawi and Uganda, HIV coinfection was related to decreased phase angle, an indicator of cell membrane integrity that has been reported to be predictive of mortality (Ott et al, 1995;Schwenk et al, 2000). One of the reasons that could explain differences in the results across studies is that they did not take into account the influence of confounding factors that affect body composition and which may also be associated with HIV infection in persons with TB.…”

Section: Introductionmentioning

confidence: 99%

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Wasting and body composition of adults with pulmonary tuberculosis in relation to HIV-1 coinfection, socioeconomic status, and severity of tuberculosis

et al. 2005

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Objective: To examine the impact of HIV coinfection, socioeconomic status (SES) and severity of tuberculosis (TB) on the body composition and anthropometric status of adults with pulmonary TB. Design: Cross-sectional study. Setting: Five TB clinics in Dar es Salaam, Tanzania. Subjects: A total of 2231 adult men and women diagnosed with pulmonary TB, prior to the initiation of anti-TB therapy. Methods: We compared the distribution of anthropometric characteristics including body mass index (BMI), mid-upper arm circumference (MUAC), triceps skin-fold (TSF), and arm muscle circumference (AMC) by HIV status, SES characteristics, and indicators of TB severity (bacillary density in sputum and Karnofsky performance score). Similar comparisons were carried out with body composition variables from bioelectrical impedance analysis and albumin concentrations, in a subsample of 731 subjects. Results: In multivariate analysis, HIV infection was significantly associated with lower MUAC and AMC in both men and women, but not with BMI or TSF. Compared to HIV-uninfected women, those who were HIV infected had lower body cell mass (BCM) (adjusted difference ¼ À0.85 kg, P ¼ 0.04), intracellular water (À0.68 l, P ¼ 0.04), and phase angle (À0.52, P ¼ 0.02). Albumin concentrations were significantly lower in both men and women infected with HIV. Among HIV-infected men, CD4 cell counts o200/mm 3 were related to lower intracellular water, BCM, fat-free mass and phase angle. Independent of HIV infection, BMI and MUAC were positively related to SES indicators and the Karnofsky performance score; and inversely related to bacillary density. Conclusions: HIV infection is associated with indicators of low lean body mass in adults with TB; socioeconomic factors and TB severity are important correlates of wasting, independent of HIV. Sponsorship: The National Institute of Allergy and Infectious Diseases (UO1 AI 45441-01).

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Wasting and body composition of adults with pulmonary tuberculosis in relation to HIV-1 coinfection, socioeconomic status, and severity of tuberculosis

et al. 2005

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“…15,30 The phase angle, one of the raw data obtained from bioelectrical impedance analysis measurements and therefore independent from the equipment and internal algorithms used, has proved to be a good prognostic, nutritional and membrane cell function marker in various diseases. 18,21,31,32 Sex-, age-and BMI-specific reference values of the phase angle from a large healthy German population 33 34 The transformation of phase angle values into standardized values (Z-score) allows us to quantify individual deviations from sex-, age-and BMI-specific population averages and to compare subjects from a heterogeneous group. Furthermore, Norman et al 16 showed that this standardization clearly enhances the phase angle's predictive power.…”

Section: Study Design and Data Collectionmentioning

confidence: 99%

Longitudinal follow-up of nutritional status and its influencing factors in adults undergoing allogeneic hematopoietic cell transplantation

Urbain

Birlinger

Lambert

et al. 2012

Bone Marrow Transplant

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There are few longitudinal data on nutritional status and body composition of patients undergoing allogeneic hematopoietic cell transplantation (alloHCT). We assessed nutritional status of 105 patients before alloHCT and its course during the early posttransplant period to day þ 30 and day þ 100 via weight history, body mass index (BMI) normalized for gender and age, Subjective Global Assessment, phase angle normalized for gender, age, and BMI, and fat-free and body fat masses. Furthermore, we present a multivariate regression model investigating the impact of factors on body weight. At admission, 23.8% reported significant weight losses (45%) in the previous 6 months, and we noted 31.5% with abnormal age-and sex-adjusted BMI values (p10th, X90th percentiles). BMI decreased significantly (Po0.0001) in both periods by 11% in total, meaning a weight loss of 8.6 ± 5.7 kg. Simultaneously, the patients experienced significant losses (Po0.0001) of both fat-free and body fat masses. Multivariate regression model revealed clinically relevant acute GVHD (parameter estimate 1.43; P ¼ 0.02) and moderate/severe anorexia (parameter estimate 1.07; P ¼ 0.058) as independent factors influencing early weight loss. In conclusion, our results show a significant deterioration in nutritional status during the early post-transplant period. Predominant alloHCT-associated complications such as anorexia and acute GVHD became evident as significant factors influencing nutritional status.

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“…Its use has been recommended as an indicator of prognosis in clinical practice. In adults, positive associations have been found between PA and survival of HIV-positive patients,6 , 7 and those with pulmonary cancer,8 as well as sepsis and those undergoing hemodialysis 9…”

Section: Introductionmentioning

confidence: 99%

Phase angle and World Health Organization criteria for the assessment of nutritional status in children with osteogenesis imperfecta

Pileggi

Scalize

Camelo

2016

Revista Paulista de Pediatria (English Edition)

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Objective:To compare the phase angle of patients with osteogenesis imperfecta treated at a tertiary university hospital with patients in a control group of healthy children, and to assess the nutritional status of these patients through the body mass index proposed by the World Health Organization.Methods:Cross-sectional study carried out in a university hospital that included seven patients with osteogenesis imperfecta and a control group of 17 healthy children of the same gender and age. Weight and height were measured and bioelectrical impedance was performed. Subsequently, the phase angle was calculated based on resistance and reactance values.Results:The phase angle of the group of children with osteogenesis imperfecta was significantly lower than that of the control group (p<0.05). The body mass index criterion for age of the World Health Organization showed no difference between groups.Conclusions:Children with osteogenesis imperfecta have a nutritional risk detected by the phase angle, which is a useful tool for nutritional screening. The calculation result could help in the diet therapy of patients with osteogenesis imperfecta.

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Phase angle from bioelectrical impedance analysis remains an independent predictive marker in HIV-infected patients in the era of highly active antiretroviral treatment

Abstract: Despite the favorable effects of HAART on the nutritional status of HIV-infected persons, low phase angle remains an independent adverse prognostic marker of clinical progression and survival.

Cited by 247 publications

References 29 publications

Wasting and body composition of adults with pulmonary tuberculosis in relation to HIV-1 coinfection, socioeconomic status, and severity of tuberculosis

Wasting and body composition of adults with pulmonary tuberculosis in relation to HIV-1 coinfection, socioeconomic status, and severity of tuberculosis

Longitudinal follow-up of nutritional status and its influencing factors in adults undergoing allogeneic hematopoietic cell transplantation

Phase angle and World Health Organization criteria for the assessment of nutritional status in children with osteogenesis imperfecta

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