Evaluating Sarcopenia Using Bioelectrical Impedance Vector Analysis and Phase Angle

Abstract

Sarcopenia becomes more common with age, being most prevalent among elderly individuals. According to the EWGSOP, muscle mass is one of the criteria for the evaluation of sarcopenia. The main methods for evaluating muscle mass are CT, MRI, and DXA, but these methods are difficult to apply in the field due to equipment costs, radioactivity, and lack of portability. BIVA and PhA are alternative approaches for assessing somatic cell mass and volume and do not require predictive equations. These variables are clinically relevant parameters that indicate cell health, especially cell membrane integrity and cell function. This study in sarcopenic and nonsarcopenic elderly volunteers aimed to determine the BIVA distribution pattern among individual sarcopenia patients; to evaluate the relationship between PhA and muscle strength, muscle quality, and physical function; and to find any correlates of PhA. The sample comprised 134 free-living elderly individuals of both sexes aged 69–91 years. Anthropometric parameters, grip strength, DXA findings, BIA results, and physical performance (the 6-meter walk test) were measured. Impedance vector distributions were evaluated in sarcopenia patients and healthy elderly individuals using BIVA. According to the AWGS criteria, sarcopenia was diagnosed according to DXA findings, grip strength and physical performance test results. Group differences were evaluated using the t test, Mann‒Whitney U test, and Hotelling's T2 test. Correlation analysis was performed to identify variables significantly associated with PhA. Linear regression analysis was performed to determine whether PhA was associated with muscle strength, muscle quality and physical function. BIVA detected a significant difference between the sarcopenia and non-sarcopenia groups (both sexes) due to higher R/H values and lower phase angles in a few individuals, whereas Xc/Ht values did not differ between the two groups. The sarcopenia group had a significantly lower PhA than the non-sarcopenia group among both males (p<0.01) and females (p<0.05). PhA was significantly correlated with age, ASM, HGS, and muscle quality in both sexes and significantly correlated with ASM/Ht2 and physical performance in males. PhA was a significant indicator of muscle strength in both males (β = 2.6; p<0.01) and females (β = 3.4; p<0.01), a significant indicator of muscle quality in both males (β = 0.07; p<0.05) and females (β = 0.17; p<0.01), and a significant indicator of physical performance in males (β = 0.3; p<0.01). BIVA can detect changes in muscle mass in individuals with sarcopenia and is a practical method for the assessment of sarcopenia in the field. PhA is a good indicator of muscle strength, muscle quality and physical performance (in males). These methods can help diagnose sarcopenia in elderly individuals with reduced mobility.