Is phase angle an appropriate indicator of malnutrition in different disease states? A systematic review

Rinaldi, Sylvia; Gilliland, Jason A.; O’Connor, Colleen; Chesworth, Bert M.; Madill, Janet

doi:10.1016/j.clnesp.2018.10.010

Cited by 57 publications

(40 citation statements)

References 60 publications

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“…Thus, it is likely that the PhA can be useful as a marker for malnutrition. A recent systematic review indicates that PhA cannot independently identify malnutrition in disease based on current body of research in patients with four disease states (liver, hospitalization, oncology and renal) [ 46 ]. The reasons of the discrepancies remain unclear, but the present study showed the first evidence for clinical usefulness of PhA in patients with CAD.…”

Section: Discussionmentioning

confidence: 99%

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

Hirose

Nakajima

Nozawa

et al. 2020

JCM

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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.

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Section: Discussionmentioning

confidence: 99%

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

Hirose

Nakajima

Nozawa

et al. 2020

JCM

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“…Besides, the inflammation processes can impact on patients’ nutritional status, thus determining the severity of the underlying disease [41,42]. Since many studies have proven an association between body mass index and vitamin D levels [38,43,44], we propose that it is necessary to deepen the nutritional aspect when evaluating the impact of body mass index (BMI) on vitamin D levels and we also suggest introducing a bioimpedentiometry parameter such as the phase angle.…”

Section: Introductionmentioning

confidence: 99%

“…While the association between BMI and vitamin D was studied in patients with IBD [17], the phase angle is never used in the gastroenteric field, nor in IBD patients. Phase angle is an indicator of fluid distribution in tissues and the electrical capacity of the human body; its measurement is performed through a bioelectrical impedance analysis (BIA) [42]. Cell mass and the integrity of cell membranes depends on patient characteristics such as age, BMI, or fluids distribution [43].…”

Section: Introductionmentioning

confidence: 99%

“…Thus the phase angle, a biomarker of nutritional status, is a parameter useful for monitoring disease progressions [44]. Studies conducted in different medical fields (such as liver and renal disease, and oncology), in which phase angle was used as a measure of patients’ nutritional status, proved that there is a negative association between low values of phase angle and disease outcome [42,46,47,48].…”

Section: Introductionmentioning

confidence: 99%

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The Association of Disease Activity, BMI and Phase Angle with Vitamin D Deficiency in Patients with IBD

et al. 2019

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Hypovitaminosis D is frequently present in inflammatory bowel disease (IBD) with a higher incidence in Crohn’s disease (CD) than in Ulcerative Colitis (UC). Given the involvement of the alimentary tract, many factors can contribute to hypovitaminosis D. The aim of the study was to investigate the association of disease activity, body mass index (BMI) and phase angle with vitamin D deficiency in patients with IBD. A cross-sectional study was conducted on a cohort of 206 IBD patients (October 2016–September 2018). Of these patients, 32.6% were affected by hypovitaminosis D (CD: 38.6%; UC: 25.6%; p < 0.01). Negative and significant associations (p < 0.01) were found between BMI and vitamin D serum levels both in CD and UC patients. BMI represented a determinant of hypovitaminosis D (Odds Ratio (OR) = 1.12, p < 0.01) only in UC patients; phase angle was associated to hypovitaminosis D in both groups (CD: OR = 0.64, p < 0.05; UC: OR = 0.49, p < 0.01). Results of the present study confirm a higher incidence of hypovitaminosis D in patients with CD than in those with UC, and show that nutritional status plays a crucial role in the incidence of vitamin D deficiency in patients with IBD.

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“…Moreover, in another study, PA could not differentiate malnourished from cachectic patients, while pre-treatment PA was not a predictive factor for cachexia during chemo-radiation treatment. In addition to this, a review by Rinaldi et al showed that currently, in cancer patients, the agreement between PA and the SGA tool regarding malnutrition, is weak [81]. Thus, further studies are needed in order to assess the association between malnutrition and altered tissue electrical properties as well as its subsequent prognostic role in HNC patients.…”

Section: Discussionmentioning

confidence: 99%

Can Bioelectrical Impedance Analysis and BMI Be a Prognostic Tool in Head and Neck Cancer Patients? A Review of the Evidence

Mantzorou

Tolia

Poultsidi

et al. 2020

Cancers

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Background: Malnutrition can significantly affect disease progression and patient survival. The efficiency of weight loss and bioimpedance analysis (BIA)-derived measures in the evaluation of malnutrition, and disease progression and prognosis in patients with head and neck cancer (HNC) are an important area of research. Method: The PubMed database was thoroughly searched, using relative keywords in order to identify clinical trials that investigated the role of BIA-derived measures and weight loss on the disease progression and prognosis of patients with HNC. Twenty-seven studies met the criteria. More specifically, six studies examined the prognostic role of the tissue electrical properties in HNC patients; five examined the role of the tissue electrical properties on identifying malnutrition; four studies looked at the changes in the tissue electrical properties of HNC patients; and 12 examined the prognostic role of weight loss on survival and/or treatment outcomes. Results: Several studies have investigated the role of nutritional status tools on prognosis in HNC patients. Current studies investigating the potential of BIA-derived raw data have shown that phase angle (PA) and capacitance of the cell membrane may be considered prognostic factors of survival. Weight loss may be a prognostic factor for treatment toxicity and survival, despite some conflicting evidence. Conclusions: Further studies are recommended to clarify the role of BIA-derived measures on patients’ nutritional status and the impact of PA on clinical outcomes as well as the prognostic role of weight loss.

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Is phase angle an appropriate indicator of malnutrition in different disease states? A systematic review

Cited by 57 publications

References 60 publications

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

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

The Association of Disease Activity, BMI and Phase Angle with Vitamin D Deficiency in Patients with IBD

Can Bioelectrical Impedance Analysis and BMI Be a Prognostic Tool in Head and Neck Cancer Patients? A Review of the Evidence

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