Phase angle as a severity indicator for liver diseases

Pagano, Ana Paula; Sicchieri, Juliana Maria Faccioli; Schiavoni, Isabela Laurencio; Barbeiro, D.; Manca, Camila Sanches; Silva, Bruna Ramos da; Bezerra, Amanda Escobar; Pinto, L.C.M.; Araújo, Roberta Chaves; Teixeira, Andreza Corrêa; Chiarello, Paula Garcia

doi:10.1016/j.nut.2019.110607

Cited by 27 publications

(22 citation statements)

References 36 publications

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“…This finding is supported by one study, where alterations of the PhA were predictive for NAFLD in patients with a BMI < 30 kg/m 2 , but not >30 kg/m 2 [ 34 ]. These findings further support the idea, that mechanisms of sarcopenia might differ in patients with and without obesity, as generally higher PhA can be seen as protective from inflammatory and liver diseases [ 40 , 41 ].…”

Section: Discussionsupporting

confidence: 81%

“…Not only muscle quantity, but also—quality is important for development of insulin resistance and inflammatory liver diseases [ 38 , 39 ]. The BIA-derived PhaseAngle (PhA) has been described as a measurement for muscle quality and nutritional status [ 21 , 40 ]. While SMM was different in patients with or without NASH in our study, PhA was not.…”

Section: Discussionmentioning

confidence: 99%

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Association of Body Composition and Sarcopenia with NASH in Obese Patients

Schmitz

Schooren

Kroh

et al. 2021

JCM

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Obese patients often suffer from sarcopenia or sarcopenic obesity (SO) that can trigger inflammatory diseases including non-alcoholic steatohepatitis (NASH). Sarcopenia and SO can be diagnosed through measuring parameters of body composition such as skeletal muscle mass (SMM), skeletal muscle index (SMI) and fat mass (FM) obtained by bioelectrical impedance analysis (BIA). The aim of this study was to assess the relationship of body composition and NASH in patients with obesity. A total of 138 patients with obesity that underwent bariatric surgery were included in this study. BIA was used to estimate body composition. A liver biopsy was taken intraoperatively and histological assessment of NASH was performed. A total of 23 patients (17%) were classified as NASH and 65 patients (47%) met the criteria for borderline NASH. Body mass index (BMI) was significantly higher in patients with NASH compared to borderline NASH and no NASH (56.3 kg/m2 vs. 51.6 kg/m2 vs. 48.6 kg/m2, p = 0.004). Concerning body composition, FM, but also SMM and SMI were significantly higher in patients with NASH (p-values 0.011, 0.005 and 0.006, resp.). Fat mass index (FMI) and weight-adjusted skeletal muscle index (SMI_weight) failed to reach statistical significance (p-values 0.067 and 0.661). In patients with obesity, higher FM were associated with NASH. Contrary to expectations, SMM and SMI were also higher in patients with NASH. Therefore, higher body fat, rather than sarcopenia and SO, might be decisive for development of NASH in patients with obesity.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Association of Body Composition and Sarcopenia with NASH in Obese Patients

Schmitz

Schooren

Kroh

et al. 2021

JCM

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“…The present study confirms a better health status in participants with a higher PhA, as assessed by a significantly lower ECW/TBW ratio found these patients (G2) as opposed to patients with lower PhA (G1). The ratio between ECW and TBW has been acknowledged as an edema index [48] The study by Cho et al [49] showed significant improvements in the ECW/TBW ratio in 29 female survivors of BC with secondary lymphedema after participating in a rehabilitation program (drainage massage, physical exercise, and use of elastic bands), with a significant difference between baseline and follow-up (p=0.043) found especially in the group with severe lymphedema (p=0.007). A better ECW/TBW ratio results in a decrease in the edema state, which consists of a decrease in the ECW [50].…”

Section: Discussionmentioning

confidence: 99%

Phase angle cutoff value as a marker of the health status and functional capacity in breast cancer survivors

Martins

Oliveira

Brito

et al. 2021

Physiology & Behavior

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Accurate predictive tools are key factors for cancer care. Phase angle (PhA) has been proposed as a marker of cellular health, particularly of cell-membrane integrity. Cutoff values have been proposed, including for cancer survivors. This study aimed to assess the usefulness of the proposed PhA cutoff, as a marker of bioelectrical impedance analysis (BIA) assessed health-status, and functional capacity in breast cancer (BC) survivors. This cross-sectional study included 25 women (50.6 ± 8.6 yrs) survivors of BC, divided into two groups according to the PhA reference value of 5.6 et al. 2008). BIA-assessed health status parameters included: extracellular water (ECW), intracellular water (ICW), total body water (TBW), PhA, body mass, fat-free mass, muscle mass, body cell mass (BCM). Four functional tests were performed: 30 s chair-stand test, timed up and go test, ball throw test and 6-minute walking test. Results showed G2 had lower ECW/ICW ratio (p=0.001; ES=1.2), ECW/BCM ratio (p=0.001; ES=3.2) and ECW/TBW ratio (p=0.001; ES=4.8). There was no difference in functional capacity between groups. The results of the present study show that patients with higher PhA values have a higher ICW values and preservation in the ECW/ICW ratio, suggesting it's a better cell membrane quality and integrity. Relation of both PhA and cell membrane integrity with functional capacity warrants further research.

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“…In patients before elective surgery, body composition may be performed by validated means such as BIA, DXA, or CT. Grade of recommendation 0 e strong consensus 94% agreement Commentary BIA has been shown to detect changes in body composition with an escape to standard nutrition assessment [80] and has been recently recommended as an indicator for the severity of liver disease [81].…”

Section: Recommendation 11mentioning

confidence: 99%