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

Barrea, Luigi; Muscogiuri, Giovanna; Pugliese, Gabriella; Laudisio, Daniela; Alteriis, Giulia de; Graziadio, Chiara; Colao, Annamaria; Savastano, Silvia

doi:10.3390/nu13051446

Cited by 56 publications

(48 citation statements)

References 75 publications

(114 reference statements)

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“…In that, it is tempting to speculate that, besides psoriasis, also in HS the increase circulating TMAO levels might represent the mechanistic link among diet, gut dysbiosis, and the inflammatory status, which in turn influence the disease severity and, possibly, the development of HS comorbidities. In support of this hypothesis, in our study the circulating TMAO level was one of the predictors of the clinical severity of HS, together with PhA, which has recently been proposed as a marker of inflammation [76].…”

Section: Discussionsupporting

confidence: 84%

Association of Trimethylamine N-Oxide (TMAO) with the Clinical Severity of Hidradenitis Suppurativa (Acne Inversa)

Barrea

Muscogiuri²,

Pugliese³

et al. 2021

Nutrients

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In this case-control, cross-sectional, observational study, we evaluated circulating trimethylamine n-oxide (TMAO) levels, a gut-derived metabolite associated with inflammation and cardiometabolic risk, in patients with hidradenitis suppurativa (HS), a highly disabling inflammatory skin disease associated with an elevated prevalence of comorbidities, especially cardiovascular and metabolic diseases. In this study, we enrolled 35 naive-treatment patients with HS and 35 controls, matched for sex, age, and body mass index (BMI). HS Sartorius score was 49.0 (33.0–75.0), while according to the Harley system 12 and 23 patients presented grade 1 and grade 2 severity, respectively. HS patients had a lower adherence to the Mediterranean diet (MD) (p = 0.002), lower phase angle (PhA) (p < 0.001), and higher circulating TMAO levels (p < 0.001) than the control group. HS patients with grade 2 rather than grade 1 of Harley grade severity showed a higher BMI (p = 0.007), waist circumference (p = 0.016), total energy intake (p = 0.005), and lower PhA (p < 0.001) and adherence to the MD (p = 0.003). Of interest, patients with Hurley grade 2 of severity exhibited higher circulating TMAO levels (p < 0.001) compared to grade 1. Circulating TMAO levels showed a positive correlation with HS Sartorius score even after adjustment for confounding covariates, including BMI, waist circumference, adherence to the MD, total energy intake, and PhA (r = 0.570, p = 0.001). Using a linear regression model, circulating TMAO levels and PhA were the main predictors of the clinical severity of HS.

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Section: Discussionsupporting

confidence: 84%

Association of Trimethylamine N-Oxide (TMAO) with the Clinical Severity of Hidradenitis Suppurativa (Acne Inversa)

Barrea

Muscogiuri²,

Pugliese³

et al. 2021

Nutrients

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“…An ideal measurement during the in-season period should stay above the 50th percentile for an athlete who is healthy and in optimal physical condition to tackle this phase of the season. Given that phase angle primarily reflects cellular health and hydration and muscle mass and its quality, nutritional support strategies should be considered, especially in athletes with low phase angle values [ 36 , 37 , 38 ].…”

Section: Discussionmentioning

confidence: 99%

Reference Percentiles for Bioelectrical Phase Angle in Athletes

Campa

Thomas

Watts

et al. 2022

Biology

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The present study aimed to develop reference values for bioelectrical phase angle in male and female athletes from different sports. Overall, 2224 subjects participated in this study [1658 males (age 26.2 ± 8.9 y) and 566 females (age 26.9 ± 6.6 y)]. Participants were categorized by their sport discipline and sorted into three different sport modalities: endurance, velocity/power, and team sports. Phase angle was directly measured using a foot-to-hand bioimpedance technology at a 50 kHz frequency during the in-season period. Reference percentiles (5th, 15th, 50th, 85th, and 95th) were calculated and stratified by sex, sport discipline and modality using an empirical Bayesian analysis. This method allows for the sharing of information between different groups, creating reference percentiles, even for sports disciplines with few observations. Phase angle differed (men: p < 0.001; women: p = 0.003) among the three sport modalities, where endurance athletes showed a lower value than the other groups (men: vs. velocity/power: p = 0.010, 95% CI = −0.43 to −0.04; vs. team sports: p < 0.001, 95% CI = −0.48 to −0.02; women: vs. velocity/power: p = 0.002, 95% CI = −0.59 to −0.10; vs. team sports: p = 0.015, 95% CI = −0.52 to −0.04). Male athletes showed a higher phase angle than female athletes within each sport modality (endurance: p < 0.01, 95% CI = 0.63 to 1.14; velocity/power: p < 0.01, 95% CI = 0.68 to 1.07; team sports: p < 0.01, 95% CI = 0.98 to 1.23). We derived phase angle reference percentiles for endurance, velocity/power, and team sports athletes. Additionally, we calculated sex-specific references for a total of 22 and 19 sport disciplines for male and female athletes, respectively. This study provides sex- and sport-specific percentiles for phase angle that can track body composition and performance-related parameters in athletes.

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“…PhA, a non-invasive bioimpedance marker, reflects cell membrane integrity and size, and it is used as a marker of body cell mass [84]. Altered measurements of the PhA are associated with inflammatory markers [85], are commonly used in the nutritional screening of several diseases, are an important independent predictor of mortality [86], and might represent an easy detectable marker of inflammation that avoid the collection of blood sampling and expensive biochemical assays [87]. Correlations have been found between increased levels of CRP and other markers of inflammation in the PCOS women compared with age-and BMI-matched controls [1].…”

Section: Discussionmentioning

confidence: 99%

Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition

et al. 2021

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Obesity and obesity-related low-grade inflammation are common findings in polycystic ovary syndrome (PCOS), the most common endocrine-metabolic disorder-affecting women in reproductive age. The terms metabolically healthy obese (MHO), and metabolically unhealthy obese (MUO) have been introduced to define individuals with obesity in whom cardio-metabolic risk factors are absent or present, respectively. To date, evidence investigating differences in body composition and adherence to the Mediterranean diet (MD) between MHO and MUO-PCOS women are lacking. Aim of this study was to better characterize the determinants of the metabolic health status in PCOS patients with obesity according to MHO and MUO phenotypes by evaluating endocrine-metabolic profile, inflammatory status, adherence to the MD, and body composition. The study population consisted of 94 treatment-naïve women with PCOS and obesity (BMI = 38.23 ± 6.62 kg/m2 and age = 24.12 ± 3.68 years). Compared PCOS MHO with PCOS MUO patients, the latter had higher levels of high-sensitivity C-reactive protein (hs-CRP) (p < 0.001), testosterone (p < 0.001), and insulin (p < 0.001), worse metabolic parameters, and higher Homeostatic Model Assessment of Insulin Resistance (HoMA-IR), Visceral Adiposity Index (VAI), and Fatty liver Index (FLI) (p < 0.001). Furthermore, PCOS MUO patients had lower adherence to the MD (p < 0.001) in spite of the same total energy intake (p = 0.102) as compared to PCOS MHO. The presence of MUO was associated with highest hs-CRP levels (OR = 1.49, p < 0.001), more severe hyperandrogenism and cardio-metabolic indices (p < 0.001). On the contrary, being PCOS MUO was associated with lower adherence to the MD (OR = 0.28, p < 0.001), and smaller PhAs (OR = 0.04, p < 0.001). Using a regression linear analysis model PREDIMED score entered at the first step (p < 0.001), followed by VAI (p < 0.001), and FLI (p = 0.032) in this analysis. At ROC analysis, a PREDIMED score of ≤4 (p < 0.001, AUC 0.926) could serve as a threshold for a significantly increased risk of presence the MUO-PCOS phenotype. To the best of our knowledge, this is the first study that characterized MHO and MUO-PCOS women on the basis of their adherence to the MD, body composition, and cardio-metabolic indices, providing evidence of the usefulness of adjunctive diagnostic parameters to better differentiate the MHO/MHO phenotypes in this cohort of PCOS patients with obesity.

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

Cited by 56 publications

References 75 publications

Association of Trimethylamine N-Oxide (TMAO) with the Clinical Severity of Hidradenitis Suppurativa (Acne Inversa)

Association of Trimethylamine N-Oxide (TMAO) with the Clinical Severity of Hidradenitis Suppurativa (Acne Inversa)

Reference Percentiles for Bioelectrical Phase Angle in Athletes

Metabolically Healthy Obesity (MHO) vs. Metabolically Unhealthy Obesity (MUO) Phenotypes in PCOS: Association with Endocrine-Metabolic Profile, Adherence to the Mediterranean Diet, and Body Composition

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