Phase angle (PhA) in overweight and obesity: evidence of applicability from diagnosis to weight changes in obesity treatment

Cancello, Raffaella; Brunani, Amelia; Brenna, Ettore; Soranna, Davide; Bertoli, Simona; Zambon, Antonella; Lukaski, Henry C.; Capodaglio, Paolo

doi:10.1007/s11154-022-09774-1

Cited by 18 publications

(15 citation statements)

References 90 publications

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“…This corroborates with the current literature, which states that FFM, an indicator of physical fitness and nutritional status in athletes of different sport disciplines, is the strongest predictor of PhA, even stronger than BMI or body fat [ 7 , 28 , 29 ]. Indeed, studies have indicated that lower PhA values are associated with higher levels of body fat, indicating a potential link between reduced cellular health and increased adiposity [ 30 , 31 ]. Likewise, we observed a negative correlation between body fat % and PhA when evaluating both sexes.…”

Section: Discussionmentioning

confidence: 99%

Phase angle as an indicator of body composition and physical performance in handball players

Oliveira Silvino,

Raffaela Barbosa Barros,

Machado Brito

et al. 2024

BMC Sports Sci Med Rehabil

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Background Phase angle (PhA), obtained from the bioimpedance analysis, is widely used in clinical situations and in sports. This study evaluated the association between PhA with body composition and physical performance of handball athletes. Methods 43 national-level players (22.19 ± 3.86 years) of both sexes were evaluated regarding anthropometry, body composition, squat (SJ) and countermovement (CMJ) jumps, handgrip strength, and cardiorespiratory fitness. Results We verified a correlation between PhA of the whole body and fat-free mass (r = 0.511), body mass index (r = 0.307), and body fat % (r = -0.303). There was a positive correlation between PhA of the whole body and SJ (r = 0.376), CMJ (r = 0.419), and handgrip for the dominant hand (r = 0.448). Moreover, PhA of the upper limbs was more strongly correlated with handgrip for the dominant (r = 0.630) and non-dominant hand (r = 0.575) compared to PhA of the whole body considering both sexes. Similarly, segmental PhA had a stronger significant correlation with SJ (r = 0.402) and handgrip for the dominant hand (r = 0.482) in males, as well as CMJ (r = 0.602) in females, compared to PhA of the whole body. Conclusion PhA of the whole body was positively related to fat-free mass, body mass index, body fat %, and lower- and upper-limbs strength in handball athletes. Segmental PhA might be used as a tool for estimating lower and upper limbs performance considering the sex, in preference to the PhA of the whole body.

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Section: Discussionmentioning

confidence: 99%

Phase angle as an indicator of body composition and physical performance in handball players

Oliveira Silvino,

Raffaela Barbosa Barros,

Machado Brito

et al. 2024

BMC Sports Sci Med Rehabil

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“…Studies are required to assess new pharmacological treatments (such as glucagon-like peptide 1 agonists), lifestyle and physical activity programs (aerobic exercise and resistance training), and bariatric surgery procedures, to study the PhA and changes in the body composition. This is also relevant for establishing long-term weight maintenance protocols after weight loss [44]. It is essential to measure electrical values of resistance, Xc and PhA to assess changes in body composition in obese patients with a BMI above 35 [45].…”

Section: Obesity and Metabolic Diseasesmentioning

confidence: 99%

Future lines of research on phase angle: Strengths and limitations

Guerrero

García-García

Talluri³

et al. 2023

Rev Endocr Metab Disord

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Bioelectrical impedance analysis (BIA) is the most widely used technique in body composition analysis. When we focus the use of phase sensitive BIA on its raw parameters Resistance (R), Reactance (Xc) and Phase Angle (PhA), we eliminate the bias of using predictive equations based on reference models. In particular PhA, have demonstrated their prognostic utility in multiple aspects of health and disease. In recent years, as a strong association between prognostic and diagnostic factors has been observed, scientific interest in the utility of PhA has increased. In the different fields of knowledge in biomedical research, there are different ways of assessing the impact of a scientific-technical aspect such as PhA. Single frequency with phase detection bioimpedance analysis (SF-BIA) using a 50 kHz single frequency device and tetrapolar wrist-ankle electrode placement is the most widely used bioimpedance approach for characterization of whole-body composition. However, the incorporation of vector representation of raw bioelectrical parameters and direct mathematical calculations without the need for regression equations for the analysis of body compartments has been one of the most important aspects for the development of research in this area. These results provide new evidence for the validity of phase-sensitive bioelectrical measurements as biomarkers of fluid and nutritional status. To enable the development of clinical research that provides consistent results, it is essential to establish appropriate standardization of PhA measurement techniques. Standardization of test protocols will facilitate the diagnosis and assessment of the risk associated with reduced PhA and the evaluation of changes in response to therapeutic interventions. In this paper, we describe and overview the value of PhA in biomedical research, technical and instrumental aspects of PhA research, analysis of Areas of clinical research (cancer patients, digestive and liver diseases, critical and surgical patients, Respiratory, infectious, and COVID-19, obesity and metabolic diseases, Heart and kidney failure, Malnutrition and sarcopenia), characterisation of the different research outcomes, Morphofunctional assessment in disease-related malnutrition and other metabolic disorders: validation of PhA with reference clinical practice techniques, strengths and limitations. Based on the detailed study of the measurement technique, some of the key issues to be considered in future PhA research. On the other hand, it is important to assess the clinical conditions and the phenotype of the patients, as well as to establish a disease-specific clinical profile. The appropriate selection of the most critical outcomes is another fundamental aspect of research.

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“…As it is known, the association between PhA with muscle mass parameters and sarcopenia have been con rmed [16][17][18]. Besides, some studies have con rmed that PhA is lower in severe or morbidly obese patients [19,20]. In particular, a decline began with a BMI value of 35 kg/m 2 , then decreased sharply for a BMI of 40 kg/m 2 [18].…”

Section: Introductionmentioning

confidence: 99%

Bioelectrical impedance analysis-derived phase angle (PhA) in adults with normal weight obesity and correlation of PhA with body composition

Luo,

Jin

2024

Preprint

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Background: Normal weight obesity (NWO) is defined as having a normal body mass index (BMI) accompany with a high percent body fat (PBF). Individuals with NWO have a higher risk for type 2 diabetes, cardiometabolic diseases and adverse health issues. Asian populations tend to have normal BMI with high PBF, which is concerning. The excessive adipose accumulation results in a significant reduction of health-related physical fitness and can affect the phase angle (PhA). Therefore, this study aimed to assess the body composition among Chinese adults with normal BMI, and to establish PhA reference data for NWO population. Methods: A total of 4839 adult participants were enrolled for analysis. A four-group comparison of the PhA for participants categorized with NWO, NWO with low muscle mass, low muscle mass, and others were conducted. Pearson’s correlation coefficients were used to evaluate the correlation between PhA and age, PBF, waist circumference (WC), visceral fat area (VFA), appendicular skeletal muscle mass index (ASMI) and BMI. Multivariate regression analysis was applied to determine the relationship between PhA and NWO, NWO with low muscle mass, low muscle mass, and others. Receiver Operating Characteristic (ROC) curves were used to identify the optimal PhA cut-off values for detecting NWO with low muscle mass in males and females. Results: A significantly difference in PhA among participants with four groups (P <0.001). Pearson correlation analysis showed a positive correlation between PhA and WC, ASMI, BMI; but a negative correlation between PhA and age, PBF, VFA (P <0.001). The results of multivariate linear regression analysis showed that age, gender, PBF, and ASMI were independent and significant determinants of PhA in NWO participants (P <0.001). NWO, NWO with low muscle mass, low muscle mass were significantly and negatively associated with the PhA in males and females (P <0.001). These results indicated that NWO with low muscle mass was more strongly associated with the PhA than NWO and low muscle mass. The area under the ROC curve (AUC) of PhA for NWO with low muscle mass was 0.786 (95% CI, 0.755-0.818, P<0.001) for males, and 0.746 (95% CI, 0.705-0.786, P <0.001) for females. The optimal cut-off value was ≤5.48° (specificity 0.660, sensitivity 0.782) for males, and ≤4.60° (specificity 0.788, sensitivity 0.565) for females. Conclusion: A negative correlation was observed between PhA and PBF. PhA can be used as a predictor of NWO with low muscle mass, and the cut-off values were ≤5.55° for males and ≤4.79° for females. Simple and practical PhA-based prediction of pre-sarcopenic obesity in normal weight population would be useful in clinical practice.

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Phase angle (PhA) in overweight and obesity: evidence of applicability from diagnosis to weight changes in obesity treatment

Cited by 18 publications

References 90 publications

Phase angle as an indicator of body composition and physical performance in handball players

Phase angle as an indicator of body composition and physical performance in handball players

Future lines of research on phase angle: Strengths and limitations

Bioelectrical impedance analysis-derived phase angle (PhA) in adults with normal weight obesity and correlation of PhA with body composition

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