Decreased Bioelectrical Impedance Phase Angle in Hospitalized Children and Adolescents with Newly Diagnosed Type 1 Diabetes: A Case-Control Study (original) (raw)
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Clinical Nutrition
Background: Nutritional status can be difficult to assess. Bioelectrical impedance analysis (BIA)-derived phase angle (PA), and the plasma markers citrulline and transthyretin (prealbumin) have the potential to assist, but the protocol of fasting and resting for BIA renders the investigation impractical for routine use, especially so in populations at high risk of malnutrition. Aims: 1-To clarify whether starving and resting are necessary for reliable measurement of PA. 2-To identify whether PA, citrulline and transthyretin correlate with nutritional status. Methods: Eighty consenting adult in-patients were recruited. Nutritional status was determined by subjective global assessment (SGA) used as gold standard. The Malnutrition Universal Screening Tool (MUST) was used and anthropometric measurements were performed. Serum was analysed for citrulline and transthyretin. PA was measured using Bodystat 4000. The PA was considered to define malnutrition when lower than reference ranges for sex and age, and severe malnutrition if more than 2 integers below the lower limit. Anthropometric measurements were categorised according to WHO reference centiles. Ordinal logistic regression estimated the strength of association of PA, citrulline and transthyretin with SGA. PA values in the different metabolic states were compared using paired t tests. Results: All 80 subjects completed the BIA and the nutritional assessments in the 3 different states; 14 declined to provide blood samples for the biochemical assays. Malnutrition was identified in 32 cases, severe malnutrition in 14 cases, the remaining 34 cases were deemed not to be malnourished. PA was strongly inversely associated with SGA (Odds Ratio [OR] per unit increase = 0.21, CI 0.12-0.37, p < 0.001). PA was not influenced by exercise (p=0.134) or food intake (p=0.184). Transthyretin was inversely associated with malnourished/severely malnourished states (OR = 0.98, 95% CI 0.97-0.99, p = 0.001), but had
ABCS Health Sciences
Introduction: Phase angle (PhA) is a Bioelectrical impedance analysis (BIA) parameter representing an indicator of cellular health and has been suggested as a biomarker of nutritional status. Objective: To evaluate the association between PhA and nutritional parameters in older adults. Methods: A cross-sectional study was conducted with community-dwelling older adults. Body mass index (BMI), arm muscle circumference (AMC), calf circumference (CC), body fat percentage (BF%), appendicular skeletal muscle mass (ASMM), serum albumin, mini-nutritional assessment (MNA), and PhA were assessed. Kolmogorov–Smirnov test, Spearman's correlation coefficient, chi-square test, and Poisson regression models were performed. Results: 144 participants were included in the study, and most of them were female, aged ≥80 years, and underweight. Most older adults with lower PhA were women, aged range 80–89 years, and with reduced ASMM (p<0.05). PhA presented a significant correlation with age (r=–0...
Folia medica
Type 2 diabetes is a metabolic disorder and as such should affect the components of body composition of diabetics. The changes it induces in patients complement the anthropological characteristics of this disease. The AIM of the present study was to assess the effect type 2 diabetes has on some of the body composition components in male diabetics. The study included 169 male patients with type 2 diabetes. All patients (ethnical Bulgarian) were allocated into two age groups: group 1--patients aged 40-60 years and group 2--patients aged 61-80 years. Direct measurements of parameters were performed with a Tanita body composition analyser. The bioimpedance parameters we measured were body fat percentage (%BF), total body water percentage (%TBW), muscle mass (MM), bone mass (BM), and visceral fat (VF). The derived parameters were total body fat (TBF) (kg), active body mass (ABM) (kg), active body mass percentage. Body composition of male diabetics aged 40-60 years: %BF, VF and TBF were s...
Bioelectrical Impedance Phase Angle: Utility in clinical practice
International Journal of Nutrology, 2012
ABSTRACTThe choice of the best nutrition assessment method in hospitalized patients remains a challenge. The aim of this study was to review the use of phase angle (PA) in clinical practice. PA is a parameter obtained from bioelectrical impedance analysis, being a derived measure from the relationship between resistance and reactance. Because PA is dependent on body cell mass (BCM) and cell membrane functions, it has been considered a prognostic marker in several clinical conditions. BCM reflects the cellular components responsible for energy transfer and biochemical activity and is considered an excellent reference for expressing the rates of physiological processes, such as energy expenditure and proteolysis. Low PA values suggest cell death or decreased cell integrity, whereas higher PA values suggest a large amount of intact cell membranes, with a consequently better prognosis. The literature lacks studies determining PA reference values, which has prevented its use in routine c...
Journal of Medical Engineering & Technology, 2017
Background: Bioelectrical impedance analysis (BIA) requires a high degree of standardisation in order to ensure valid and reproducible impedance measurements. The overall aim of this review was to study the degree to which BIA papers conducted in healthy paediatric populations (aged 0-17 years) were standardised. Methods: Literature was identified on the basis of a systematic search of internationally-recognised electronic databases and hand searching of the reference lists of the included papers in order to identify additional relevant papers. The review was limited to lead-type BIA devices for whole-body, segmental-and focal impedance measurements. In total, 71 papers published between 1988 and 2016 were included. To evaluate the degree of standardisation of the papers, a recently published review detailing critical factors that may impact on BIA measurements in children was used as a model for structuring and extracting data. Results: There was a general lack of BIA standardisation, or its reporting, in the papers under review, which hinders comparison of data between studies and could potentially lead to erroneous measurements. Conclusions: If the BIA technique should be accepted clinically for routine use in paediatric populations, there is a need for an increased focus on the importance of improved standardisation and its reporting in future studies. Consequently, this review contains recommendations for performing and reporting BIA measurements in a standardised manner.
Segmental bioelectrical impedance in the assessment of body composition of Sri Lankan children
Journal of the National Science Foundation of Sri Lanka
Over the years bioelectrical impedance assay (BIA) has gained popularity in the assessment of body composition. However, equations for the prediction of whole body composition use whole body BIA. This study attempts to evaluate the usefulness of segmental BIA in the assessment of whole body composition. A cross sectional descriptive study was conducted at the Professorial Paediatric Unit of Lady Ridgeway Hospital, Colombo, involving 259 (M/F:144/115) 5 to 15 year old healthy children. The height, weight, total and segmental BIA were measured and impedance indices and specific resistivity for the whole body and segments were calculated. Segmental BIA indices showed a significant association with whole body composition measures assessed by total body water (TBW) using the isotope dilution method (D 2 O). Impedance index was better related to TBW and fat free mass (FFM), while specific resistivity was better related to the fat mass of the body. Regression equations with different combinations of variables showed high predictability of whole body composition. Results of this study showed that segmental BIA can be used as an alternative approach to predict the whole body composition in Sri Lankan children.
Comparison of bioelectrical impedance analysis with measures of body composition in children
1989
The measurement of body composition has become an important component in the diagnosis of health, physical conditioning and nutritional status. The aim of this study was to compare two methods of detecting body composition, bioelectrical impedance and air displacement plethysmography for athletes and non-athletes. Specifically, we compared the parameters as fat mass, fat free mass and the value of basal metabolic rate. A sample size of 52 men (age 26.2 ± 5.4 years) that included a group of mixed martial arts (MMA) fighters (n = 31, age 27.2 ± 5.5 years) and a group of the non-athletes (n =21, age 24.6 ± 5.1 years). Both groups were measured by bioelectrical impedance and air displacement plethysmography. Significant differences in % body fat (p<0.05) and fat-free mass (p<0.05) were noted between bioelectrical impedance and air displacement plethysmography of non-athletes, but there were no significant differences for athletes. Furthermore, there was a significant difference (p<0.001) of basal metabolic rate between bioelectrical impedance and air displacement plethysmography, but the correlation with fat free mass was very strong for both methods. Therefore, the use of bioelectrical impedance and air displacement plethysmography may be useful for detecting changes in body composition, but their accuracy is controversial and for this reason we recommend using only one method and not combining them.
Current opinion in clinical nutrition and metabolic care, 2017
Malnutrition affects prognosis in many groups of patients. Although screening tools are available to identify adults at risk for poor nutritional status, a need exists to improve the assessment of malnutrition by identifying the loss of functional tissues that can lead to frailty, compromised physical function, and increased risk of morbidity and mortality, particularly among hospitalized and ill patients and older adults. Bioimpedance analysis (BIA) offers a practical approach to identify malnutrition and prognosis by assessing whole-body cell membrane quality and depicting fluid distribution for an individual. Two novel applications of BIA afford opportunities to safely, rapidly, and noninvasively assess nutritional status and prognosis. One method utilizes single-frequency phase-sensitive measurements to determine phase angle, evaluate nutritional status, and relate it to prognosis, mortality, and functional outcomes. Another approach uses the ratio of multifrequency impedance va...
Critical factors and their impact on bioelectrical impedance analysis in children: a review
Journal of Medical Engineering & Technology, 2016
Several guidelines for bioelectrical impedance analysis (BIA) have been prepared for adults, but not for children. For that reason, there is a pressing need to develop a consensus set of guidelines to facilitate standardisation of BIA in this important group. This review provides an introduction to BIA, highlights critical factors that may impact on BIA and identifies areas where there is a need for further research in order to increase the quality of impedance measurements and prediction of body composition in children. Although the results of this review highlights a lack of studies in children to provide definitive BIA guidelines, the technique has, however, still proven valuable for body composition assessment in ill and healthy children. To fill the gaps in our knowledge, future studies should focus on methodological issues, particularly with regard to hydration, voiding, clothing, skin preparation and body position. The review may advantageously be used as a checklist in the planning of future studies. Finally, this review forms the basis for the development of guidelines for BIA assessment in this particular group; a task appropriately to be undertaken by scientific societies within the field.