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The diagnostic value of phase angle, an integrative bioelectrical marker, for identifying individuals with dysmobility syndrome: the Korean Urban-Rural Elderly study

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Abstract

Summary

Low phase angle, a non-invasive bioimpedance marker, is associated with elevated odds of dysmobility syndrome and its components. Phase angle (estimated cutoffs: < 4.8° in men; < 4.5° in women) can be used to detect dysmobility syndrome in community-dwelling older adults as a simple, integrative screening tool.

Introduction

Dysmobility syndrome uses a score-based approach to predict fracture risk that incorporates the concepts of osteoporosis, sarcopenia, and obesity. Low phase angle (PhA), a simple, non-invasive bioelectrical impedance marker, was associated with low lean mass, high fat mass, and poor muscle function. We aimed to investigate the association between PhA and dysmobility syndrome, with the exploration of the diagnostic cutoffs.

Methods

In a community-dwelling Korean older adult cohort, dysmobility syndrome was defined as the presence of ≥ 3 of the following components: osteoporosis, low lean mass, falls in the preceding year, low grip strength, high fat mass, and poor timed up and go performance.

Results

Among the 1825 participants (mean age 71.6, women 66.7%), subjects were classified into sex-stratified PhA tertiles. The prevalence of dysmobility syndrome increased from the highest PhA tertile group to the lowest (15.50 to 2.45% in men; 33.41 to 12.25% in women, P for trend < 0.001). The mean PhA values decreased as the dysmobility score increased (5.33° to 4.65° in men; 4.76° to 4.39° in women, P for trend < 0.001). Low PhA (cutoff: < 4.8° in men; < 4.5° in women) was associated with twofold elevated odds of dysmobility syndrome after adjusting for age, sex, and conventional risk factors. Low PhA improved the identification of individuals with dysmobility syndrome when added to the conventional risk model (area under the curve, 0.73 to 0.75, P = 0.002).

Conclusion

Low PhA was associated with dysmobility syndrome and its components, independent of age, sex, body mass index, nutritional status, and inflammation.

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Data availability

The survey dataset of the KURE cohort are not available for sharing at this point and further directions regarding sharing archived dataset will be announced by the National Biobank of Korea.

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Acknowledgments

We thank all our participants and the technical staff of the KURE study. We thank Minheui Yoo of ‘SENTINEL (Severance ENdocrinology daTa scIeNcE pLatform)’ program of the Endocrinology Division, Department of Internal medicine, Yonsei University College of Medicine, Seoul, Korea (4-2018-1215; DUCD000002) for the support of statistical analysis.

Funding

This work was supported by the Research of Korea Centers for Disease Control and Prevention (2013-E63007-01, 2013-E63007-02) and the Student Research grant of Yonsei University College of Medicine (Jung, Mar. 2020).

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Authors and Affiliations

  1. Division of Endocrinology, Endocrine Research Institute, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun–gu, Seoul, 03722, Korea

    Y. W. Jung, N. Hong & Y. Rhee

  2. Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea

    C. O. Kim

  3. Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea

    H. C. Kim

  4. Department of Sociology, Yonsei University, Seoul, Korea

    Y. Youm

  5. Department of Radiology, Yonsei University College of Medicine, Seoul, Korea

    J. -Y. Choi

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  1. Y. W. Jung
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Correspondence to N. Hong.

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The study protocol was approved by the International Review Board of Yonsei University Health System, Severance Hospital (IRB No. 4-2012-0172). All participants provided written informed consent prior to study participation. All procedures performed in the studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

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Jung, Y.W., Hong, N., Kim, C.O. et al. The diagnostic value of phase angle, an integrative bioelectrical marker, for identifying individuals with dysmobility syndrome: the Korean Urban-Rural Elderly study. Osteoporos Int 32, 939–949 (2021). https://doi.org/10.1007/s00198-020-05708-2

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