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Archives of Osteoporosis

, 13:39 | Cite as

A low phase angle measured with bioelectrical impedance analysis is associated with osteoporosis and is a risk factor for osteoporosis in community-dwelling people: the Yakumo study

  • Satoshi Tanaka
  • Kei Ando
  • Kazuyoshi Kobayashi
  • Tetsuro Hida
  • Kenyu Ito
  • Mikito Tsushima
  • Masayoshi Morozumi
  • Masaaki Machino
  • Kyotaro Ota
  • Taisuke Seki
  • Naoki Ishiguro
  • Yukiharu Hasegawa
  • Shiro Imagama
Original Article

Abstract

Summary

Although the phase angle has been reported to be related to predictive factors and therapeutic effects in various diseases, its relation with osteoporosis is unclear. In our large prospective survey of community-dwelling people, a low phase angle was related with osteoporosis, and it could be a predictor of osteoporosis.

Purpose

The phase angle measured with bioelectrical impedance analysis (BIA) is one of the clinically important impedance parameters, and it is a predictor of prognosis and mortality for several diseases. The present cross-sectional study aimed to elucidate the association between osteoporosis and variables measured with BIA, including the phase angle.

Methods

The study included 307 participants from an annual health checkup. All participants underwent measurement of bone status by quantitative ultrasound and body composition by BIA. Osteoporosis was diagnosed according to the WHO classification, and statistical comparisons were conducted between normal individuals and osteoporosis patients.

Results

Age, proteins, minerals, and the phase angle were significantly different between normal individuals and osteoporosis patients (p < 0.001). Furthermore, after controlling for age and sex, proteins, minerals, and the phase angle were significantly lower in osteoporosis patients than those in normal individuals (p < 0.001). In multivariate logistic regression analysis, older age and a low phase angle were risk factors for osteoporosis. Additionally, multiple regression analysis showed that age, sex, proteins, minerals, and the appendicular skeletal muscle index were significantly related to the phase angle.

Conclusions

The phase angle is a predictor of osteoporosis, which is unaffected by age and sex, and a lower phase angle is associated with greater probability of osteoporosis. The phase angle can be easily measured, and osteoporosis can be confirmed even at home. This may facilitate early diagnosis and treatment, which may be useful for preventing diseases related to osteoporosis.

Keywords

Community-dwelling people Osteoporosis Quantitative ultrasound Bioelectrical impedance analysis Phase angle 

Notes

Acknowledgments

We are grateful to the staff of the Comprehensive Health Care Program held in Yakumo, Hokkaido, and Ms. Marie Miyazaki and Ms. Hiroko Ino of Nagoya University for their assistance throughout this study.

Compliance with ethical standards

All participants provided written informed consent, and the study protocol was approved by the Institutional Review Board of Nagoya University Graduate School of Medicine. Moreover, the study protocol was approved by the Committee on Ethics in Human Research of our university, and the study procedures were carried out in accordance with the principles of the Declaration of Helsinki.

Conflicts of interest

None.

References

  1. 1.
    (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis. Report of a WHO Study Group. World Health Organ Tech Rep Ser 843:1–129Google Scholar
  2. 2.
    Kanis JA (1994) Assessment of fracture risk and its application to screening for postmenopausal osteoporosis: synopsis of a WHO report. WHO Study Group. Osteoporos Int 4:368–381CrossRefPubMedGoogle Scholar
  3. 3.
    Pisani P, Renna MD, Conversano F, Casciaro E, Di Paola M, Quarta E, Muratore M, Casciaro S (2016) Major osteoporotic fragility fractures: risk factor updates and societal impact. World J Orthop 7:171–181CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Kuo TR, Chen CH (2017) Bone biomarker for the clinical assessment of osteoporosis: recent developments and future perspectives. Biomark Res 5:18CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Imagama S, Matsuyama Y, Hasegawa Y, Sakai Y, Ito Z, Ishiguro N, Hamajima N (2011) Back muscle strength and spinal mobility are predictors of quality of life in middle-aged and elderly males. Eur Spine J 20:954–961CrossRefPubMedGoogle Scholar
  6. 6.
    Imagama S, Hasegawa Y, Matsuyama Y, Sakai Y, Ito Z, Hamajima N, Ishiguro N (2011) Influence of sagittal balance and physical ability associated with exercise on quality of life in middle-aged and elderly people. Arch Osteoporos 6:13–20CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Sun Q, Zheng Y, Chen K, Yan W, Lu J, Dou J, Lv Z, Wang B, Gu W, Ba J, Mu Y (2017) Osteopenia is associated with glycemic levels and blood pressure in Chinese postmenopausal women: a cross-sectional study. Clin Exp Med 17:85–91CrossRefPubMedGoogle Scholar
  8. 8.
    Norman K, Stobaus N, Pirlich M, Bosy-Westphal A (2012) Bioelectrical phase angle and impedance vector analysis—clinical relevance and applicability of impedance parameters. Clin Nutr 31:854–861CrossRefPubMedGoogle Scholar
  9. 9.
    Imagama S, Hasegawa Y, Ando K, Kobayashi K, Hida T, Ito K, Tsushima M, Nishida Y, Ishiguro N (2017) Staged decrease of physical ability on the locomotive syndrome risk test is related to neuropathic pain, nociceptive pain, shoulder complaints, and quality of life in middle-aged and elderly people—the utility of the locomotive syndrome risk test. Mod Rheumatol 27:1051–1056CrossRefPubMedGoogle Scholar
  10. 10.
    Imagama S, Hasegawa Y, Wakao N, Hirano K, Muramoto A, Ishiguro N (2014) Impact of spinal alignment and back muscle strength on shoulder range of motion in middle-aged and elderly people in a prospective cohort study. Eur Spine J 23:1414–1419CrossRefPubMedGoogle Scholar
  11. 11.
    Imagama S, Ito Z, Wakao N, Seki T, Hirano K, Muramoto A, Sakai Y, Matsuyama Y, Hamajima N, Ishiguro N, Hasegawa Y (2013) Influence of spinal sagittal alignment, body balance, muscle strength, and physical ability on falling of middle-aged and elderly males. Eur Spine J 22:1346–1353CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Imagama S, Hasegawa Y, Wakao N, Hirano K, Hamajima N, Ishiguro N (2012) Influence of lumbar kyphosis and back muscle strength on the symptoms of gastroesophageal reflux disease in middle-aged and elderly people. Eur Spine J 21:2149–2157CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Imagama S, Hasegawa Y, Seki T, Matsuyama Y, Sakai Y, Ito Z, Ishiguro N, Ito Y, Hamajima N, Suzuki K (2011) The effect of β-carotene on lumbar osteophyte formation. Spine (Phila Pa 1976) 36:2293–2298CrossRefGoogle Scholar
  14. 14.
    Hoffer EC, Meador CK, Simpson DC (1969) Correlation of whole-body impedance with total body water volume. J Appl Physiol 27:531–534CrossRefPubMedGoogle Scholar
  15. 15.
    Yamada Y, Ikenaga M, Takeda N, Morimura K, Miyoshi N, Kiyonaga A, Kimura M, Higaki Y, Tanaka H, Nakagawa Study (2014) Estimation of thigh muscle cross-sectional area by single- and multifrequency segmental bioelectrical impedance analysis in the elderly. J Appl Physiol (1985) 116:176–182CrossRefGoogle Scholar
  16. 16.
    Roubenoff R, Baumgartner RN, Harris TB, Dallal GE, Hannan MT, Economos CD, Stauber PM, Wilson PW, Kiel DP (1997) Application of bioelectrical impedance analysis to elderly populations. J Gerontol A Biol Sci Med Sci 52:M129–M136CrossRefPubMedGoogle Scholar
  17. 17.
    Lim J, Hwang S (2017) Identification of osteoporosis-associated protein biomarkers from ovariectomized rat urine. Curr Proteomics 14:130–137CrossRefPubMedPubMedCentralGoogle Scholar
  18. 18.
    Kulcsar-Jakab E, Petho Z, Pap Z, Kalina E, Foldesi R, Balogh A, Antal-Szalmas P, Bhattoa HP (2015) Cystatin C as a potential predictor of osteoprotegerin levels in healthy men, a cross-sectional, observational study. BMC Musculoskelet Disord 16:227CrossRefPubMedPubMedCentralGoogle Scholar
  19. 19.
    Khosla S, Hofbauer LC (2017) Osteoporosis treatment: recent developments and ongoing challenges. Lancet Diabetes Endocrinol 5:898–907CrossRefPubMedPubMedCentralGoogle Scholar
  20. 20.
    Guo M, Qu H, Xu L, Shi DZ (2017) Tea consumption may decrease the risk of osteoporosis: an updated meta-analysis of observational studies. Nutr Res 42:1–10CrossRefPubMedGoogle Scholar
  21. 21.
    Sin DD, Man JP, Man SF (2003) The risk of osteoporosis in Caucasian men and women with obstructive airways disease. Am J Med 114:10–14CrossRefPubMedGoogle Scholar
  22. 22.
    Mattar JA (1996) Application of total body bioimpedance to the critically ill patients. Brazilian Group for Bioimpedance Study. New Horiz 4:493–503PubMedGoogle Scholar
  23. 23.
    Zdolsek HJ, Lindahl OA, Sjoberg F (2000) Non-invasive assessment of fluid volume status in the interstitium after haemodialysis. Physiol Meas 21:211–220CrossRefPubMedGoogle Scholar
  24. 24.
    Bosy-Westphal A, Danielzik S, Dorhofer RP, Later W, Wiese S, Muller MJ (2006) Phase angle from bioelectrical impedance analysis: population reference values by age, sex, and body mass index. JPEN J Parenter Enteral Nutr 30:309–316CrossRefPubMedGoogle Scholar
  25. 25.
    Selberg O, Selberg D (2002) Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis. Eur J Appl Physiol 86:509–516CrossRefPubMedGoogle Scholar
  26. 26.
    Oliveira CM, Kubrusly M, Mota RS, Silva CA, Choukroun G, Oliveira VN (2010) The phase angle and mass body cell as markers of nutritional status in hemodialysis patients. J Ren Nutr 20:314–320CrossRefPubMedGoogle Scholar
  27. 27.
    Basile C, Della-Morte D, Cacciatore F, Gargiulo G, Galizia G, Roselli M, Curcio F, Bonaduce D, Abete P (2014) Phase angle as bioelectrical marker to identify elderly patients at risk of sarcopenia. Exp Gerontol 58:43–46CrossRefPubMedGoogle Scholar
  28. 28.
    Colin-Ramirez E, Castillo-Martinez L, Orea-Tejeda A, Asensio Lafuente E, Torres Villanueva F, Rebollar Gonzalez V, Narváez David R, Dorantes García J (2006) Body composition and echocardiographic abnormalities associated to anemia and volume overload in heart failure patients. Clin Nutr 25:746–757CrossRefPubMedGoogle Scholar
  29. 29.
    Demirci MS, Demirci C, Ozdogan O, Kircelli F, Akcicek F, Basci A, Ok E, Ozkahya M (2011) Relations between malnutrition-inflammation-atherosclerosis and volume status. The usefulness of bioimpedance analysis in peritoneal dialysis patients. Nephrol Dial Transplant 26:1708–1716CrossRefPubMedGoogle Scholar
  30. 30.
    Johansen KL, Kaysen GA, Young BS, Hung AM, da Sliva M, Chertow GM (2003) Longitudinal study of nutritional status, body composition, and physical function in hemodialysis patients. Am J Clin Nutr 77:842–846CrossRefPubMedGoogle Scholar
  31. 31.
    Hassan EB, Duque G (2017) Osteosarcopenia: a new geriatric syndrome. Aust Fam Physician 46:849–853PubMedGoogle Scholar
  32. 32.
    Afshinnia F, Pennathur S (2016) Association of hypoalbuminemia with osteoporosis: analysis of the national health and nutrition examination survey. J Clin Endocrinol Metab 101:2468–2474CrossRefPubMedPubMedCentralGoogle Scholar
  33. 33.
    Hammad LF (2016) Measurements of bone mineral density and stiffness index in young Saudi females. Pak J Med Sci 32:399–402PubMedPubMedCentralGoogle Scholar

Copyright information

© International Osteoporosis Foundation and National Osteoporosis Foundation 2018

Authors and Affiliations

  • Satoshi Tanaka
    • 1
  • Kei Ando
    • 1
  • Kazuyoshi Kobayashi
    • 1
  • Tetsuro Hida
    • 1
  • Kenyu Ito
    • 1
  • Mikito Tsushima
    • 1
  • Masayoshi Morozumi
    • 1
  • Masaaki Machino
    • 1
  • Kyotaro Ota
    • 1
  • Taisuke Seki
    • 1
  • Naoki Ishiguro
    • 1
  • Yukiharu Hasegawa
    • 2
  • Shiro Imagama
    • 1
  1. 1.Department of Orthopaedic SurgeryNagoya University Graduate School of MedicineNagoyaJapan
  2. 2.Department of RehabilitationKansai University of Welfare ScienceOsakaJapan

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