Relation of Disease with Standardized Phase Angle Among Older Patients
- 33 Downloads
A low phase angle (PA) has been associated with negative outcome in specific diseases. However, many patients suffer from several co-morbidities. This study aims at identifying the impact of the type and the severity of diseases on PA in a retrospective cohort study of older people.
We included all people ≥65 years who underwent a PA measurement (Nutriguard®) between 1990 and 2011 at the Geneva University Hospitals. PA was standardized for gender, age and body mass index according to German reference values. Co-morbidities were reported in form of the Cumulative Illness Rating Scale which considers 14 different organs/systems (disease categories), each rated from 0 (healthy) to 4 (severe illness) (severity grades). The association between the diseases categories and standardized PA was evaluated by a multivariate linear regression. For each significant disease category, we performed univariate regression models. The adjusted R2 was used to identify the best predictors of standardized PA. We considered that the severity grade affected standardized PA if there was a progressive decrease in the regression coefficients.
We included 1181 people (37% women). The multivariate regression model showed that the disease categories explain 17% of the variance of standardized PA. Many disease categories affect standardized PA and the ones best associated with standardized PA were the hematopoietic and vascular (R2 7.4%), the musculo-skeletal (R2 5.5%) and the respiratory (R2 4.0%) diseases. The regression coefficients in the univariate linear regression model decreased progressively with higher severity grades in respiratory (-0.15, -0.27, -0.55, -0.67) and musculo-skeletal diseases (-0.09, -0.46, -0.85, -0.86).
Many different diseases affect standardized PA. The higher the severity grade in musculo-skeletal and respiratory diseases, the lower is the standardized PA.
Key wordsBioelectrical impendance analysis cumulative illness rating scale phase angle severity of disease older people
- 7.Ruiz-Margain A, Macias-Rodriguez RU, Duarte-Rojo A, Rios-Torres SL, Espinosa-Cuevas A, Torre A. Malnutrition assessed through phase angle and its relation to prognosis in patients with compensated liver cirrhosis: a prospective cohort study. Dig Liver Dis. 2015 Apr;47(4):309–14. PubMed PMID: 25618555.CrossRefPubMedGoogle Scholar
- 10.Thibault R, Makhlouf AM, Mulliez A, Rotovnic Kozjek N, Gonzalez C, Kekstas G, et al. Bioimpedance phase angle measured at admission predicts 28-day mortality in intensive care unit patients: the international prospective observational study PHASE ANGLE PROJECT. Intensive Care Med. 2016;In press.Google Scholar
- 11.Salvi F, Miller MD, Grilli A, Giorgi R, Towers AL, Morichi V, et al. A manual of guidelines to score the modified cumulative illness rating scale and its validation in acute hospitalized elderly patients. J Am Geriatr Soc. 2008 Oct;56(10):1926–31. PubMed PMID: 18811613. eng.CrossRefPubMedGoogle Scholar
- 12.Zekry D, Loures Valle BH, Graf C, Michel JP, Gold G, Krause KH, et al. Prospective comparison of 6 comorbidity indices as predictors of 1-year post-hospital discharge institutionalization, readmission, and mortality in elderly individuals. J Am Med Dir Assoc. 2012 Mar;13(3):272–8. PubMed PMID: 21450226.CrossRefPubMedGoogle Scholar
- 13.Barrea L, Muscogiuri G, Macchia PE, Di Somma C, Falco A, Savanelli MC, et al. Mediterranean Diet and Phase Angle in a Sample of Adult Population: Results of a Pilot Study. Nutrients. 2017 Feb 17;9(2). PubMed PMID: 28218645. Pubmed Central PMCID: 5331582.Google Scholar
- 20.Silva AM, Heymsfield SB, Gallagher D, Albu J, Pi-Sunyer XF, Pierson RN, Jr., et al. Evaluation of between-methods agreement of extracellular water measurements in adults and children. Am J Clin Nutr. 2008 Aug;88(2):315–23. PubMed PMID: 18689366. Pubmed Central PMCID: 2752354.CrossRefPubMedPubMedCentralGoogle Scholar
- 24.Siervo M, Faber P, Gibney ER, Lobley GE, Elia M, Stubbs RJ, et al. Use of the cellular model of body composition to describe changes in body water compartments after total fasting, very low calorie diet and low calorie diet in obese men. Int J Obes (Lond). 2010 May;34(5):908–18. PubMed PMID: 20142822.CrossRefGoogle Scholar
- 29.Cox-Reijven PL, van Kreel B, Soeters PB. Bioelectrical impedance measurements in patients with gastrointestinal disease: validation of the spectrum approach and a comparison of different methods for screening for nutritional depletion. Am J Clin Nutr. 2003 Dec;78(6):1111–9. PubMed PMID: 14668272.CrossRefPubMedGoogle Scholar
- 30.Levitt DG, Beckman LM, Mager JR, Valentine B, Sibley SD, Beckman TR, et al. Comparison of DXA and water measurements of body fat following gastric bypass surgery and a physiological model of body water, fat, and muscle composition. J Appl Physiol (1985). 2010 Sep;109(3):786–95. PubMed PMID: 20558754. Pubmed Central PMCID: 2944634.CrossRefPubMedCentralGoogle Scholar