Abstract 14623: Phase Angle as an Indicator of Sarcopenia, Undernutrition, and Cachexia in Inpatients With Cardiovascular Diseases

Abstract

Introduction: In patients with heart failure, malnutrition is often associated with sarcopenia, and cachexia, closely related to the prognosis of the disease. Phase angle(PA) is an angle that expresses the resistance of the cell membrane, and is related to the health of the cell and the nutritional state of the cell membrane. It is attracting attention as a prognostic factor and nutritional index for various diseases. We investigated the clinical usefulness of PA as markers of sarcopenia, cachexia and malnutrition in hospitalized patients with cardiovascular disease. Methods: Total 412 patients(277 males and 135 females) who underwent cardiac rehabilitation on admission due to cardiovascular diseases were included in this study. We performed body composition analysis(Inbody S10) such as PA, and skeletal muscle mass index(SMI). The nutritional states were evaluated by BMI, CONUT score, blood albumin level(Alb), and Hb. The blood concentration of BNP and eGFR were also measured. Sarcopenia was judged by the AWGS algorithm, and cachexia was judged by using BMI<20 and serum parameters of Alb, Hb, and CRP. Results: Both SMI and PA negatively correlated with age, and positively correlated with BMI, grip strength, knee extension strength, and SPPB score in both sexes. SMI and PA were also significantly associated with CONUT score, Hb, and Alb in males, but PA was more strongly associated with these nutritional aspects. In females, PA was correlated with Hb and Alb, but not with SMI. Sarcopenia was found in 31.6% of men and 32.4% of women. The cut-off values of PA obtained from the ROC curve in patients with sarcopenia were 4.55°for males and 4.25°for females. The cut-off values for PA in ROC curves for those with cachexia were 4.15°for males and 4.25°for females. When grip strength, knee extension strength, CRP, BNP, eGFR, Hb, and Alb were independent factors, multiple regression analysis showed that grip strength and BNP were the independent determinants of SMI, whereas grip strength, BNP, and Hb were the independent determinants of PA, after adjusting for age and BMI in males. Conclusions: This study provides the evidence showing that PA can be highly useful as a marker for sarcopenia, malnutrition and then cachexia in hospitalized patients with cardiovascular disease.