Bioelectrical Impedance Analysis Measurements Research Articles

Nutritional and Body Composition Changes in Paediatric β-Thalassemia Patients Undergoing Hematopoietic Stem Cell Transplantation: A Retrospective Study Using Bioelectrical Impedance Analysis.

This retrospective study evaluated nutritional status and body composition changes in paediatric β-thalassemia (β-TM) patients before and after hematopoietic stem cell transplantation (HSCT), using bioelectrical impedance analysis (BIA), and explored their relationship with HSCT outcomes. A cohort of 40 paediatric β-TM patients undergoing allogeneic HSCT was assessed for their nutritional status, anthropometric parameters, including body mass index (BMI), weight, and height, and body composition parameters pre-and post-HSCT, focusing on BIA measurements, including intracellular water (ICW), extracellular water (ECW), fat mass (FAT), fat-free mass (FFM), Skeletal Muscle Mass (SMM), soft Lean Mass (SLM), percent body fat (PBF), Body Cell Mass (BCM), Phase angle (PA) and muscle balance pre- and post-HSCT. Post-HSCT clinical outcomes, including acute graft-vs-host disease (aGVHD), engraftment time, oral mucositis (OM), sinusoidal obstruction syndrome (SOS), and diarrhoea in relation to nutrition status after HSCT were analysed. After HSCT, 28.21% experienced diminished nutritional status, with 71.43% of those who were wasting before HSCT showing diminished nutritional status, significantly higher than the normal group (18.75%, P = 0.012). Anthropometric changes included significant weight reduction (87.5%, 22.15 ± 7.46 vs 20.74 ± 6.57, P < 0.001) and BMI decrease (90%, 15.19 ± 1.70 vs 14.05 ± 1.48, P < 0.001). Body composition parameters, which are FFM, SMM, SLM, ICW, ECW, BCM, and PA (18.26 ± 5.71 vs 17.27 ± 5.19, 8.68 ± 3.30 vs 7.93 ± 3.02, 17.11 ± 5.28 vs 16.06 ± 4.84, 8.19 ± 2.54 vs 7.62 ± 2.31, 5.15 ± 1.58 vs 4.94 ± 1.47, 11.74 ± 3.63 vs 10.92 ± 3.32, 4.42 ± 0.50 vs 3.90 ± 0.57, respectively, P < 0.001) analysis revealed significant decreases. No significant differences in clinical outcomes were observed based on nutritional status. Paediatric β-TM patients undergoing HSCT exhibit significant changes in nutrition status and body composition, emphasizing the need for focused attention on malnourished children who are more prone to diminished nutritional status. Comprehensive BIA aids in understanding the impact, urging consideration for extended follow-up and larger cohorts in future research.

Reliability and Agreement Assessment of Sarcopenia Diagnosis through Comparison of Bioelectrical Impedance Analysis and Dual-Energy X-ray Absorptiometry.

A unified diagnostic criterion has yet to be established for sarcopenia. Therefore, we analyzed the reliability and validity of sarcopenia diagnosis using bioelectrical impedance analysis (BIA) compared with the gold standard, dual-energy X-ray absorptiometry (DEXA), and evaluated the predictive accuracy of BIA for diagnosis. The clinical trial, involving a total of 239 participants, was conducted between December 2018 and September 2019 on healthy volunteers without significant medical histories. The participants underwent health assessments, followed by sequential DEXA and BIA measurements. In both the low and normal appendicular skeletal muscle (ASM) groups, there were significant differences in the right arm, left arm, right leg, left leg, ASM, and ASM index (ASMI) between DEXA and BIA across all age groups (p < 0.05). BIA tended to overestimate compared to DEXA, but ASMI values for males and females were consistent with the criteria for sarcopenia. Bland-Altman analysis showed that each segment in both the low and normal ASM groups fell within the limits of agreement (LOA). The diagnosis of sarcopenia using BIA was significantly different from that using DEXA. However, it exhibited a significantly high correlation, fell within the LOA, and demonstrated high predictive accuracy. BIA can be considered an effective tool for diagnosing sarcopenia.

Fat and fat-free mass measurement agreement by dual-energy X-ray absorptiometry versus bioelectrical impedance analysis: Effects of posture and waist circumference.

Bioelectrical impedance analysis (BIA) operates under the assumption that the conductor has a uniform cylindrical shape. However, this assumption may be violated if measures are taken in the seated position, especially in people with a high waist circumference (WC). The aims of this research were to determine whether posture (supine, standing, and seated) and WC affect agreement between BIA and dual-energy X-ray absorptiometry (DXA) measures of fat mass (FM) and fat-free mass (FFM). Baseline data were collected from 28 adults (mean=61.4±6.9years, 64.3% female) with obesity (BMI 38.6±5.0kg/m2). Body composition was measured using BIA in the supine, standing, and seated positions and by DXA while supine. Intraclass correlation coefficient (ICC) analyses with two-way mixed effects and absolute agreement were performed to determine agreement. Point estimates were excellent for FM and FFM while supine, excellent for FM and good for FFM while standing, and moderate for FM and good for FFM while seated. BIA measures in the supine position resulted in the narrowest 95% confidence intervals compared with other positions. Better agreement was observed across all positions in participants with a WC below the median (118.3cm). Despite the potential pragmatic value of measuring with BIA in a seated position, the results of this analysis demonstrate the poorest agreement between DXA and BIA methods, especially in individuals with high WC. Findings from this study demonstrate that BIA, particularly when measured in a supine position, can serve as a viable alternative to DXA for measuring body composition in people with obesity.

Bioelectrical Impedance in Premature Newborns and Its Relationship with Diet Therapy in a Neonatal Intensive Care Unit.

(1) Background: To estimate resistance, reactance, and phase angle values among moderate preterm infants and their variation according to neonatal and maternal characteristics and nutritional intake. (2) Methods: This was a cohort that evaluated 43 moderate preterm infants using bioelectrical impedance analysis. The study variables included resistance, reactance, and phase angle measurements, in addition to classification of nutritional intake. (3) Results: Mean resistance was 602.0 ± 118.2 Ω, reactance was 57.2 Ω (IQR = 42.6-65.2), and phase angle was 522° (IQR = 4.1-6.6). Lower resistance values were found in the presence of risky pregnancy (532.2 ± 111.9 Ω vs. 650.9 ± 97.9 Ω, p < 0.001) and lower reactance values, in the presence of harmful maternal lifestyle habits at both the first (p = 0.01) and second assessments (p = 0.01). Eight preterm infants were considered to have insufficient nutritional intake (23.5%); 17, sufficient (50.0%) and 9, partially sufficient (26.5%). There was less reactance among preterm infants with insufficient nutritional intake (p < 0.001). (4) Conclusions: The bioelectrical impedance analysis measurements were within the range of values reported in other studies. There was an association between full diet and adequate nutritional intake with higher resistance values, while a lower reactance value was associated with the presence of risky pregnancy and harmful maternal lifestyle.

The applicability of a commercial 3DO body scanner in measuring body composition in Chinese adults with overweight and obesity: a secondary analysis based on a weight-loss clinical trial.

A commercial three-dimensional optical (3DO) scanning system was reported to be used in body composition assessment. However, the applicability in Chinese adults has yet to be well-studied. This secondary analysis was based on a 16-week weight-loss clinical trial with an optional extension to 24 weeks. Waist and hip circumference and body composition were measured by 3DO scanning at each follow-up visit during the study. Bioelectrical impedance analysis (BIA) was also performed to confirm the reliability of 3DO scanning at each visit. We used Lin's concordance correlation coefficients (CCC) to evaluate the correlation between the two methods above-mentioned. Bland-Altman analysis was also performed to evaluate the agreement and potential bias between different methods. A total number of 70 Chinese adults overweight and obese (23 men and 47 women, aged 31.8 ± 5.8 years) were included in the analysis, which resulted in 350 3DO scans and corresponding 350 BIA measurements. The percent body fat, fat mass, and fat-free mass were 33.9 ± 5.4%, 26.7 ± 4.6 kg, and 50.3 ± 8.7 kg before the trial by 3DO scanning. And they were 30.5 ± 5.8%, 22.5 ± 4.7 kg, and 49.4 ± 8.3 kg after 16 weeks of the trial. Compared with BIA, 3DO scanning performed best in the assessment of fat-free mass (CCC = 0.89, 95%CI: 0.86, 0.90), then followed by fat mass (CCC = 0.76, 95%CI: 0.71, 0.80) and percent body fat (CCC = 0.70, 95%CI: 0.64, 0.75). Subgroup analysis showed that 3DO scanning and BIA correlated better in women than that in men, and correlated better in measuring fat-free mass in participants with larger body weight (BMI ≥28.0 kg/m2) than those with smaller body weight (<28.0 kg/m2). 3DO scanning is an effective technology to monitor changes in body composition in Chinese adults overweight and obese. However its accuracy and reliability in different ethnicities needs further exploration.

Fluid Status Assessment in Critically Ill Patients with COVID-19: A Retrospective Cohort Study.

Fluid status (FS) is a diagnostic challenge in critically ill patients with COVID-19. Here, we compared parameters related to FS derived from cumulative fluid balance (CFB), bioelectrical impedance analysis (BIA) and venous congestion assessed by ultrasound (VExUS) to predict mortality. We retrospectively reviewed the medical records of individuals with severe pneumonia due to COVID-19 between July and November 2021 in a single center. Comorbidities, demographic, clinical and laboratory data as well as results from CFB, BIA and VExUS measurements were collected on admission and weekly afterwards for two consecutive evaluations. Seventy-nine patients were included, of which eighteen (14.2%) died. Abnormalities of FS were only identified by BIA. Extracellular water/total body water ratio (ECW/TBW) > 0.394 (overhydrated) by BIA was a good predictor of mortality (AUC = 0.78, 95% CI: 0.067-0.89). Mortality risk was higher in overhydrated patients (OR: 6.2, 95% CI: 1.2-32.6, p = 0.02) and in persistently overhydrated patients (OR: 9.57, 95% CI: 1.18-77.5, p = 0.03) even after adjustment to age, serum albumin and acute kidney injury (AKI) in stages 2-3. Time to death was shorter in overhydrated patients (HR: 2.82, 95% CI: 1.05-7.5, log-rank test p = 0.03). Abnormalities in FS associated with mortality were only identified by BIA in critically ill patients with COVID-19.

An Investigation of the Role of Phase Angle in Malnutrition Risk Evaluation and Clinical Outcomes in Patients with Head and Neck or Brain Tumors Undergoing Radiotherapy

This cross-sectional study aimed to investigate the role of bioelectrical impedance analysis (BIA) and phase angle measurement in assessing malnutrition in head and neck (n = 37) and brain (n = 63) tumor patients received radiotherapy. Common nutritional screening and assessment tests were used to identify malnutrition in the patients. Each patient underwent these tests once, along with phase angle measurement. Additionally, inflammation parameters, including neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), and systemic inflammatory index (SII), were calculated. All study results were correlated with the phase angle cutoff point of 5.72°. The phase angle demonstrated significant correlations with subjective global assessment (SGA), mini nutritional assessment (MNA) scores, BIA parameters, nutritional index, NLR, and SII (p < 0.05). Moreover, in head and neck tumor patients, those with higher standardized phase angle values exhibited significantly better two-year overall survival (32.1% vs. 87.5%, p = 0.006). The phase angle measurement is a convenient, noninvasive, and reproducible method that can complement existing tools for assessing malnutrition risk in radiotherapy patients. The significant correlations observed between the phase angle and various nutritional, inflammation markers and prognosis highlight its potential utility. Further studies incorporating a larger patient cohort will be beneficial in establishing a standard phase angle reference value for cancer patients.

Effect of peritoneal dialysate on bioelectrical impedance analysis variability in pediatric patients receiving peritoneal dialysis.

Previous adult studies have yielded conflicting results regarding whether the presence (D +) or absence (D-) of peritoneal dialysate affects the accuracy of bioelectrical impedance analysis (BIA) measurements. The aim of this study was to investigate whether the accuracy of BIA data varies between D + and D- measurements in children. This cross-sectional study recruited chronic kidney disease stage 5 patients aged 3 to 18years who received peritoneal dialysis. Body composition was assessed by multifrequency BIA, and values were compared between D + and D- measurements using the intraclass correlation coefficient (ICC). Fifty paired BIA measurements were collected from 18 patients with a mean age of 13.6 ± 4.1years and a mean dialysate fill volume of 1,006 ± 239.7ml/m2. Sixteen out of 17 BIA parameters (94.1%) exhibited excellent correlations between D + and D- measurements (ICC values = 0.954, 0.998). There was a trend of increased fluid status, including extracellular water, edema index, and overhydration, in D + measurements, with mean differences (95% CIs) of 0.5 (0.4, 0.6) L, 0.002 (0.001, 0.002), and 0.1 (0.1, 0.2) L, respectively. Soft lean mass and fat-free mass were higher in D + measurements, with mean differences (95% CIs) of 1.4 (1.2, 1.6), and 1.6 (1.4, 1.8) kg, respectively. In addition, patients older than 10years had a stronger correlation between D + and D- measurements than younger patients. A total of 94.1% of BIA parameters exhibited excellent correlations between D + and D- measurements, especially patients older than 10years. We recommend that BIA measurements be collected from children regardless of the presence of peritoneal dialysate.

PSXIV-29 Seminal Plasma Uterine Priming in Embryo-Recipient Beef Cows Alters Preweaning Offspring Growth But Not Indices of Body Composition

Abstract Seminal plasma primes the uterus for pregnancy through the recruitment of cells aiding in microbial clearance, tissue remodeling and angiogenesis, and embryo implantation and growth. Less is known about the effects of seminal plasma uterine priming in practices devoid of seminal plasma, specifically evaluating offspring growth in embryo-recipient beef cows. In the present study, we sought to determine the effects of seminal plasma uterine priming on postnatal body weights, carcass ultrasound measures, and indices of body composition. To realize these objectives, embryo-recipient cows randomly received 0.5 mL of pooled seminal plasma or no treatment (control) at estrus and underwent embryo transfer seven days later. Following parturition, offspring pre-weaning body weights were collected at 30, 90, and 180 days of age. Indices of body composition, carcass ultrasounds and bioelectrical impedance analysis (BIA), were collected pre-weaning at an average 209 days of age. Weaning weights and hip heights were collected at an average of 212 days of age. Ultrasound, BIA, and weaning weight data were analyzed using the MIXED procedure of SAS for fixed effects of treatment. Pre-weaning body weights were analyzed similarly with repeated measures for treatment, day, and their interaction. Covariates of sire, dam, sex, and age were included in all models if P ≤ 0.10. Correlations between carcass ultrasounds and BIA parameters of fat-free mass and fat-free soft tissue were analyzed using the CORR procedure of SAS. Significance is declared at P ≤ 0.05 and data were presented as means ± standard error. A treatment by day interaction was not observed for pre-weaning body weight. However, a main effect of treatment was observed for pre-weaning body weights, which was decreased (P = 0.0130) in seminal plasma calves compared with controls. Weaning weights and hip height were not different between treatments. There was not an effect of treatment on carcass ultrasound measures, including ribeye area, ribeye area adjusted by body weight, rib fat, intramuscular fat, or rump fat. Similarly, BIA measures of fat-free mass and fat-free soft tissue were not different between treatments. Ribeye area and rib fat ultrasound were moderately correlated (P &amp;lt; 0.05) with BIA measures of fat-free mass and fat-free soft tissue. Interestingly, previously reported data from this project show offspring from seminal plasma treated cows had decreased embryo size at days 35, 40, and 45 of gestation, and decreased birth weights. It appears seminal plasma uterine priming prior to embryo transfer negatively impacts offspring growth pre-weaning, however, by weaning this difference is diminished. It is less clear why pre-weaning weights differ due to similar body composition among treatment and control calves; however, these measures may have been collected after the period of compensatory gain occurred.

Associations of phase angle with platelet-activating factor metabolism and related dietary factors in healthy volunteers.

Phase angle (PA) is derived from bioelectrical impedance analysis (BIA). It reflects cell membrane function and decreases in disease. It is affected by inflammation, oxidative stress, and diet. Platelet-activating factor (PAF) is a potent inflammatory lipid mediator. Its levels, along with the activity of its metabolic enzymes, including CDP-choline:1-alkyl-2-acetyl-sn-glycerol-cholinephosphotransferase, acetyl-CoA:lyso-PAF-acetyltransferases, and PAF-AH/Lp-PLA2 are also related to dietary factors, such as the dietary antioxidant capacity (DAC). The aim of the study was to estimate whether the PAF metabolic circuit and related dietary factors are associated with PA in healthy volunteers. In healthy subjects, PAF, its metabolic enzyme activity, and erythrocyte fatty acids were measured, while desaturases were estimated. Food-frequency questionnaires and recalls were used, and food groups, macronutrient intake, MedDietScore, and DAC were assessed. Lifestyle and biochemical variables were collected. DXA and BIA measurements were performed. Lp-PLA2 activity was positively associated with PA (rho = 0.651, p < 0.001, total population; rho = 0.780, p < 0.001, women), while PAF levels were negatively associated with PA only in men (partial rho = -0.627, p = 0.012) and inversely related to DAC. Estimated desaturase 6 was inversely associated with PA (rho = -0.404, p = 0.01, total sample). Moreover, the DAC correlated positively with PA (rho = 0.513, p = 0.03, women). All correlations were adjusted for age, body mass index, and sex (if applicable). PA is associated with PAF levels and Lp-PLA2 activity in a gender-dependent fashion, indicating the involvement of PAF in cell membrane impairment. The relationship of PA with DAC suggests a protective effect of antioxidants on cellular health, considering that antioxidants may inhibit PAF generation.

Prognostic Utility of Skeletal Muscle Mass Metrics in Patients With Heart Failure.

Sarcopenia is associated with risks of various adverse outcomes, and the assessment of skeletal muscle mass is necessary for its diagnosis. However, heart failure (HF) is a syndrome characterised by fluid retention, which affects muscle mass measurements. Different measurement methods have been reported to have different prognostic implications. We investigated the association between skeletal muscle mass metrics measured with the use of bioelectrical impedance analysis (BIA) and anthropometric measures and prognosis in patients with HF. The findings of 869 consecutive patients with HF were reviewed. We investigated the skeletal muscle mass index (SMI) measured with the use of BIA, the mid-upper arm circumference (MUAC), the arm muscle circumference (AMC), and the calf circumference (CC), and the patients were divided into 3 groups according to the sex-specific tertiles of the skeletal muscle mass metrics. The end points were all-cause death and readmission due to HF. The high MUAC and AMC groups showed significantly better prognoses than their respective low groups (combined events: high MUAC group hazard ratio [HR] 0.559, 95% confidence interval [CI] 0.395-0.789 [P < 0.01]; high AMC group HR 0.505, 95% CI 0.359-0.710 [P < 0.01]), although high SMI and high CC were not associated with better prognoses. Among patients with HF, MUAC and AMC are more associated with prognosis than SMI and CC, which are recommended in preexisting sarcopenia guidelines. MUAC and AMC may also be useful measures in sarcopenia assessments.

Age-dependent effect of vitamin D supplementation on musculoskeletal health in chronic spinal cord injury patients: A pilot study

Objective To determine the effect of vitamin D supplementation on changes in body composition associated with musculoskeletal health status in patients with chronic SCI and vitamin D deficiency as a response to age. Design Prospective drug-intervention study. Setting Department of rehabilitation medicine, Veterans Health Service Medical Center. Participants Seventeen patients with vitamin D insufficiency/deficiency (<30 ng/mL) and chronic SCI were divided into two groups: groups A <65 years (n = 8) and B ≥65 years of age (n = 9). Interventions Both groups received 800 IU/day cholecalciferol for 12 weeks. Outcome measures We used blood samples to evaluate metabolites related to vitamin D, testosterone (T), lipid profiles, and sex hormone-binding globulin (SHBG). Bioelectrical impedance analysis (BIA) was used to evaluate body composition. Results Group A had significantly better baseline clinical characteristics for all BIA measurements. SHGB was significantly higher in Group B (P = 0.003) and albumin was significantly higher in Group A (P = 0.000). When comparing pre- to post-treatment, Group A showed a significant improvement in T (P = 0.042), total cholesterol (P = 0.035), and triglyceride (P = 0.025) levels, whereas Group B significantly increased vitamin D (P = 0.038) and protein mass (PM) (P = 0.034) levels. Conclusion This study suggested that addressing vitamin D deficiency in patients with SCI had different effects in young and older adults, with both groups showing positive changes in body composition. Particularly, the increase in PM on BIA measurements in elderly patients at high risk of sarcopenia was encouraging.

The value of ultrasound measurement of muscle thickness at different sites and shear wave elastography in Parkinson's disease with sarcopenia: a pilot study.

Patients with Parkinson's disease (PD) and sarcopenia often exhibit resilience, frailty, disability, and depression, highlighting the complex and interrelated nature of these conditions. Despite the presence of clinical manifestations of muscle atrophy in both PD and sarcopenia, accurately discerning the coexistence of sarcopenia in PD patients remains a challenging task with significant implications for treatment strategies and prognostic assessments. This study aims to elucidate the specific ultrasonic diagnostic parameters associated with PD accompanied by sarcopenia through a comparative analysis of muscle ultrasound parameters in patients with PD, thereby presenting a novel approach for rapid identification of this condition. A total of 110 participants were enrolled in this study, including patients with PD and control subjects. Demographic data, clinical characteristics, physical performance tests, appendicular skeletal muscle mass index (ASMI), bioelectrical impedance analysis and muscle ultrasound measurements were collected from all participants. The muscle ultrasound measurements encompassed assessments of muscle thickness, pennation angle and shear wave elastography at various anatomical sites. Parkinson's disease patients exhibited decreased muscle strength and physical performance, and increased shear wave elastography value. In PD patients with sarcopenia, body circumference, including calf circumference, mid-arm circumference, Waist-to-Hip Ratio and body mass index (BMI) were all significantly decreased. Biceps brachii muscle thickness (MT) and gastrocnemius MT decreased in PD patients with sarcopenia and low ASMI. Binary logistic regression analysis revealed that male PD patients, BMI and gastrocnemius MT were predictive factors for ASMI in PD patients. Biceps brachii MT and gastrocnemius MT are important indicators for distinguishing whether PD patients have sarcopenia. Male patients, low BMI and gastrocnemius MT were identified as valid predictors of low ASMI in PD patients. The findings of this study provide important insights into the use of muscle ultrasound in the diagnosis of PD with sarcopenia.

Ratio of visceral fat area to body fat mass (VBR) is a superior predictor of coronary heart disease.

Ratio of visceral fat area to body fat mass (VBR) is a superior predictor of coronary heart disease.

Muscle Mass Adjusted for Body Weight Is Associated with Significant Liver Fibrosis in Young Adults with Nonalcoholic Fatty Liver Disease: A Cross-Sectional Study from a Korean Military Hospital.

Sarcopenia has been associated with nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the correlation between liver fibrosis and muscle mass in young adults with NAFLD. We conducted a retrospective review of 88 Korean soldiers <35 years of age who underwent bioelectrical impedance analysis and liver stiffness measurements. A FibroScan-aspartate aminotransferase score >0.35 was used to determine the presence of liver fibrosis. Among the 88 patients, 38 were classified as having significant fibrosis. In the univariate analysis, muscle mass percentage (MMP), muscle-to-fat ratio (MFR), waist-to-hip ratio (WHR), body mass index, impaired fasting glucose or diabetes mellitus, and alanine transaminase (ALT) level were all significantly associated with fibrosis (P<0.001). After adjusting for ALT level, height, and age, MMP and WHR were associated with fibrosis. In young adults, MMP and MFR were significantly associated with hepatic fibrosis.

819 ELLIPSE: Electrical Impedance Analysis in Patients Undergoing Emergency Abdominal Surgery

Abstract Introduction An ageing population represents greater operative risk; therefore, preoperative risk stratification is required to allow patients to make an informed decision. One method of risk stratification is bioelectrical impedance analysis (BIA) which can provide information such as muscle and fat mass, providing a proxy for patient metabolic health. Aim Metabolic health is intrinsically linked to outcomes following surgery. We hypothesised that BIA is a feasible method of assessing patients undergoing emergency abdominal surgery and predicting postoperative outcomes. Method A BIA analyser was used to measure patients body composition. All adult patients who met the National Emergency Laparotomy Audit (NELA) inclusion criteria were prospectively recruited and followed up until 30 days postoperatively. These patients had serial BIA measurements and compared with a healthy population. The phase angle (PA) is a raw variable which can be standardised to a healthy reference population and matched for age and gender. In summary, a higher phase angle is associated with improved outcomes. Results 31 patients were recruited and BIA analysis in patients undergoing emergency abdominal surgery was feasible. Patients with a phase angle lower than the reference population had a greater incidence of complications (p = 0.03) and had more severe complications (p = 0.023). Furthermore, the same patients also had a significantly higher NELA morbidity percentage (p = 0.022). Conclusions Our study shows that conducting BIA analysis in patients undergoing emergency abdominal surgery is feasible. The presence and severity of complications correlates with the phase angle. This represents a successful proof of concept study of BIA to predict postoperative outcomes.

Bioelectrical impedance analysis in patients with posterior vitreous detachment.

The purpose of the study is to assess body hydration in patients with posterior vitreous detachment (PVD) by bioelectrical impedance analysis (BIA). PVD, one of the most common eye diseases, is associated in both research and the collective image with reduced daily water intake, but this finding is not supported by strong evidence in the literature. Based on Spectral Domain Optical Coherence Tomography (SD-OCT) evaluation, different PVD stages are identified: absent posterior vitreous detachment, partial posterior vitreous detachment (P-PVD), or complete posterior vitreous detachment (C-PVD). BIA is a simple, non-invasive bedside method used to assess body composition. Patients underwent BIA and completed a floaters symptoms. 30 patients were enrolled and divided into two groups according to the degree of vitreous detachment, in P-PVD (n=12) and C-PVD (n=18). Patients underwent BIA and completed a floaters symptoms questionnaire. BIA measured the Resistance (R), Reactance (Xc), Phase Angle (PhA), Total Body Water (TBW), Extracellular Water (ECW), Fat Mass (FM), Fat-Free Mass (FFM), and Body Cell Mass Index (BCMI). Finally, patients received a test to assess adherence to the Mediterranean diet (Mediterranean Diet Test Score, MDTS) with the addition of daily water intake. Relevant data were obtained from the BIA evaluation: the values of R and Xc were lower in the P-PVD group than C-PVD group (respectively 417.08±58.12 Ω vs. 476.94±51.29 Ω p=0.006 and 41.33±8.23 Ω vs. 50.61±7.98 Ω p=0.004). Instead, patients in the P-PVD group reported higher values of TBW and ECW than C-PVD group (respectively 44.13±7.57 L vs. 37.96±6.27 L p=0.021 and 21.03±4.06 L vs. 17.24±2.63 L p=0.004). In the present study, we reported a significant correlation between vitreous pathology and anthropometric and BIA measurements.

Dehydration among the Elderly: A Comparison between Nine Different Clinical and Metabolic Criteria

Background: Dehydration, as a common problem in older adults, plays a significant role in morbidity and mortality. The elderly are more susceptible to dehydration and fluid deficiency due to age-related factors. There is not much literature concerning fluid intake in older adults. This study aims to investigate fluid intake and dehydration prevalence in older people and compare the accuracy of potential markers in the detection of dehydration.&#x0D; Methods: This cross-sectional study was done on 127 old people (48 males and 79 females) selected from a nursing home in Shiraz, Iran. Socioeconomic status was assessed via interview. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), urine specific gravity (USG), urine color (UC) and bioelectrical impedance analysis (BIA), extracellular water (ECW), intracellular water (ICW), and total body water (TBW) were measured. The fluid intakes were recorded using a beverage and fluid intake questionnaire. Total fluid intakes were compared using two fluid intake guidelines (European guidelines and US guidelines) as well. Furthermore, anthropometric indices were measured.&#x0D; Results: The mean age of participants was 73.01± 5.70 year. Fluid intake was 2.32 ± 0.48 liter/day. Based on urine specific gravity (USG) (˃1.020) and SBP (SBP ˂ 100 mmHg), 9.4% and 14.2% of the participants were dehydrated respectively. Among all hydration criteria, ECW had the highest potential for detection which identified 72.4% of participants as dehydrated. Among fluid intake guidelines, US guidelines were the best in dehydration diagnosis (112 individuals out of 127).&#x0D; Conclusions: Although urinary markers and physical indexes (SBP and HR) could not be used to determine hydration status, BIA measurements, especially ECW, have the potential to detect dehydration. In addition, daily fluid intakes are still practical for assessment of hydration status.

Examining cardiac cachexia in the thai heart failure patients

Abstract Funding Acknowledgements Type of funding sources: Private grant(s) and/or Sponsorship. Main funding source(s): Ministry of Public Health, Thailand Background Cardiac cachexia (CC) can occur in heart failure (HF)with weight and muscle loss. Screening for suspected CC and CC using Cachexia consensus, including CC symptoms, had not been examined among the Thai heart failure patients. Purpose To screen for suspected CC and CC in a HF out-patients setting in Thailand using the international cachexia consensus Method Anthropometric data, such as body weight, height, grip strength, skinfold thickness and waist circumferences, were collected. Bloods for haemoglobin, albumin, c-reactive protein (CRP), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and serum osmolarity were collected. Bioelectrical impedance analysis (BIA) measurement using INBODY S10 was conducted. Participants were asked to complete questionnaires that were Simplified on Nutrition Appetite Questionnaire (SNAQ), Thirst Distress Scale-Heart Failure (TDS-HF) and Kansas City Cardiomyopathy Questionnaire. Results Thirty-eight participants were recruited. Of these two participants had confirmed and five with suspected CC and the remainder did not have CC (n=31). We analysed the data by comparing between two groups: 1) highly suggestive CC (confirmed CC and suspected CC), 2) non-CC. Anthropometric measurements, BIA parameters and fatigue were not significantly different between those with confirmed and suspected CC and those who have not have CC (P&amp;gt;0.05). CRP and NT-proBNP levels were higher in those with CC and suspected CC than those who have not have CC (CRP median 4.39 vs 1.25 and NT-proBNP median 3,889.00 vs 1,957.00, respectively). The SNAQ scores were significantly lower in highly suggestive CC than non-CC group (13.14±2.41 vs 15.07±2.28, p≤0.05), but TDS-HF scores were not significantly different (20.57±7.28 vs 19.74±9.54, p = 0.678). Quality of life scores were lower in highly suggestive CC group than non-CC group although it was not statistically significant (60.71±24.40 vs 66.67±24.06, p = 0.559). Phase angle positively correlated to SNAQ (r = 0.550, p = 0.015) and albumin (r = 0.622, p = 0.004). Conclusion This is the first pilot study in Thailand screening for CC. SNAQ with the support of phase angle can be a useful and affordable tool to simply screen for CC. NT-proBNP might be associated with the development of CC and poor disease prognosis.

The Extract Of Ophiocephalus Striatus Affect Levels Of TNF-Α, TGF-Β1, IL-17 And SuPAR, Pulmonary Diffusing Capacity For Carbon Monoxide, And Health-Related Quality Of Life In Stable COPD Patients With Muscle Wasting

Objective — This study aimed to evaluate the effect of Ophiocephalus striatus extract on body composition, levels of TNF-α, TGF-β1, IL-17, suPAR and neutrophils, diffusing capacity of the lungs for carbon monoxide (DLCO) and health-related quality of life (HRQoL) in stable COPD patients with muscle wasting. Methods — Clinical pre- and post- quasi-experimental study of 32 stable COPD patients with muscle wasting from the Pulmonary Outpatient Clinic of Saiful Anwar General Hospital Malang, determined in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2016 and bioelectrical impedance analysis (BIA) measurements (FFM &lt;14.6 kg/m; BMI &lt;18.5 kg/m2). Measurements of the following health-related parameters for the QoL due to COPD were performed before and after the nutritional intervention of 3,000 mg of O. striatus extract daily for 12 weeks: TNF-α, TGF-β1, IL-17 and suPAR levels (by ELISA), neutrophils (by blood test), DLCO (by body plethysmography), and CAT score. Results — A non-significant reduction of TNF-α (p=0.302), IL-17 (p=0.275), neutrophil (p=0.619), and suPAR (p=0.674) levels, along with an increase in DLCO (p=0.369), occurred after 12 weeks of O. striatus extract administration. However, the level of TGF-β1 declined significantly (p=0.022), followed by an increase in QoL as assessed by the CAT score (p=0.000). There was no significant correlation between inflammatory cytokines and DLCO, nor with the CAT score. Conclusion — The study results demonstrated a potential role of oral nutritional supplementation in the management of COPD patients with muscle wasting.