Bioimpedance Research Articles

Prognostic value of sarcopenia defined by the Sarcopenia Definitions and Outcomes Consortium criteria in patients with heart failure

Abstract Background Sarcopenia, the loss of skeletal muscle mass and function, is recognized as a negative prognostic factor in heart failure patients. Current guidelines, such as those by the Asian Working Group for Sarcopenia (AWGS), emphasize quantifying muscle mass using methods like bioelectrical impedance analysis or dual-energy X-ray absorptiometry, known for their precision. In contrast, the Sarcopenia Definitions and Outcomes Consortium (SDOC) focuses on functional parameters. However, its applicability and effectiveness as a prognostic indicator in heart failure remain uncertain. Purpose To determine the prognostic utility of sarcopenia determined by the SDOC diagnostic criteria in predicting all-cause mortality among older patients with heart failure, and to compare its prognostic predictability with that of the AWGS 2019 diagnostic algorithms. Methods This was a post-hoc analysis of the FRAGILE-HF study, a prospective, multicenter, observational study involving patients aged ≥65 years hospitalized for heart failure. Sarcopenia was diagnosed according to two definitions: AWGS 2019 guidelines criteria and the SDOC criteria, which diagnose sarcopenia based only on grip strength and gait speed. With SDOC criteria, patients were divided into three groups: sarcopenia (low grip strength and decreased gait speed), pre-sarcopenia (low grip strength or decreased gait speed), and non-sarcopenia (normal grip strength and normal gait speed) groups. Two logistic models for the primary outcome were constructed by adding the information on pre-sarcopenia and sarcopenia defined by AWGS 2019 and SDOC to the MAGGIC-HF risk score + log BNP, and prognostic predictability was compared by receiver operating characteristic curve areas under the curve (ROC-AUC) and net-reclassification improvement (NRI) between three models. The primary outcome was 2-year mortality. Results Of 1282 study patients, pre-sarcopenia and sarcopenia were diagnosed in 357 and 786 individuals, respectively, according to SDOC criteria. The Kaplan-Meier analysis revealed a significant stepwise association between the sarcopenic status and the primary outcome. The adjusted Cox proportional hazards analysis indicated a significant stepwise association between sarcopenic status and mortality risk (pre-sarcopenia, hazard ratio [HR]: 1.22, 95% confidence interval [CI]: 0.66–2.28, P= 0.525; sarcopenia, HR: 1.89, 95% CI: 1.08–3.34, P= 0.027). No significant difference was observed in the prognostic capabilities between the two models adding sarcopenia defined by SDOC and AWGS 2019 diagnostic criteria to the model incorporating the MAGGIC-HF risk score + log BNP (NRI: -0.009, 95% CI: -0.193–0.174, P=0.920, with ROC-AUC of 0.697 for SDOC and 0.703 for AWGS 2019, P=0.675, respectively). Conclusion Diagnosing sarcopenia with the SDOC criteria, which does not include muscle mass, provides incremental prognostic information as same as that defined by AWGS 2019 criteria.Figure

Pulmonary hypertension in patients on chronic hemodialysis

Abstract Introduction Pulmonary hypertension (PH) is a common condition in patients with advanced chronic kidney disease and is associated with higher morbidity and mortality. High arteriovenous fistula (AVF) flow is one of known etiological factors, but the association of AVF flow within the acceptable range and PH has not been tested. Moreover, the prevalence of PH differed among various studies. Purpose The aims of this study were: 1. to describe the prevalence of PH in the Czech hemodialysis population; 2. to analyze the relation between dialysis fistula flow and PH; 3. to reveal other etiology of PH in a cross-sectional non-invasive trial. Methods We analyzed index visits of the cohort CZecking HF-CKD study (ISRCTN 18275480). Thus, this is a cross-sectional analysis based on detailed echocardiography with cardiac output (CO) calculation, evaluation of the central venous pressure (CVP) and AVF flow, bio-impedance and basic laboratory tests. All these measurements were done within an hour. The presence of PH was based on the peak systolic pulmonary arterial pressure (PASP) estimation above 35 mmHg. Results We analyzed data of 162 patients. They were 73,2 ± 12,6 years old, dialysis vintage 30 ± 69 months. Pulmonary hypertension was present in 35 % of analyzed patients. Among these patients, mild PH was present in 35 %, moderate in 53 % and severe in 12 %. There was no significant impact of AVF/AVG flow on the presence of PH or PASP value (Table 1.). However patients with PH had higher prevalence of heart failure (HF), which was present in 86 % of patients with PH and only in 46 % without PH (p<0.00001), see Figure 1. This and other differences presented in Table 1. document significant contribution of postcapillary PH. Patients with PH were also more overhydrated when considered by CVP, by overhydration measurement using bioelectrical impedance analysis and had higher N-terminal pro brain natriuretic peptide (NTproBNP) (Table 1.). There was a positive correlation between systemic vascular resistance (SVR) and PASP (R=0,333, p= .001). Conclusions PH is present in approximately one third of the dialysis patients. The presence of heart failure and changes of left heart chambers show for the postcapillary etiology of PH. Neither the prevalence nor the severity of PH were significantly related to arteriovenous access flow.

Association of visceral adipose tissue with echocardiographic abnormalities in type 2 diabetes patients

Abstract Introduction Ectopic deposition of adipose tissue, particularly visceral adipose tissue (VAT) has been identified as a significant contributor to cardiometabolic complications among individuals with type 2 diabetes (T2D). An increase in VAT has been suggested to cause cardiac dysfunction, which may lead to echocardiographic abnormalities such as alterations in speckle-tracking and left ventricular ejection fraction (LVEF). However, this relationship has not been fully elucidated. Purpose This study aims to determine the association between VAT and echocardiographic abnormalities in patients with T2D. Methods A cross-sectional study in a tertiary hospital which included 195 individuals with T2D, the diagnosis of autoimmune diabetes was excluded. VAT was measured using electrical bioimpedance (BIA), and cardiac function was determined using echocardiography. A Spearman rank correlation analysis was conducted to evaluate the association between VAT and echocardiographic parameters, with significance set at p < 0.05. Results Within our cohort, the median age was 57 years, with 37% men. Based on the third quartile (P75) cutoff (5 liters for men, 3.75 liters for women), the population was categorized into P1-75 and P75-100 (Table). There were significant differences in LVEF (61% in P1-75 vs. 58% in P75-100, p = 0.041), left ventricular global longitudinal strain (LV GLS) (P1-75: -20.3%, P75-100: -19.2%, p = 0.012), and conduit phase of left atrial strain (LAScd) (P1-75: 25%, P75-100: 20%, p = 0.046). Positive correlations (Figure) were observed between VAT and indexed LV mass (r = 0.171, p = 0.020), basal diameter of the right ventricle (r = 0.308, p = 0.001), and LV GLS (r = 0.197, p = 0.006). Additionally, negative correlations were observed between VAT and LVEF (r = -0.342, p = <0.001) and right ventricular fractional area change (r = - 0.227, p= 0.001). Conclusion Increased VAT was associated with cardiac dysfunction, as indicated by altered LV GLS and LAScd. This study underscores the relevance of VAT in influencing both functional and structural changes in the left and right ventricles. It also highlights the significance of monitoring VAT for comprehensive cardiovascular risk assessment in T2D patients.Clinical demographics tableScatter plots with correlation graphs

Standardization of transthoracic impedance values for estimating heart failure and its utility

Abstract Background The use of intrathoracic impedance for examining pleural effusion in heart failure patients has been explored previously. However, due to concerns about its accuracy and complexity, transthoracic impedance values have had limitations in quantifying extravascular lung water. Our dual objectives were to clarify the relationship between intrathoracic conditions and percutaneous transthoracic impedance values, and to establish a basic model for a new machine learning-based estimation system for assessing intrathoracic conditions in patients with heart failure. Methods First, we developed a live porcine congested lung model that induced pleural effusion by substantial fluid loading, and then longitudinally evaluated its correlation with percutaneous transthoracic impedance values. Second, we conducted multi-frequency bioelectrical impedance analysis to simultaneously collect electrical, physical, and hematological data from 63 hospitalized heart failure patients and 82 healthy volunteers Results In the porcine model, pleural effusion correlated with a concurrent decrease in SpO2 and a gradual decrease in impedance. We indexed and generated features from the measured values and developed an intrathoracic estimation model based on electrical measurements and clinical findings using a decision tree-based machine learning approach. Among the 286 features collected per individual, the model used 16 features. Notably, the model demonstrated high accuracy in discriminating patients with pleural effusion, achieving an AUC of 0.905 (95% CI: 0.870-0.940) in cross-validation, significantly outperforming the conventional frequency-based method. Conclusions Transthoracic impedance values, when indexed, reflect intrathoracic conditions and improve estimation. Our results highlighted the potential of machine learning and thoracic impedance measurement for accurate estimation of pleural effusion. This approach provides an effective means of assessing intrathoracic conditions. Figure: The upper figure shows the relationship between impedance values and pleural effusion in the congested lung model. On these results, human data were collected to construct the estimation model. The lower illustrates the accuracy of the model and provides a comprehensive view of the system.

New nomenclature and subclassification of steatotic liver disease and loss of skeletal muscle mass: A longitudinal cohort study.

Identifying risk factors for sarcopenia is important due to its significant effect on health. The association between sarcopenia and the newly proposed steatotic liver disease (SLD) and its subclassification has largely been unexplored. This longitudinal cohort study included 67905 adults who underwent at least two health checkup examinations. SLD participants were categorized as cryptogenic SLD, metabolic dysfunction-associated SLD, metabolic dysfunction-associated alcoholic liver disease, or alcoholic liver disease. Appendicular skeletal muscle mass (ASM) was evaluated by bioelectrical impedance analysis. The average duration of follow-up was 5.9years. The annual ASM change was -31.0g (95% CI -32.3, -29.6) and -38.3g (-40.3, -36.3) in participants without and with SLD, respectively. When assessed based on SLD severity, annual ASM loss was fastest in SLD participants with Fibrosis-4 score ≥1.3, followed by those with Fibrosis-4 score <1.3 and those without SLD. In multivariable adjusted analysis, annual ASM loss was fastest in participants with metabolic dysfunction-associated alcoholic liver disease (-49.8g; -93.1, -6.5), followed by those with metabolic dysfunction-associated SLD (-24.7g; -60.4, 11.1), and alcoholic liver disease (-24.4g; -91.1, 42.3), and slowest in those with cryptogenic SLD (reference). This pattern was more pronounced in participants with Fibrosis-4 score ≥1.3. The loss of skeletal muscle mass was fastest in the participants with metabolic dysfunction-associated alcoholic liver disease, followed by participants with metabolic dysfunction-associated SLD, alcoholic liver disease, and cryptogenic SLD. Particular attention to prevent sarcopenia should be given to SLD patients with cardiometabolic risk factors or alcohol consumption, especially in patients with advanced fibrosis.

Evaluating Muscle Mass Changes in Critically Ill Patients: Rehabilitation Outcomes Measured by Ultrasound and Bioelectrical Impedance

Background/Objectives: The loss of muscle mass is common in critically ill patients and is associated with poor prognosis, and efforts have been made to mitigate muscle loss through rehabilitation. This study aimed to evaluate changes in muscle mass in critically ill patients following rehabilitation. Methods: We enrolled 53 patients expected to stay in the ICU for more than 7 days, dividing them into rehabilitation (15 patients) and no rehabilitation groups (38 patients). Muscle mass was measured using ultrasound and bioelectrical impedance analysis (BIA). Results: Baseline characteristics and comorbidities showed no statistical differences between the two groups. Initial measurements of muscles showed no significant differences between the groups in rectus femoris thickness, total anterior thigh muscle thickness, cross-sectional area, echogenicity, or in-body skeletal muscle mass at baseline and 7 days. However, at 14 days, significant differences emerged. The rehabilitation group had greater rectus femoris thickness (1.42 cm vs. 0.81 cm, p = 0.007) and total anterior thigh muscle thickness (3.79 cm vs. 2.32 cm, p = 0.007) compared to the no rehabilitation group. Additionally, the rehabilitation group experienced a significantly smaller reduction in rectus femoris cross-sectional area (−4.6% vs. −22.8%, p = 0.021). Although survival rates were higher in the rehabilitation group (73.3% vs. 52.6%), this difference was not statistically significant (p = 0.096). Conclusions: Our findings suggest that rehabilitation in critically ill patients is associated with a slower rate of muscle loss, particularly in the cross-sectional area of the rectus femoris muscle, which may be beneficial for patient recovery.

Association of age to nutritional status and muscle mass in children with transfusion-dependent β-thalassemia: a cross-sectional study

BackgroundTransfusion-dependent β-thalassemia (TDT) is a hereditary blood disorder that often leads to complications affecting growth, nutritional status, and muscle mass in children. This study aims to investigate the associations between age, nutritional status, and muscle mass in children with TDT, providing insights into the progressive impact of age on these parameters.MethodsOne hundred twenty-two children with TDT from March 2023 to March 2024 were enrolled in this cross-sectional study. Their nutritional status was assessed using the 2006–2007 World Health Organization (WHO) Growth Charts, and their muscle mass was measured using bioelectrical impedance analysis (BIA). Data related to age, gender, weight, height, fat-free mass (FFM), skeletal muscle mass (SMM), and soft lean mass (SLM) of children were collected for comparative analysis from the hospital record room. Furthermore, Spearman’s rank correlation coefficients and regression analyses were utilized to investigate the associations between age and both nutritional status and muscle mass.ResultsThe results of this study revealed negative correlations between age and wasting (r = −0.26, p &amp;lt; 0.001), stunting (r = −0.28, p &amp;lt; 0.001), FFM (r = −0.3, p &amp;lt; 0.001), SMM (r = −0.23, p &amp;lt; 0.01), and SLM (r = −0.36, p &amp;lt; 0.001). The regression analysis indicated that age was an independent predictor of wasting, stunting, and reduced muscle mass in these children (all p &amp;lt; 0.001).ConclusionOur study observed a trend of worsening stunting, wasting, and muscle loss in children with TDT as they age. These findings highlight the importance of monitoring both nutritional and muscular health in TDT patients. Early detection and comprehensive nutritional management may improve outcomes in this population.

Anthropometric indices in older adults with and without Locomotive Syndrome

BackgroundLocomotive syndrome is a major challenge for older adults, and anthropometric indices can greatly affect the musculoskeletal system. This study aimed to compare the anthropometric indices between older adults with and without locomotive syndrome.MethodsThis descriptive-analytical study was performed on 211 older adults using random cluster sampling from a population of over-60 individuals covered by comprehensive health service centers in Sari in Autumn, 2021. Participants were divided into two groups: with and without locomotive syndrome. Locomotive syndrome was assessed via the 25-item Geriatric Locomotive Function Scale questionnaire, and the level of anthropometric indices was determined through the Bioelectrical Impedance Analysis device. Data were analyzed by independent t-test, Mann-Whitney U, Chi-Square, and Binary logistic regression in SPSS, Version 23 (P < 0.05).ResultsThe average age of older adult participants was 78.4 ± 6.6 years. In older adults with locomotive syndrome, the average percentage of fat-free mass (P < 0.001) was significantly lower while the average percentage of fat mass and fat mass index (P < 0.001) was significantly higher. Older adults with locomotive syndrome were shorter in height (P < 0.001) and had a higher body mass index (P < 0.05). Fat-free mass percentage (OR = 0.59) and body mass index (OR = 1.4) predicted the incidence of locomotive syndrome in the subjects. Significant differences such as chronic diseases, chronic pain, falls, age, and gender were observed between the two groups (P < 0.05).ConclusionAnthropometric indices can play an important role in the occurrence of locomotive syndrome in older adults. Evaluation of anthropometric indices and management of body composition can help prevent locomotive syndrome and improve the quality of life of older adults.

Habitual water intake impacted the body composition of young male athletes in free-living conditions: a cross-sectional study

The study aimed to explore the associations between water intake and body composition and differences of body composition in different water itake and hydration statuses among young male athletes. A cross-sectional study was conducted among 111 young male athletes in Beijing, China. Total drinking fluids (TDF) and water from food were assessed using a 7-day, 24-h fluid intake record questionnaire and the duplicate portion method, respectively. The osmolality of 24-hour urine and blood samples was tested. Body composition was measured using a bioelectrical impedance analyzer twice at 5-min intervals. Participants were divided into two groups based on the recommendations of total water intake (TWI) and TDF in China, as well as into three groups based on 24-h urine osmolality. Pearson's correlation coefficients were calculated to determine the relationship between water intake and body composition. Chi-square tests and Student's t-tests were used to compare differences. A total of 109 participants completed the study. TDF (r = 0.230, p = 0.016; r = 0.234, p = 0.014; r = 0.242, p = 0.011) and TWI (r = 0.275, p = 0.004; r = 0.243, p = 0.011; r = 0.243, p = 0.011) were positively correlated with total body water (TBW), intracellular water (ICW), and extracellular water (ECW). TBW/body weight (BW) was positively associated with TDF percentage of BW (TDF/BW) (r = 0.267, p = 0.005), water from food percentage of BW (r = 0.217, p = 0.024), and TWI percentage of BW (TWI/BW) (r = 0.316, p = 0.001). Participants who met the TDF recommendation of China had 1.3 kg higher skeletal muscle mass (SMM), 0.9 kg higher ICW, and 0.5% higher TBW/BW than those who did not (all p &amp;lt; 0.05), with fat-free mass (FFM) and TBW being higher (p = 0.051; p = 0.050). Those who met the TWI recommendation of China had 1.3 kg higher SMM, 2.4 kg higher FFM, 1.1 kg higher ICW, 0.6 kg higher ECW, and 1.7 kg higher TBW than their counterparts (all p &amp;lt; 0.05). Moderate associations were found between water intake and body composition. No significant differences were observed among participants in three hydration statuses (all p &amp;gt; 0.05). Participants who met the TWI or TDF recommendations had better body composition distribution than their counterparts. Thus, habitual water intake, not hydration status, affects body composition among athletes in free-living conditions.

Somatotype and body composition profiles of children and adolescent male basketball players.

Somatotype and body composition (BC) are related to athletes' physical fitness and performance. The aims of this study were (a) to determine the somatotype and BC profiles of children and adolescent male basketball players and (b) to investigate the relationship between somatotype and BC. Four hundred forty-nine children and adolescent male basketball players between the ages of 7-17 participated in the study voluntarily. Somatotype scores were determined according to the Heath & Carter method, and BC was evaluated by the bioelectrical impedance analysis (BIA) method. Pearson correlation test was used to determine the relationship between somatotype and BC. A significant positive relationship between body mass (BM), body fat (BF), body mass index (BMI), and fat mass (FM) with endomorphy and mesomorphy scores; a significant negative relationship between body height (BH) with endomorphy and mesomorphy scores were found. In addition, ectomorphy scores were significantly positively correlated with BH and negative with other parameters. This current research shows that as age increases, BH, BM, BMI, and FM increase, and BF, endomorphy, and mesomorphy scores decrease. With increasing age, the somatotype score changes from endomorphic mesomorphy (5-7-2) to balanced mesomorphy (3-6-3). The comprehensive data presented in this study can serve as a reference value and be used as an indicator for children and adolescent basketball coaches.

Anthropometric Profile and Position-Specific Changes in Segmental Body Composition of Professional Football Players Throughout a Training Period.

Body and anthropometric profiles of football players vary depending on the physiological and technical demands imposed by different positions. The aim of this study was to evaluate the body composition of professional soccer players in relation to their position on the field during a training macrocycle. The Direct Segmental Multi-Frequency Bioelectrical Impedance Analysis method was used to analyze 58 players at six key moments of the macrocycle. The results show that body profiles are adjusted to the specific demands of each position. Midfielders showed the lowest muscle mass, while defenders showed many notable changes. In general, as the season progressed, all field players experienced an increase in trunk body fat. Fat and lean mass values of goalkeepers differed greatly from the rest. The greatest variations in body composition were observed during pre-season and transition in relation to variations in training load and competitive intensity. The results suggest that the phase of the macrocycle has a greater influence on these variations, although the physical characteristics of each position are relevant. Understanding these dynamics allows for the design of more personalized and efficient training programs to optimize the performance of footballers according to their roles and each stage of the season.

Weight loss, changes in body composition and inflammatory status after a very low-energy ketogenic therapy (VLEKT): does gender matter?

BackgroundConsidering differences in body composition and inflammatory status between sexes, as well as recent recommendations advocating for personalized dietary approaches, this study aimed to explore how sex influences weight loss, changes in body composition, and inflammatory status in subjects with grade I and II obesity undergoing a 45-day of the Very Low-Energy Ketogenic Therapy (VLEKT).MethodsParticipants (21 premenopausal females and 21 males), included in the study adhered to the 45-day of the VLEKT and underwent assessments of anthropometric parameters (weight, height, body mass index—BMI –, and waist circumference), body composition via bioelectrical impedance analysis, and inflammatory status measured by high sensitivity C-reactive protein (hs-CRP) levels at baseline and post-intervention.ResultsAt baseline, premenopausal females and males did not differ in BMI (p = 0.100) and hs-CRP levels (p = 0.948). Males demonstrated overall larger benefits than premenopausal females from the VLEKT in terms of weight loss (Δ% = − 11.63 ± 1.76 vs − 8.95 ± 1.65 kg, p < 0.001), fat mass (Δ% = − 30.84 ± 12.00 vs -21.36 ± 4.65 kg, p = 0.002), and hs-CRP levels (Δ% = − 41.42 ± 21.35 vs − 22.38 ± 17.30 mg/L, p = 0.003). Of interest, in males phase angle values are statistically improved compared to female (Δ% = 17.11 ± 9.00 vs 7.05 ± 3.30°, p < 0.001).ConclusionThese findings underscore the importance of considering sex-specific responses in personalized obesity treatment strategies, particularly dietary interventions like VLEKTs.Graphical

Improved functional oral intake and exercise training attenuate decline in aerobic capacity following chemoradiotherapy in patients with esophageal cancer.

To investigate the impact of chemoradiotherapy on the physical fitness of patients with oesophageal cancer, and the clinical factors influencing it. A total of 67 participants successfully completed the study, with 18 of them engaging in supervised, in-hospital aerobic training at moderate intensity for a minimum of 20 sessions. Cardiopulmonary exercise testing, hand grip strength, body composition assessed via bioelectrical impedance analysis, patient-generated subjective global assessment, albumin, and the Functional Oral Intake Scale (FOIS) were evaluated before chemoradiotherapy and 6-8 weeks after its completion. Among the participants, cardiopulmonary fitness, hand grip strength, and phase angle of BC-BIA declined during chemoradiotherapy. Before and after chemoradiotherapy, V̇O2peak was 19.6 ± 4.4 and 17.4 ± 3.9 mL/min/kg respectively. The improvement in FOIS during chemoradiotherapy showed a positive correlation with changes in aerobic capacity. Additionally, exercise training was associated with attenuating the decline in aerobic capacity. Physical fitness deteriorated in patients with oesophageal cancer following chemoradiotherapy. Improvement in dysphagia helps maintain aerobic capacity. Additionally, exercise training has the potential to mitigate the decline. This discovery can serve as a reference for enhancing holistic care for patients with oesophageal cancer.

Is body composition important in the context of renal function in pediatric neurogenic bladder?

Neurogenic bladder due to myelomeningocele (MMC) is a significant risk factor for chronic kidney disease in children. Cystatin C (CysC) is a more accurate GFR marker than creatinine as it is unaffected by muscle mass but may be influenced by fat mass and BMI. This study evaluates: (1) GFR measurement accuracy using CysC and creatinine in MMC-related neurogenic bladder, (2) the relationship between body composition via bioelectrical impedance analysis (BIA) and renal parameters, and (3) the use of BIA for non-invasive GFR and body composition assessment. Forty children (median age 9.96years) underwent serum creatinine, CysC testing, and BIA measurements. We assessed age, sex, spinal lesion level, anthropometric measurements, BMI, and activity using Hoffer's scale. GFR was calculated using five creatinine-based formulas, three CysC-based, and three combining CysC and creatinine, including BIA GFR as an alternative approach. Creatinine-based GFR estimates were significantly higher than CysC-based GFR. Although only 30% of MMC patients met the traditional BMI criteria for overweight/obesity, 62.5% were obese based on BIA-measured body fat percentage. Significant differences were found in CysC and CysC-based GFR equations within BMI and fat mass groups. Positive correlations were observed between CysC and body weight, BMI percentiles, body fat mass and fat-to-muscle ratio. Muscle mass positively correlated with creatinine. BIA-determined fat mass percentage is a more sensitive obesity indicator than BMI in MMC patients. CysC levels and CysC-based GFR equations are influenced by body fat mass, requiring consideration of adiposity to avoid misestimating renal impairment.

Dynamics of Blood Lipids Before, During, and After Diurnal Fasting in Inactive Men: Quasi-Experimental Study.

There is a lack of investigation into the dynamics of blood lipids before, during, and after diurnal fasting, especially in inactive men. This study determined dynamic changes in blood lipids in inactive men before, during, and after they underwent diurnal fasting. A total of 44 young men aged a mean 27.6 (SD 5.8) years were recruited to evaluate their habitual physical activity and diet using a questionnaire developed for this study. Body composition was evaluated using a bioelectrical impedance analysis machine (Tanita BC-980). An 8-ml blood sample was collected to evaluate blood lipids and glucose. All measurements were taken 2-3 days before Ramadan, during Ramadan (at week 2 and week 3), and 1 month after Ramadan. A 1-way repeated measures ANOVA was used to compare the measured variables before, during, and after the month of Ramadan. When a significant difference was found, post hoc testing was used. Differences were considered significant at P<.05. There was a significant reduction in low-density lipoprotein during Ramadan compared to before and after Ramadan (83.49 mg/dl at week 3 vs 93.11 mg/dl before Ramadan [P=.02] and 101.59 mg/dl after Ramadan [P=.007]). There were significant elevations in fasting blood glucose (74.60 mmol/L before Ramadan vs 81.52 mmol/L at week 3 [P=.03] and 86.51 mmol/L after Ramadan [P=.01]) and blood pressure (109 mm Hg before Ramadan vs 114 mm Hg after Ramadan; P=.02) reported during and even after the month of Ramadan, although both fasting blood glucose and blood pressure were within normal levels. Ramadan fasting could be an independent factor in reducing low-density lipoprotein. Further investigations are encouraged to clarify the impact of diurnal fasting on blood lipids in people with special conditions.

Bioelectrical Impedance Analysis Demonstrates Reliable Agreement with Dual-Energy X-ray Absorptiometry in Identifying Reduced Skeletal Muscle Mass in Patients with Metabolic Dysfunction-Associated Steatotic Liver Disease and Hypertension.

Background/Objectives: Body composition (BC) affects the risk of developing metabolic dysfunction-associated steatotic liver disease (MASLD) and hypertension (HTN). Currently, dual-energy X-ray absorptiometry (DEXA) is considered the gold standard for assessing BC, even though it has some limitations, including immobility, ionizing radiation, and patient weight restrictions. The aim of the study was to evaluate the correlations of BC parameters measured by bioelectrical impedance analysis (BIA) with those measured by DEXA in patients with MASLD and HTN. Methods: Overall, 78 patients with MASLD and HTN underwent the following study procedures: compilation of an anamnesis, physical examination of a patient, laboratory tests, abdominal ultrasound, BIA, DEXA, and anthropometric measurements. Results: The agreement between BIA and DEXA in diagnosing reduced skeletal muscle mass (SMM) in patients with MASLD and HTN was moderate (kappa values were 0.440 and 0.404 in males and females, respectively). Significant strong direct correlations were found between fat mass (FM) and body fat percentage measured by BIA with corresponding measurements by DEXA (p < 0.001 for both). The area under the receiver operating characteristic curves (AUC) of SMM to body weight ratios calculated using BIA data were 0.834 and 0.929 for reduced appendicular SMM determined by DEXA in males and females with MASLD and HTN, respectively. Conclusions: In conclusion, BIA is an easy-to-use and widely available tool for assessing SMM and FM in patients with MASLD and HTN, demonstrating reliable agreement with DEXA measurement results and completely free of its limitations.

The female athlete—reliability of body composition analyses during the female menstrual cycle in young women without hormonal contraception

Abstract Background The menstrual cycle (MC) is characterized by rapid changes of female sexual hormone concentrations with consecutive water retention alterations, which in turn might affect underlying parameters of body composition (BC) analyses in terms of air-displacement plethysmography (ADP) or bioelectrical impedance analysis (BIA). Objective The purpose of this study was to evaluate BC and the assessment’s reproducibility and reliability during the MC. Methods In a repeated measures design with four time points (t1–t4) and a double testing within 10 min at t1 (t1.1–t1.2) covering a complete MC (t1.1: start of menstruation [t1.2: double testing], t2: late follicular, t3: ovulation, t4: mid-luteal), 17 eumenorrheic women without hormonal contraception (age: 24.8 [18.5–33.1] years, body mass index [BMI]: 23.3 [18.0–27.8] kg/m2) were examined by means of ADP (BODPOD GS‑X, Cosmed, Rome, Italy) and BIA (mBCA 515/514, Seca, Hamburg, Germany) in order to determine reliability (intraclass correlation [ICC2.1]) and within-subjects variability (standard error of the measurement [SEM], minimal detectable change [MDC], coefficient of variation [CV%]) covering the complete MC (t1–t4). Results The CV% showed small variations ranging between 0.8 and 2.7%, except for the BIA reactance (4.2%). Reliability was excellent (ICC2.1 &gt; 0.9) for all BC parameters and all intervals (t1.1 vs. t1.2, t2, t3, and t4, respectively), except for the reactance (0.7 &gt; ICC2.1 &gt; 0.55). Conclusion Reproducibility and reliability of BC analyses were not influenced by the MC. Thus, BC of female athletes may be determined irrespective of the phase of their MC. Future research might cover more than one MC or consider women with hormonal contraception or males serving as controls.

The Abdominal Adiposity Index (A Body Shape Index) Predicts 10-Year All-Cause Mortality in Elderly Active Non-Obese Subjects

Background/Objectives: A Body Shape Index (ABSI), which accounts for waist circumference relative to mass and height, shows a robust association with mortality risk. The present study evaluates the effectiveness of ABSI as a predictor of 10-year all-cause mortality in physically active, non-obese elderly individuals. Methods: This prospective cohort study included 159 volunteers (94 women, aged 60–80 years), recruited in the frame of the “Physical Activity and Nutrition for Great Ageing” (PANGeA) Cross-border Cooperation Program Slovenia–Italy 2007–2013, and followed for 10 years. Baseline characteristics included anthropometric measurements, bioelectrical impedance analysis, and cardiovascular fitness tests (VO2max). Statistical analyses (Cox regression, Kaplan–Meier survival) were conducted to examine the relationship between ABSI and mortality. Results: During the 10-year follow-up, 10 deaths (6.7%) were recorded. ABSI (adjusted for age, smoking, comorbidities, and therapy) was an independent predictor of mortality (hazard ratio = 4.65, p &lt; 0.001). Higher ABSI scores were linked to reduced VO2max (r = −0.190, p = 0.017) and increased systolic blood pressure (r = 0.262, p = 0.001). An ABSI-based predictive model showed strong discriminatory power (AUROC = 0.91). Conclusions: ABSI is a reliable predictor of 10-year mortality in active, non-obese elderly individuals and may improve risk stratification in clinical practice.

Bioelectrical impedance analysis–derived phase angle predicts possible Sarcopenia in patients on maintenance hemodialysis: a retrospective study

BackgroundThe prevalence of possible sarcopenia is notably high among maintenance hemodialysis (MHD) patients. Possible sarcopenia, defined as a decrease in muscle strength and/or somatic function, is an early and reversible condition between non-sarcopenic and sarcopenia, and early recognition and intervention for possible sarcopenia is important for preventing adverse outcomes and improving the quality of life of these patients. This study aimed to establish a simple and effective model for screening and identifying MHD patients at high risk of possible sarcopenia by using 50 kHz-Whole Body Phase Angle (PhA), with a specific focus on gender differences.MethodsThis prospective cross-sectional study was conducted from September to December 2023 at the Wenjiang Hemodialysis Center in the Department of Nephrology, West China Hospital, Sichuan University, Chengdu, China. A total of 244 MHD patients, including 130 males and 114 females, were enrolled. Data were collected prospectively, including demographic information and physical measurements. All participants provided informed consent before enrollment. Measurements were taken post-dialysis to ensure consistency. The whole-body phase angle was measured using the InBody S10 device, grip strength was measured using an electronic grip strength tester, and physical function was assessed by the Short Physical Performance Battery (SPPB). The Skeletal Muscle Index (SMI) was also calculated.ResultsA total of 244 patients receiving hemodialysis were enrolled in this study. Among these, 109 patients were categorized as non-sarcopenic, 111 as having possible sarcopenia, and 24 as sarcopenic. The prevalence of sarcopenia among MHD patients is 9.8%, while the prevalence of possible sarcopenia is 45.5%. The receiver operating characteristic (ROC) curve analysis showed that for male patients, the AUC of PhA for predicting possible sarcopenia was 0.798, with a sensitivity of 80.36%, specificity of 69.70%, and a cutoff value of 6.20°. For female patients, the AUC of PhA was 0.701, with a sensitivity of 70.91% and specificity of 62.79%, and a cutoff value of 5.70°.ConclusionsPhA may be a useful and simple predictor of the risk of possible sarcopenia in MHD patients, and more research is needed to further promote the use of PhA in possible sarcopenia.

Phase angle variability on bleeding risks in hemodialysis patients.

This study investigated the association between Phase Angle (PhA), measured by bioelectrical impedance analysis, and bleeding risk in hemodialysis patients to evaluate PhA as a predictive marker for bleeding events. This retrospective cohort study included 102 hemodialysis patients who underwent PhA measurements between July 2019 and April 2024. Demographic data, medical histories, dialysis parameters, and bleeding events were collected. Patients were stratified by PhA values and followed for a median of 832days (IQR: 516-1304days). Multivariate Cox proportional hazards regression and Kaplan-Meier analysis were performed. The cohort had an average age of 74.0years and a median dialysis vintage of 6.7years. During follow-up, 19 patients (18.6%) experienced major bleeding events. Lower PhA was an independent risk factor for bleeding (HR: 0.24, 95% CI 0.11-0.52, p < 0.001). Kaplan-Meier analysis showed that patients with PhA ≥ 4.00 had a higher probability of remaining free from major bleeding at 2years (94.3%) compared to those with PhA < 4.00 (75.0%) (p < 0.001). In 82 patients with repeat PhA measurements, bleeding event-free rates at 2years were 97.5%, 75%, 100%, and 78.3% for the High to High, High to Low, Low to High, and Low to Low groups, respectively (p < 0.001). PhA is a predictive marker for bleeding risk in hemodialysis patients. Routine PhA monitoring could help stratify bleeding risk and optimize clinical management.