Bioimpedance Research Articles

BODY COMPOSITION AND REGIONAL PHASE ANGLE AS INDICATORS OF VO2max IN ELITE MALE AND FEMALE COMBAT ATHLETES

Various potentially related factors, such as maximal oxygen consumption (VO2max) and anthropometric, physiological, genetic, and chronotype data, can contribute to athletes' training programs. Therefore, this study examined the relationship between bioelectric impedance analysis (BIA), phase angle (PhA) values, and aerobic power in female and male combat athletes. PhA, lean mass (kg), fat mass (kg), and body fat percentage (%) values of the athletes were measured using the BIA method. Oxygen consumption (VO2) was measured using a mobile cardiopulmonary exercise test system. Statistical tests included analyses of bivariate correlation, t-tests, and multiple regressions. All parameters differed except for male and female athletes' age and training experience. Male athletes have higher maximal oxygen consumption (VO2max) and PhA values than female athletes. BIA and PhA were differentially (small-medium) associated with absolute and relative VO2max in all athletes (p<0.05), whereas no correlation was found between both PhA and relative VO2max, respectively. The relationship between PhA and VO2max is more revealing, especially in male and female athletes. PhA and BIA have the potential to be used in the field by conditioning and trainers to assess aerobic endurance swiftly; this can aid in determining competition readiness, training progress, and monitoring the recovery of muscle performance following injury.

Is phase angle associated with visceral adiposity and cardiometabolic risk in cardiology outpatients?

Phase angle (PhA) serves as a prognostic marker in various clinical scenarios, reflecting oxidative stress and cellular damage. Despite its clinical relevance, its connection with adiposity and cardiovascular risk markers remains underexplored. Hence, our study sought to investigate the relationship between PhA and metabolic, adiposity, and cardiovascular risk parameters among outpatients with cardiology diagnosis. Adults aged between 26 and 59 years, under the care of a cardiology unit, were included. Ultrasound imaging was used to assess visceral adipose tissue (VAT). Single-frequency bioelectrical impedance analysis (BIA) [50 kHz] was employed to calculate PhA, from BIA's resistance and reactance measurements. Muscle strength, body mass index, waist circumference, and waist-to-height ratio were also evaluated. Framingham's risk score was calculated to estimate the cardiovascular risk events. Metabolic blood samples' results were obtained from medical records. One hundred and five participants were included in our study. Low PhA was observed in 29.5% of our sample. Higher PhA values were independently and inversely associated with both higher VAT and cardiovascular risk (adjusted OR: 0.79 [95% CI 0.69;0.91], OR: 0.74 [95% CI 0.60;0.89], respectively). Lower PhA values (≤5.59) were goodly associated with high VAT (AUC: 0.82 p < 0.001). Lower PhA values (≤5.06) were fairly associated with higher cardiovascular risk (AUC: 0.70 p = 0.003). Our study provides evidence that PhA is independently and inversely associated with elevated VAT and cardiovascular risk. These findings underscore the potential of PhA as a valuable complementary marker in assessing cardiometabolic health.

Diabetes is associated with higher body composition and bone mineral density in hemodialysis patients

Abstract Background The relationship between bone mineral density (BMD) and body composition in hemodialysis (HD) patients with end-stage kidney disease (ESKD) is still inconclusive. Methods A number of 124 ESKD patients who received regular HD were included. Body mass index (BMI) was calculated. Body fat mass (BFM), soft lean mass (SLM), fat-free mass (FFM), skeletal muscle mass (SMM), percent body fat (PBF), and skeletal muscle mass index (SMI) were measured using bioelectrical impedance analysis. BMD of the proximal radius of the selected subjects was measured by dual-energy X-ray absorptiometry. Results Among 124 ESKD patients, 32 (25.8%) had diabetes. BMD, BMI, BFM, SMI, and PBF were significantly higher in HD patients with diabetes than in those without diabetes (P &lt; 0.05). In patients with diabetes, BMD, SLM, FFM, and SMM were significantly higher in male patients than in female patients (P &lt; 0.05), while BFM and PBF were lower in female patients (P &lt; 0.05). Spearman correlation analysis showed that SLM, FFM, and SMM were positively associated with BMD in HD patients (P &lt; 0.05). Multiple linear regression analysis showed that SMI was positively correlated with BMD in non-diabetes HD patients. Logistic regression analysis showed that diabetes was independently associated with a lower risk of developing osteoporosis than non-diabetes (odds ratio [OR] = 0.169, 95% confidence intervals [CI] = 0.043–0.661, P = 0.011). Conclusion BMI, SMI, and BMD were higher in HD patients with diabetes than in non-diabetes. Diabetes may be associated with a lower risk of developing osteoporosis in HD patients.

Bioelectrical Impedance Phase Angle Value and Prolongations of PR and Corrected QT Intervals in Patients Undergoing Dialysis

Introduction: Phase angle value, derived from bioelectrical impedance analysis, represents the body cell mass and nutritional status of patients undergoing hemodialysis. Although the phase angle value has clinical significance in these patients, its relationship with electrocardiogram (ECG), another clinically relevant bioelectrical examination, has not yet been well clarified. Methods: Two hundred and twenty-four patients undergoing dialysis (80 females and 144 males; mean ± SD, 72.2 ± 12.0 years old; 117 diabetic and 107 nondiabetic patients) were studied retrospectively. Multifrequency bioelectrical impedance analysis was performed immediately after the end of dialysis therapy. The phase shift was geometrically converted into a phase angle value. The ECG was recorded simultaneously, and the upper limits of the PR interval, QRS width, and corrected QT interval (QTc) were set at 0.20, 0.12, and 0.44 s, respectively. The geriatric nutritional risk index (GNRI), a representative nutritional index, was also determined. In addition, we examined the incidence of cardiac events, including heart failure, myocardial infarction, cardiac revascularization procedure, cardiac arrhythmia, and cardiac death, or all-cause death. Results: Of 224 patients undergoing dialysis, the prolongation of the PR interval, QRS width, and QTc was found in 30.7, 17.4, and 62.1%, respectively. The prevalence of QTc prolongation was higher in females and diabetic patients than in males and nondiabetic patients. An inverse relationship between phase angle value and QTc was observed only in males and nondiabetic patients. The relationships of GNRI both with phase angle value and QTc were stronger in males and nondiabetic patients. In addition, PR interval was inversely correlated with a phase angle value only in nondiabetic patients. No significant correlation was found between phase angle value and QRS width. Five-year survival probability for the composite endpoints was significantly worse in patients with lower phase angle values. QTc prolongation was associated with survival in males and nondiabetic patients. Prolonged PR was associated with survival in nondiabetic patients. Discussion: Relationships between phase angle value and ECG findings were demonstrated in patients undergoing dialysis, especially in males and nondiabetic patients. Although the phase angle value has been considered as an index for evaluating nutritional status, another clinical application of phase angle value in predicting cardiac complications seems to be useful.

Assessment of Body Mass Index, Body Composition, Physical Activity, and Dietary Preferences in University Students: A Pilot Study

(1) Background: Body composition analysis, particularly the assessment of the amount and distribution of body fat and muscle mass in young people, is of considerable clinical importance for the detection of nutritional disorders. (2) Methods: University students aged 19–25 years had their body composition measured using a bioimpedance (BIA) device InBody 370S. Furthermore, a questionnaire survey was performed using the questionnaires: factors that influence your choice of food (FCQ); food preference questionnaire for adolescents and adults (FPQ); the international physical activity questionnaire (IPAQ). (3) Results: Body mass index (BMI) values were within a normal range in 89.5% of men and 77.9% of women, while statistically significant differences between the sexes were confirmed for all body parameters (p &lt; 0.001; p = 0.025). The waist-to-hip ratio (WHR) and percentage body fat (PBF) were abnormally high in 50.4% and 44.3% of women, respectively. High values of skeletal muscle mass (SMM), protein, minerals, and bone mineral content (BMC) were identified in 36.8% of men. A total of 88 students (66.7% of men and women) had a higher level of physical activity, i.e., achieved metabolic equivalent (MET) values of more than 3000 per week. (4) Conclusions: BMI does not always have explanatory power for assessing body weight, as it does not consider the percentage distribution of fat and non-fat body mass in the total body weight. Physical activity and a varied diet have a positive effect on achieving optimal body weight and are effective in preventing nutritional disorders (such as obesity and malnutrition) and associated health problems.

Skeletal muscle mass increases after viral eradication with direct-acting antivirals in patients with chronic hepatitis C: A longitudinal study.

Results of studies evaluating the effect of viral eradication following direct-acting antiviral (DDA) therapy on skeletal muscle mass of patients with chronic hepatitis C (CHC) are scarce. To assess the components of sarcopenia (low muscle mass, low muscle strength and low physical performance) in a cohort of CHC individuals before and after DAA therapy. We performed a longitudinal study of patients with CHC who underwent body composition assessment before (T0), and at 12 (T1) and 48 (T2) weeks after DDA therapy. Bioelectrical Impedance Analysis was used to assess skeletal mass muscle (SM) and phase angle (PhA). SM index (SMI) was calculated by dividing the SM by squared height. Muscle function was evaluated by hand grip strength (HGS) and timed up-and-go (TUG) test. Mixed-effects linear regression models were fitted to SMI, HGS and physical performance and were used to test the effect of HCV eradication by DAA. 62 outpatients (mean age, 58.6 ± 10.8 years; 58% with compensated cirrhosis) were included. Significant decreases in liver fibrosis markers and an increase of 0.20 and 0.22 kg/m2 in the SMI were observed at T1 and T2. Following DAA therapy, an increase of one unit of PhA was associated with a reduction of 0.38 min in TUG. HCV eradication with DAA therapy was associated with a dynamic reduction of non-invasive markers of liver fibrosis and increased muscle mass in 62 patients with CHC who had an undetectable HCV load at 12 weeks after completion of antiviral treatment.

Abstract P350: Increased Trunk Fat and Decreased Limb Fat Linked to Elevated Cardiovascular Risk in Hong Kong Chinese Women

Introduction: Despite known links between overall body fat and cardiovascular disease (CVD) risk, the relationship involving regional body fat (arm, trunk, and leg) remains underexplored in Chinese populations. This study examined the associations between overall and regional body fat percentage (BFP) and CVD risk in Hong Kong Chinese women. Hypothesis: We hypothesized that higher overall and trunk BFP were associated with increased CVD risk, whereas higher arm and leg BFP predicted decreased risk. Methods: This study used baseline data of 3616 women (mean age 56.12±8.51) from an ongoing cohort named ‘MECH-HK’ (Migraine Exposures and Cardiovascular Health in Hong Kong Chinese Women). The recruitment was conducted between October 2019 and October 2021. BFP was measured using the bioelectrical impedance analysis device of Inbody 270 model. Framingham 10-Year Risk Score (FRS) was calculated to present the CVD risks. Multivariate linear models were used to estimate the BFP-FRS associations. Potential non-linear relationships were assessed with restricted cubic spline models. Results: Mean overall BFP was 32.55%, and regional BFP for arm, trunk and leg were 4.59%, 15.38% and 10.76%, respectively. Non-linear associations between overall BFP and FRS were observed (P for non-linear = 0.03). After adjustment for age, education level, monthly family income, smoking and drinking status, physical activity level, family history of CVD and BMI, the overall BFP was associated with increased FRS (β: 0.04, 95% CI: 0.00 to 0.08, P = 0.03) when overall BFP &lt; 35%. However, no significant association was observed when overall BFP &gt;= 35% (β:-0.07, 95% CI: -0.16 to 0.02, P = 0.13). Higher trunk BFP was associated with increased FRS (β: 0.30, 95% CI: 0.21 to 0.38, P &lt; 0.001), while higher arm (β: -0.69, 95% CI: -0.98 to -0.40, P &lt; 0.001) and leg (β: -0.38, 95% CI-0.50 to -0.25, P &lt; 0.001) BFP were associated with decreased FRS. Conclusions: Increased overall (when &lt; 35%) and trunk BFP and decreased arm and leg BFP are associated with elevated CVD risk.

Bioelectrical Impedance Analysis Detects Body Fat Changes After Surgical Subcutaneous Fat Removal.

Background: The risk and metabolic effects of obesity are determined by the distribution of fat throughout the body. It has been proposed that the distribution of abdominal fat is more closely related to the metabolic risks of obesity. High prevalence of overweight and obesity has thereby contributed to an increased uptake of surgical subcutaneous fat removal (SSFR) procedures. The goal of this study was to determine whether bioelectrical impedance analysis (Tanita system) can be used to detect the removal of excess abdominal subcutaneous fat tissue during SSFR when studying the metabolic effects of such procedures. Methods: Study population comprised patients who received body contouring procedures at the Hamad General Hospital's plastic surgery department between November 2020 and December 2022. To evaluate the factors of interest, subjects were prospectively followed up at two time points: within 1 week before the surgery and within 1-2 weeks thereafter. The following factors were measured: body weight, body fat percentage, body fat mass, body mass index (BMI), fat-free mass, estimated muscle mass, total body water, visceral fat score, and basal metabolic rate. Results: In total, 22 patients were included in the study. The two visits' medians for height, weight, BMI, fat percent (fat%), fat mass, visceral fat rating, and Doi's weighted average glucose (dwAG) were compared. Only in the case of Tanita fat% and fat mass, were the preoperative and postoperative medians significantly different. Furthermore, there was no association between these Tanita measures and dwAG or homeostatic model assessment (HOMA; insulin resistance [IR]) changes (before and after surgery). Tanita measures overestimated fat loss, as seen by the mountain plot and Bland-Altman plot agreement methods. Conclusions: Our findings indicated that the only two Tanita measures exhibited meaningful early associations with the amount of tissue excised which were fat mass and fat% differences. Although dwAG and HOMA-IR are not impacted immediately postsurgery, a trend was seen that suggested improvements in those parameters, even though the changes are not clinically significant.

Phase angle associated is with low ankle-brachial index in type 2 diabetes patients in Ghana

BackgroundType 2 diabetes (T2DM) is associated with high burden of atherosclerotic macrovascular disease which could be diagnosed with ankle-brachial index (ABI). Phase angle (PhA) from bioelectric impedance analysis is associated with the development of cardiovascular diseases. We investigated the association between low ABI and phase angle in T2DM patients in Ghana. MethodIn a cross-sectional study, 462 T2DM patients were systematically recruited for the study. ABI was measured using an 8 Hz continuous Doppler and ABI≤0.9 was considered to be low ABI. PhA was obtained from resistance and reactance from Bioelectric impedance analysis. ResultsThe prevalence of low ABI was 16 % in the study population. T2DM patients with low ABI have decreased PhA (7.5 ± 1.9 vs 8.3 ± 2.2 units, p = 0.004) compared to those with normal ABI. An increase in phase angle by 1° was associated with a decrease in odds of having low ABI in unadjusted [OR (95 % CI) = 0.79 (0.48 – 0.95), p = 0.007] and adjusted models [0.88 (0.43 – 0.98), p = 0.036]. ConclusionThe prevalence of low ABI in T2DM patients in this study was 16 %. Also, PhA was lower in patients with low ABI compared to those with normal ABI.

Effects of Additional Protein Intake on Lean Body Mass in Patients Undergoing Multimodal Treatment for Morbid Obesity.

(1) Multimodal treatment is a standard treatment for patients with obesity. However, weight loss also leads to reductions in fat-free mass. The aim was to investigate whether additional protein intake contributes to better preservation of lean body mass (LBM). (2) A total of 267 obesity patients (age 45.8 years; BMI 47.3 kg/m2) were included in this analysis. For the first 12 weeks of the program, patients were given a formula-based diet of 800-1000 kcal per day. Patients were divided into a control group (CG) (n = 148) and a protein group (PG) (n = 119). The PG was characterized by an additional protein intake with the aim of consuming 1.5 g of protein per kilogram of normalized body weight, whereas the CG had a protein intake of 1 g/kg/d. Bioelectrical impedance analysis was performed at the beginning (t0) and after 12 weeks (t1) of the program. (3) There were no significant differences between the groups with respect to weight loss (p = 0.571). LBM was also significantly reduced in both groups, without significant differences between CG and PG. (4) Increased protein intake had no significant effect on body composition of morbidly obese patients during a 12-week formula-based diet and multimodal treatment.

Correlation between body composition and disease severity in patients with chronic obstructive pulmonary disease.

Body composition changes are important extrapulmonary manifestations in chronic obstructive pulmonary disease (COPD) patients. This study aimed to investigate the characteristics of body composition in patients with COPD, and its correlation with disease severity. A total of 105 COPD patients admitted to Zhongshan Hospital affiliated to Dalian University, from May 1, 2021 to January 31, 2023, were included as the COPD group, and 105 subjects without COPD were enrolled as the control group during the same period. According to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) comprehensive assessment indicators, COPD patients were divided into groups: the degree of pulmonary function airflow limitation was grouped according to FEV1%pred; clinical symptoms were grouped according to mMRC scores and CAT scores; the risk of acute exacerbation was divided into low risk and high risk groups. Body composition was measured by bioelectrical impedance analysis (BIA). (1) Concerning body composition, the body mass index (BMI), fat-free mass index (FFMI), and angle of phase (PhA) of COPD patients were lower than those of the control group. Extracellular water-to-total body water ratio (ECW/TBW) and extra-to-intracellular water ratio (ECW/ICW) were higher than those of the control group, and the difference was statistically significant (p < 0.05). (2) There were differences in body composition among COPD patients with different severity of disease: FFMI and PhA in the mild/moderate airflow limitation group were higher than those in the severe/very severe airflow limitation group. According to mMRC scores classification, the FFMI and PhA of the less symptomatic group were higher than those of the more symptomatic group, and ECW/TBW and ECW/ICW were lower than those of the more symptomatic group. According to CAT scores classification, FFMI and PhA in the mild/moderate disease group were higher than those in the severe/very severe disease group. The FFMI of the low-risk group was higher than that of the high-risk group, and ECW/TBW was lower than that of the high risk group. (3) Correlation analysis between body composition and disease severity indicators showed that FFMI and PhA were negatively correlated with mMRC scores and CAT scores, and positively correlated with FEV1%pred. ECW/TBW ratio and ECW/ICW ratio were positively correlated with mMRC scores and CAT scores, and negatively correlated with FEV1%pred, and the difference was statistically significant (p < 0.05). There are significant differences in body composition between COPD patients and the control group, and there are significant differences in body composition between COPD patients with different severity of disease, with correlations between body composition and severity of disease.

Pathophysiological roles of the serum acylcarnitine level and acylcarnitine/free carnitine ratio in patients with cardiovascular diseases

IntroductionL-carnitine exerts protective effects, such as maintaining mitochondrial functions and decreasing reactive oxygen species, while acylcarnitine (AC) is linked to the development of heart failure and atherosclerosis. HypothesisSerum carnitines play important pathophysiological roles in cardiovascular diseases. MethodsPre-operative biochemical data were obtained from 117 patients (71 men, average age 69.9 years) who underwent surgery for cardiovascular diseases. Measurements included pre-operative biochemical data including estimated glomerular filtration rate (eGFR), physical functions, skeletal muscle mass index (SMI) measured by bioelectrical impedance analysis, anterior thigh muscle thickness (MTh) measured by ultrasound, and routine echocardiography. Carnitine components were measured with the enzyme cycling method. Muscle wasting was diagnosed based on the Asian Working Group for Sarcopenia criteria. ResultsPlasma brain natriuretic peptide (BNP) level was correlated with serum free carnitine (FC) and AC level, and the acylcarnitine/free carnitine ratio (AC/FC). AC/FC was elevated with stage of chronic kidney disease. In multivariate analysis, log (eGFR) and log (BNP) were extracted as independent factors to define log (serum AC) (eGFR: β = 0.258, p = 0.008; BNP: β = 0.273, p = 0.011), even if corrected for age, sex and body mass index. AC/FC was negatively correlated with hand-grip strength (r = -0.387, p = 0.006), SMI (r = -0.314, p = 0.012), and anterior thigh MTh (r = -0.340, p = 0.014) in men. ConclusionsA significant association between serum AC level and AC/FC, and chronic kidney disease and heart failure exists in patients with cardiovascular diseases who have undergone cardiovascular surgery. Skeletal muscle loss and muscle wasting are also linked to the elevation of serum AC level and AC/FC.

Two-year results of laparoscopic sleeve gastrectomy and Roux-En-Y Gastric Bypass in patients with morbid obesity

Objective: To compare the long-term results of LSG and RYGB with a fixed restrictive component in patients with morbid obesity in terms of weight loss, control of associated diseases and the development of long-term complications, including sarcopenia.Materials and methods: our study included the results of treatment of 251 patients (153 LSG and 98 RYGB). The follow-up period was at least 24 months (median follow-up 38 months). The restrictive component was assessed 12 months after surgery using CT-volumetry. The size of the gastroenetroanastomosis was additionally measured using fibrogastroscopy in the RYGB group. The bioelectrical impedance analysis (BIA) was used to assess body composition and determine the skeletal muscle mass index (SMMI) initially and during control examinations in the postoperative period.Results: both groups obtained good results in terms of weight loss and control of associated diseases, however, RYGB shows some advantages in these parameters. On the other hand, in the RYGB group a higher rate of progression of signs of sarcopenia was detected (8.2% (including 3% of severe sarcopenia) vs 3.3% in the LSG group). Most patients who progressed to sarcopenia were older, had type 2 diabetes mellitus (T2DM), or had mild sarcopenia at baseline.Conclusions: RYGB demonstrates better results in terms of weight loss and control of associated diseases compared to LSG, however, in elderly patients, as well as in the presence of T2DM or signs of sarcopenia, it is advisable to choose operations without a pronounced malabsorptive effect.

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.

The association between healthy beverage index and sarcopenia in Iranian older adults: a case-control study

BackgroundSarcopenia is a progressive disease with age-related loss of skeletal muscle mass, strength, and function. No study has investigated the association between healthy beverage index (HBI) and sarcopenia in older adults. Therefore, the present study aimed to investigate the association between HBI and sarcopenia in Iranian older adults.MethodsIn the present case-control study, 80 sarcopenic and 80 non-sarcopenic participants matched in sex were included. Body composition was measured using bioelectrical impedance analysis. Handgrip strength (HGS), skeletal muscle mass index (SMI), and gait speed were utilized to confirm sarcopenia. Also, a food frequency questionnaire was used to evaluate food intake. HBI score was calculated based on ten sub-components of the total beverages. Moreover, logistic regression was applied to assess the association between HBI and sarcopenia.ResultsIn the crude model, we observed no significant association between HBI and the odds of sarcopenia. Still, after adjusting the confounders, the odds of developing sarcopenia decreased significantly in the second and last tertiles (T) (T2– odds ratio (OR) = 0.04, 95% confidence interval (CI): 0.01–0.25 and T3– OR = 0.10, 95% CI: 0.01–0.60).ConclusionsOur findings indicated that HBI is inversely related to the chance of sarcopenia. Therefore, to reduce the odds of sarcopenia, it is recommended to consume healthy drinks such as fruit juices and milk.

Recent Topic of Phase Angle (PhA) by Bioelectrical Impedance Analyses (BIA) Measurement for Anti-Aging Medicine

Anti-aging medicine has been more emphasized in developed countries. For detecting sarcopenia and frailty, bioelectrical impedance analyses (BIA) have recently attracted attention. From BIA by InBody, useful data of water balance, muscle index, and cellular health can be obtained as extracellular water/total body water (ECW/TBW), skeletal muscle mass index (SMI), and phase angle (PhA). PhA shows a close relationship with exercise habits and physical activity. The cut-off values of PhA are approximately 4.05° to 5.05°, which are related to sarcopenia. Average PhA values in males/females showed 7.7°/6.9° in university athletes and 4.1°/3.6° in aged people of 81 years old.

Relationship between muscle mass ratio and rocuronium dose required for maintaining deep neuromuscular blockade: A prospective observational study

BackgroundDeep neuromuscular blockade (NMB) has benefits in various surgical procedures, however, precise quantitative neuromuscular monitoring is crucial for its proper maintenance and recovery. Neuromuscular blocking agent dosage relies on actual body weight (ABW), but this varies among individuals. Therefore, this study hypothesizes that there is a correlation between the rocuronium requirement for deep NMB and muscle mass ratio measured by bioelectric impedance analysis. MethodsNinety adult female patients undergoing laparoscopic operation were enrolled in this study. Muscle and fat masses were assessed using a body composition analyser. Deep NMB, defined as a post-tetanic count of 1–2, was maintained through the continuous infusion of rocuronium. The primary outcome involves determining the correlation between the rocuronium dose required for deep NMB and the muscle mass ratio. Conversely, secondary outcomes included assessing the relationship between the rocuronium dose for deep NMB and fat mass ratio, and ABW. Additionally, we investigated their relationship with rocuronium onset time and profound blockade duration. ResultsNo relationship was observed between the muscle mass ratio and rocuronium dose required for maintaining deep NMB (r = 0.059 [95% CI = 0.153–0.267], p = 0.586). Fat mass ratio and ABW showed no correlation with the rocuronium dose, whereas rocuronium onset time was positively correlated with muscle mass ratio (r = 0.327) and negatively correlated with fat mass ratio (r = −0.302), respectively. Profound blockade duration showed no correlation with any of the assessed variables. ConclusionsNo correlation was detected between muscle mass ratio and the rocuronium dose required to achieve deep NMB.

Prevalence of Sarcopenia in Chronic Heart Failure and Modulating Role of Chronic Kidney Disease

Introduction: Sarcopenia, heart failure (HF), and chronic kidney disease (CKD) are common among the older people. Our objective was to evaluate the frequency of sarcopenia, among community-dwelling older adults with HF, possible causative factors, and the additive factor of CKD. Methods: A cross-sectional analysis of 1,420 older people living in the community was carried out. Participants (aged 75 years and more) came from a European multicenter prospective cohort (SCOPE study). Global geriatric assessment including short physical performance battery, handgrip strength test, and bioelectrical impedance analysis was performed. Previous known HF was defined as physician-diagnosed HF registered in the patient’s medical record or the use of HF-related medications, regardless of left ventricular ejection fraction (LVEF). Sarcopenia was defined by the updated criteria of the European Working Group on Sarcopenia in Older People (EWGSOP2). Estimated glomerular filtration rate was calculated using Berlin Initiative Study (BIS) to define the stages of CKD. Two-year mortality was also collected. Results: A total of 226 (15.9%) participants had a prior chronic HF diagnosis, with a median age of 80.0 (5.0), and 123 (54.4%) were women. Using EWGSOP2 definition, 11.5% HF and 10.7% in non-HF participants met diagnostic criteria for sarcopenia. In multivariate analyses, only a lower body mass index (BMI) (odds ratios [OR], 0.82; 95% confidence interval [CI], 0.73–0.93) and lower short physical performance battery score (OR, 0.81; 95% CI, 0.69–0.96) were associated with sarcopenia. Patients with HF and sarcopenia have a similar all-cause mortality risk but higher 2-year cardiovascular mortality risk (p = 0.047). Discussion/Conclusion: One out of ten community-dwelling older adults with concurrent clinical stable chronic HF, without considering LVEF, have sarcopenia. Lower BMI and poor physical performance are associated with sarcopenia in this population, but not CKD.

Quantitative analysis of the effect of docetaxel-induced edema on quality of life in patients with breast cancer and related factors: a prospective cohort study

BackgroundSystemic edema is an adverse effect of docetaxel chemotherapy and causes distress to patients, including those receiving this agent for breast cancer. However, its characteristics and factors related to its effect on quality of life (QoL) have not been adequately investigated. In this study, we assessed systemic edema quantitatively, explored related factors, and evaluated QoL in patients receiving docetaxel for breast cancer.MethodsThe study had a prospective cohort design and included 37 patients with no known history of swelling who were treated with docetaxel between September 2019 and April 2022. Patients were examined at the start, middle, and end of their course of treatment and 1 and 2 months later. Body water content, body mass, fat mass, and muscle mass were quantified using bioelectrical impedance analysis. Systemic edema was evaluated with reference to the Common Terminology Criteria for Adverse Events. The timing of development of systemic edema at any anatomical site that was grade 2 or worse was recorded. QoL was assessed using the Quality of Life-Anti Cancer Drug scale. Nutrition was evaluated using the Brief-type self-administered diet history questionnaire. Multivariable logistic regression analysis was performed to identify related factors. QoL was also compared between patients with edema and those without edema.ResultsSystemic edema developed in 67% of the study participants and was most prevalent at the end of treatment. Body fat mass (adjusted odds ratio [aOR] 0.802, 95% confidence interval [CI] 0.651–0.988, p = 0.038), disease stage (aOR 3.279, 95% CI 0.493–21.793, p = 0.219), and history of alcohol consumption (aOR 0.141, 95% CI 0.013–1.521, p = 0.106) were identified as risk factors for docetaxel-induced edema. Participants who developed systemic edema experienced more physical, vital, and emotional distress 1 month after treatment than those who did not. There was no association between systemic edema and nutrition.ConclusionsSystemic edema may develop after treatment with docetaxel and increase distress in patients with a high body fat mass. Patients at risk of systemic edema should be informed in advance about the potential frequency, location, and timing of its onset and encouraged to self-manage this condition.

Association of intrinsic capacity with functional ability, sarcopenia and systemic inflammation in pre-frail older adults.

Decline in intrinsic capacity (IC) has been shown to accelerate progression to disability. The study aims to explore association of IC composite score with functional ability, sarcopenia and systemic inflammation in pre-frail older adults. Cross-sectional study of pre-frail older adults ≥60 years old recruited from the community and primary care centers. Composite scores of four domains of IC were measured: locomotion, vitality, cognition and psychological. FRAIL scale was used to define pre-frailty. Muscle mass was measured using the bioelectrical impedance analysis. Systemic inflammation biomarkers [Interleukin-6 (IL-6), Interleukin-10 (IL-10), Tumor Necrosis Factor Alpha (TNF-α), and Growth differentiated factor 15 (GDF-15)] were measured. Participants in the lowest tertile (T1) exhibited greater decline in IC. A total of 398 pre-frail older adults were recruited, mean age was 72.7 ± 5.8 years, 60.1% female, education level 7.8 years, and 85.2% were of Chinese ethnicity. A total of 75.1% had decline in locomotion, 40.5% in vitality, 53.2% in cognition and 41.7% in psychological domain. A total of 95% had decline in at least one domain. T1 was significantly associated with ADL impairment (aOR 3.36, 95% CI 1.78-6.32), IADL impairment (aOR 2.37, 95% CI 1.36-4.13), poor perceived health (aOR 0.96, 95% CI 0.95-0.98), fall (aOR 1.63, 95% CI 1.05-2.84), cognitive impairment (aOR 8.21, 95% CI 4.69-14.39), depression (aOR 101.82, 95% CI 33.62-308.37), and sarcopenia (aOR 2.40, 95% CI 1.60-5.45). T1 had significant associations with GDF-15, IL-10, and IL-10 to TNF-α ratio. Decline in IC composite score among pre-frail older adults was associated with functional limitation, sarcopenia, and systemic inflammation.