Bioimpedance Research Articles

Association of muscle quantity and quality with knee extension strength in knee osteoarthritis: the Nagahama study.

We aimed to examine whether lower-limb muscle quantity and quality assessed by bioelectrical impedance analysis (BIA) were associated with knee extension strength and if the association differed with knee osteoarthritis (OA) severity. We included 1,525 participants (63.6% women; mean age, 68.0±5.3 years) from the Nagahama Prospective Cohort. Knee extension strength was measured during maximum voluntary isometric contraction. Lower limb muscle mass and extracellular-to-intracellular water (ECW/ICW) ratio were used as indicators of muscle quantity and quality, respectively, and assessed via a BIA device. We executed multiple linear regression analyses to investigate the association of muscle quantity and quality with knee extension strength. Additionally, participants were classified into three groups with respect to OA severity and symptoms: control, early, and advanced OA groups; subgroup analyses were also executed. The muscle mass (p<0.001) and ECW/ICW ratio (p=0.009) were significantly associated with knee extension strength. In the subgroup analysis, the muscle mass was significantly associated with knee extension strength (p<0.001), but there was no association between ECW/ICW ratio and knee extension strength (p=0.731) in the control group. In the early and advanced OA groups, the muscle mass (both p<0.001) and ECW/ICW ratio (early OA: p=0.034, advanced OA: p=0.015) were significantly associated with knee extension strength. Lower limb muscle quality was associated with knee extension strength, and the association was stronger in patients with knee OA. These findings suggest that both muscle quantity as well as quality should be assessed to better understand muscle function in patients with knee OA.

TRUNK MUSCLE MASS MEASURED BY BIOELECTRICAL IMPEDANCE ANALYSIS REFLECTS THE CROSS-SECTIONAL AREA OF THE PARAVERTEBRAL MUSCLES AND BACK EXTENSOR STRENGTH

BackgroundTrunk muscles play an important role in supporting the spinal column. A decline in trunk muscle mass, as measured by bioelectrical impedance analysis (TMM–BIA), is associated with low back pain and poor quality of life.PurposeThe purpose of this study was to determine whether TMM–BIA correlates with quantitative and functional assessments traditionally used for the trunk muscles.MethodsWe included 380 participants (aged ≥ 65 years; 152 males, 228 females) from the Shiraniwa Elderly Cohort (Shiraniwa) study, for whom the following data were available: TMM–BIA, lumbar magnetic resonance imaging (MRI), and back muscle strength (BMS). We measured the cross-sectional area (CSA) and fat-free CSA of the paravertebral muscles (PVM), including the erector spinae (ES), multifidus (MF), and psoas major (PM), on an axial lumbar MRI at L3/4. The correlation between TMM–BIA and the CSA of PVM, fat-free CSA of PVM, and BMS was investigated.ResultsTMMBIA correlated with the CSA of total PVM and each individual PVM. A stronger correlation between TMM–BIA and fat-free CSA of PVM was observed. The TMM–BIA also strongly correlated with BMS.ConclusionTMM–BIA is an easy and reliable way to evaluate the trunk muscle mass in a clinical setting.Conflict of interestNoneSources of fundingNone

Relationship between phase angle measured with bioelectrical impedance analysis and nonalcoholic fatty liver disease in adults

Purpose The phase angle (PhA) measured by bioelectrical impedance analysis (BIA) is associated with nutritional status and cellular health, and it is a clinically important parameter used to assess the risk of various diseases. It remains unclear whether PhA is associated with nonalcoholic fatty liver. The purpose of this study is to investigate the relationship between the BIA parameter PhA and nonalcoholic fatty liver disease (NAFLD). Design/methodology/approach This cross-sectional study was conducted with 300 adults aged 20–64 years (NAFLD: 196, normal: 104). Some biochemical findings of the participants were collected, and whole-body and segmental PhAs were measured using Tanita (MC-780) at 50 kHz. Findings The PhA values of the whole body (p = 0.003), trunk (p &lt; 0.001), right and left legs (p &lt; 0.001 for both) were found to significantly differ according to the degrees of fatty liver. It was observed that the highest PhA values were in normal individuals. Logistic regression analysis showed that the reduction in PhAs of the whole body (p = 0.038), right (p = 0.019) and left legs (p = 0.049) and trunk (p = 0.001) after adjusting for all confounding factors increased the risk of NAFLD. Additionally, whole body PhA was significantly associated with age (year, p = 0.02), BMI (kg/m2; p &lt; 0.001), fat mass (kg; p = 0.001), fat mass (%; p &lt; 0.001), albumin (g/L; p &lt; 0.001) and CRP (mg/dL; p = 0.001). Originality/value The results of this study showed that PhA can be used in the management of NAFLD. To identify potential mechanisms in the relationship between the angle of the liver and NAFLD, large-scale prospective studies are needed.

Association between muscle-localized bioelectrical impedance analysis parameters and performance in a multi-set exercise on the isokinetic dynamometer in young women.

This study aimed to verify the relationship between changes in thigh muscle-localized bioelectrical impedance analysis (ML-BIA) parameters and performance in a multiple-set exercise. The sample consisted of 30 female university students (22.1±3.2years). The ML-BIA parameters, including localized muscle resistance (ML-R), reactance (ML-Xc), and phase angle (ML-AngF), were evaluated using a tetrapolar bioelectric impedance device operating at a frequency of 50KHz. The multiple sets protocol was performed with an isokinetic dynamometer. For body composition, total and leg lean soft tissue (LST) were evaluated using dual X-ray absortiometry. Student's t-test for paired samples was used to compare the ML-BIA parameters and thigh circumference pre and postexercise. Linear regression analysis was performed to verify the ∆ML-PhA as a predictor of peak torque for the three sets alone while controlling for total and leg LST. There were differences in the ML-R (∆=0.02±1.45Ω; p=0.001; and E.S=0.19), ML-Xc (∆=2.90±4.12Ω; p=0.043; and E.S=0.36), and thigh circumference (∆=0.82±0.60cm; p<0.001; and E.S=0.16) pre- and post-multiple sets. ΔML-PhA was a predictor of performance in the first set (p=0.002), regardless of total and leg LST. However, the ΔML-PhA lost its explanatory power in the other sets (second and third), and the variables that best explained performance were total and leg LST. The ML-BIA (ML-R and ML-Xc) parameters were sensitive and changed after the multiple sets protocol, and the ΔML-PhA was a predictor of performance in the first set regardless of the total and leg LST.

The association of initial and changes in serum A-FABP level with the development and improvement of pre-sarcopenia.

Several cross-sectional studies have reported the association between serum adipocyte fatty acid binding protein (A-FABP) level and pre-sarcopenia. However, data on the impacts of serum A-FABP level and its changes over time on the development and improvement of pre-sarcopenia are scarce. This longitudinal cohort study included 1496 adults (41.2% men; median age, 58 [53-63] years) in 2013-2014 and was followed up to 2015-2016. Participants underwent serum A-FABP level measurements at baseline and follow-up visit. Visceral fat area (VFA) was measured using magnetic resonance imaging. Skeletal muscle mass (SMM) was estimated by bioelectrical impedance analysis and converted to skeletal muscle index (SMI). Pre-sarcopenia was defined as SMI < 1 standard deviation of the sex-specific mean for the young reference group. During an average follow-up period of 2.1 years, baseline serum A-FABP level was positively associated with the incidence of pre-sarcopenia (standardized by weight: risk ratio [RR] 3.22, 95% confidence interval [CI] 1.96-5.38; standardized by VFA: RR 2.11, 95%CI 1.29-3.51) and negatively associated with the improvement of pre-sarcopenia (standardized by weight: RR 0.66, 95%CI 0.45-0.97; standardized by VFA: RR 0.71, 95%CI 0.54-0.94), regardless of whether SMM was standardized by weight or VFA. Moreover, changes in serum A-FABP level provided additional information on the incidence and improvement of pre-sarcopenia, independent of baseline serum A-FABP level (all P < 0.05). Baseline serum A-FABP level and its changes were positively associated with the incidence, and negatively associated with the improvement of pre-sarcopenia.

The Prevalence of Normal-Weight Obesity and Its Possible Related Dietary Factors: A Cross-Sectional Study of University Employees of Shiraz, Iran

Background: Normal-weight obesity (NWO), defined as normal body mass index (BMI) but high body fat, is related to chronic health conditions. This study aims to assess the prevalence of NWO and some possible relationships with dietary factors in an Iranian population. Methods: A cross-sectional study was conducted on the participants of the Employees Health Cohort Study, Shiraz, Iran. Based on the anthropometric assessments, participants were categorized into three groups: Normal-weight non-obese, NWO, and Overweight/Obese. NWO was defined as having a normal BMI but high body fat. Body fat was assessed by bioelectrical impedance analysis. Then, a 116-item semi-quantitative Food Frequency Questionnaire (FFQ) was used to obtain food intake. Dietary factors included energy intake, macro-nutrients intake, frequency of meals, fried and grilled foods’ consumption, and salt intake. Results: Overall, 1038 participants (513 men and 525 women) were studied with a mean age of 41.04±6.98. 35.9% had normal weight and 63.0% were overweight or obese according to BMI criteria. Based on WHO criteria, the prevalence of NWO was 21.68% and 26.63% among men and women, respectively. Women were more likely to have excess body fat compared with men (P&lt;0.001). Moreover, no significant relationship was observed between any dietary factor and NWO. Conclusions: NWO was prevalent among university employees, and no relationship was observed between dietary factors and NWO. Considering the high cardio-metabolic risk of this condition, it needs further attention.

The association between visceral fat obesity and prefrailty in Chinese older adults: a cross-sectional study

BackgroundThe prevalence of obesity is escalating. Previous research has concentrated on the link between frailty and obesity; however, the association between prefrailty and obesity has been less studied. Prefrailty screening and intervention may prevent or postpone frailty in older persons.ObjectiveThe study was to investigate into the relationship between prefrailty and several obesity indicators in Chinese community-dwelling older individuals.MethodsThis research employed the Frailty Screening Index to investigate the frailty phenotype of people living in Shanghai. Bioelectrical impedance analysis was used for evaluating body composition.ResultsThere were 510 participants (39.0%) with high visceral adipose areas. Participants with a high visceral adipose area showed a higher risk of prefrailty (adjusted OR, 1.53; 95% CI, 1.19–1.96), according to multivariate models. When body mass index (BMI) and visceral fat area (VFA) were combined, it was discovered that having an overweight BMI with normal VFA was a protective factor for prefrailty (corrected OR, 0.62; 95% CI, 0.43–0.90), but having a normal weight but excess VFA increased the risk of prefrailty (corrected OR, 1.87; 95% CI, 1.15–3.03).ConclusionVisceral fat obesity is an independent risk factor for prefrailty in Chinese older adults. Implementing targeted interventions, such as dietary modifications, increased physical activity, and other lifestyle changes, could play a crucial role in reducing the risk of prefrailty and improving overall health outcomes in this population.

Identifying Malnutrition Risk in the Elderly: A Single- and Multi-Parameter Approach.

Malnutrition is a significant concern affecting the elderly, necessitating a complex assessment. This study aims to deepen the understanding of factors associated with the assessment of malnutrition in the elderly by comparing single- and multi-parameter approaches. In this cross-sectional study, 154 individuals underwent a comprehensive geriatric assessment (CGA). Malnutrition risk was determined using the mini nutritional assessment (MNA). Additional factors assessed included sarcopenia, polypharmacy, depression, appetite, handgrip strength, and gait speed. Phase angle (PA) and body composition were measured using bioelectrical impedance analysis (BIA). The MNA identified a malnutrition risk in 36.8% of individuals. The geriatric depression scale (GDS) and PA demonstrated moderate effectiveness in assessing malnutrition risk, with AUC values of 0.69 (95% CI: 0.60-0.78) and 0.62 (95% CI: 0.54-0.72), respectively. A logistic regression model incorporating handgrip strength, skeletal muscle mass, sarcopenia, osteoporosis, depression, specific antidepressant use, mobility, appetite, and smoking achieved superior performance in predicting malnutrition risk, with an AUC of 0.84 (95% CI: 0.77-0.91). In conclusion, this study demonstrates that integrating multiple parameters into a composite model provides a more accurate and comprehensive assessment of malnutrition risk in elderly adults.

Prognostic value of electrical bioimpedance measured with a portable and wireless device in acute heart failure

Introduction and objectivesThe current evaluation of acute heart failure (HF) does not allow an adequate prediction of its evolution. The electrical bioimpedance (BI) allows knowing the state of blood volume, until now only with fixed equipment. We have developed and validated a portable and wireless device to measure BI at the ankle (IVOL). The objective of the study is to know the long-term prognostic value of the point measurement of BI with IVOL in patients with acute HF. MethodsA prospective cohort study of unselected patients admitted for acute HF in a tertiary hospital. The association between BI and different clinical, analytical and echocardiographic variables on admission and clinical evolution were analyzed. Results76 patients were included (mean age 66.1 years, 71.1% men, 68.4% hypertensive, 34.2% diabetic, mean NT-ProBNP: 7,103 pg/ml). Of these, 52.6% with non-preserved left ventricular ejection fraction (LVEF) (<50%) and 56.6% with right ventricular (RV) dysfunction. 26.3% died during a mean follow-up of 35.8 months. Survival in patients with BI ≤ 21,8 Ω was lower, globally and in the subgroups of patients without preserved LVEF and with RV dysfunction, p < 0.008). In the multivariate analysis, a BI ≥ 21.8 Ω was an independent survival factor (HR 0.242, 95% CI:0.86−0.681, p = 0.007). ConclusionsBI values ​​measured with IVOL may be an independent predictor of long-term mortality in patients hospitalized for acute HF. This prognostic value is maintained in patients without preserved LVEF function and with RV dysfunction.

Ángulo de fase: diferencias entre desnutrición relacionada con la enfermedad, obesidad y población sana

Introduction: Bioelectrical Impedance Analysis (BIA) is a tool used in clinical nutrition and pure electrical data such as phase angle (PA) has shown prognostic value. It relates resistance and reactance indicating cellular health.Objective: To determine differences in PA between patients with obesity and disease-related malnutrition (DRM) compared to the healthy population, and to establish associations between PA and other body composition (BC) parameters.Materials and methods: Retrospective observational study with 1079 patients from the Obesity and Nutrition Department of the Complejo Asistencial Universitario de León between April/2014 and August/2022 as well as 86 healthy controls. Demographic and anthropometric variables were collected and BC was performed with BIA Tanita MC780®. Diagnosis of malnutrition according to GLIM criteria and obesity with body mass index (BMI).Results: PA50KHz in obesity group is 5.98º, DRM 4.79º and control group 6.08º. Statistically significant differences in PA between DRM and control groups, as well as DRM and obesity (p<0.001). Weak positive correlation in total population (r=0.452, p<0.001) as well as control group (r=0.463, p<0.001) between BMI and PA. Weak negative correlation in the total population (r=-0.408, p<0.001), DRM (r=-0.268, p<0.001) and obesity (r=-0.342, p<0.001) between age and PA.Conclusions: In this study, significantly lower PA was observed in the DRM group than in the control and obesity groups. No statistically significant differences between PA in the obesity and control groups and no correlation between BMI and PA in the obesity group. More studies are needed to standardise cut-off points in different contexts and populations.

Distinct biophysiological effects of Ramadan fasting and traditional intermittent fasting on markers of body fat storage. A real-life study

BackgroundRamadan Intermittent fasting (RIF) exerts beneficial metabolic effects and improves gastrointestinal motility. However, a comparison between RIF and the traditional 16-hours intermittent fasting (16IF), a strategy for weight loss, is lacking. MethodsA total of 34 subjects (median age 32.5 years, range 18–63 years; median BMI 24.5 Kg m-1², range 18.6–37.6 Kg m-1²) were assigned to RIF (N = 18) or 16IF (N = 16) for 30 days. We measured variations in anthropometric measures (BMI, waist, and abdominal circumference), serum insulin, glucose, cortisol, non-esterified fatty acid (NEFA), body fat composition (bioelectrical impedance analysis), and the ultrasonographic measurements of liver steatosis (Hepatorenal index, HRI) and thickness of subcutaneous (SAT) and visceral (VAT) fats. ResultsAt baseline, BMI, rates of liver steatosis and distribution of normal weight, overweight, and obese subjects were comparable between the two groups. Body weight significantly decreased at the end of fasting in both RIF (-4.2 % vs baseline, P = 0.002) and 16IF (-2.1 % vs baseline, P = 0.002). Waist and abdominal circumferences significantly decreased only in RIF as well as the amount of body fat. In subjects with liver steatosis, SAT and VAT significantly decreased following RIF, but not 16h-IF, as well as the ultrasonographic HRI. ConclusionBoth 16IF and RIF are able, during 1-month, to reduce body weight. However, RIF but not 16IF also generates marked beneficial effects in terms of reduced subcutaneous fat and liver steatosis. Further studies urge to verify the effects of different models of IF in weight-cycling and long-term management of obesity and related dysmetabolic conditions, such as ectopic fat over-storage.

Body composition of adults with chronic intestinal failure receiving home parenteral nutrition: A descriptive cohort study.

Chronic intestinal failure (CIF) refers to the long-lasting reduction of gut function below the minimum necessary to absorb macronutrients, water, and/or electrolytes. Patients with CIF likely develop various forms of malnutrition and dehydration, yet studies that focus primarily on body composition are lacking. Therefore, this study aimed to evaluate the body composition of adult patients with CIF. This retrospective descriptive cohort study was performed at the Radboud University Medical Center, a tertiary referral center for CIF treatment in the form of home parenteral nutrition. We collected available bioelectrical impedance analysis (BIA) data from routine care between 2019 and 2023. The primary outcome was body composition, which was evaluated by assessing body mass index (BMI), fat-free mass index (FFMI), and fat percentage (fat%). Overall, 147 adult patients with CIF were included with a median (interquartile range) age of 58 (25-68) years; 69% were female. The mean (SD) BMI was 22.1 (4.3) kg/m2, FFMI was 14.2 (1.9) kg/m2 in females and 17.0 (2.0) kg/m2 in males, and fat% was 33.7% (6.8%) in females and 24.6% (6.4%) in males. 63% had an FFMI below references, and 48% had a high fat%. This study found that most adult patients with CIF have an unfavorable body composition characterized by a high fat% and low FFMI despite having a normal mean BMI. These results highlight the necessity for in-depth nutrition assessment, including BIA measurement. Moreover, future studies should focus on exercise interventions to increase FFMI and improve body composition and function.

Correlates of body composition in children with stunting: A cross-sectional study in Uganda

Development of body composition (BC) may be disrupted in children with stunting. Such disruption may affect the later risk of excess adiposity and metabolic health, yet few studies have investigated correlates of BC in children with stunting. We aimed to investigate nutritional status, infection and inflammation, breastfeeding behaviors, and other factors as correlates of BC in children with stunting. Among Ugandan children with a height-for-age z-score <-2, BC was estimated using bioelectrical impedance analysis and compared with United Kingdom references. We used multiple linear regression analysis to identify correlates of fat mass (FM), fat-free mass (FFM), FM-index (FMI), and FFM index (FFMI) and height, adjusting for gender and age. In 750 children aged 1-5 y, FMI was 0.46 (95% confidence interval [CI]: 0.38, 0.54] and FFMI 0.18 [95% CI: 0.11, 0.26) z-scores lower than United Kingdom references. Elevated serum α1-acid glycoprotein was associated with 1.14 [0.76, 1.52] cm lower height, 0.50 [0.35, 0.65] kg/m2 less FFMI, and 0.48 [0.31, 0.66] kg/m2 greater FMI. Similar, weaker, associations for elevated serum C-reactive protein were detected. A positive malaria rapid test was associated with 0.64 [0.25, 1.02] cm shorter height, but 0.36 [0.18, 0.54] kg/m2 greater FMI. Anemia (according to hemoglobin) was associated with 0.20 [0.07, 0.33] kg less FFM in proportion to shorter height. Longer breastfeeding duration was associated with 0.03 [0.02, 0.04] kg greater FFM per month, in proportion to greater height. These children exhibited deficits in FM and FFM, proportionally to their stunted height, compared with United Kingdom references. Systemic inflammation correlated inversely with linear growth and FFM but positively with fatness, making it a possible target for intervention where fat-free tissue accretion is desirable. Longer breastfeeding may offer protection to lean linear growth, but findings for micronutrients were less clear. Longitudinal studies are warranted to support these findings. The study was registered at www.isrctn.com (Ref.ISRCTN13093195).

Validation of Bioelectrical Impedance Devices for the Determination of Body Fat Percentage in Firefighters.

Jagim, AR, Luedke, J, Erickson, JL, Fields, JB, and Jones, MT. Validation of bioelectrical impedance devices for the determination of body fat percentage in firefighters. J Strength Cond Res 38(8): e448-e453, 2024-To cross-validate bioelectrical impedance devices for the determination of body fat percentage (BF%) in firefighters. Twenty-eight structural firefighters were evaluated (female, n = 2; male, n = 26 [mean ± SD] age: 38.2 ± 8.3 years; height: 180.2 ± 7.5 cm; body mass: 86.7 ± 20.8 kg; body mass index: 25.8 ± 7.8 kg·m-2) using multifrequency bioelectrical impedance analysis (MFBIA) hand-to-foot device, and single-frequency BIA foot scale (F2FBIA), and a single-frequency handheld BIA device (HHBIA). Dual X-ray absorptiometry served as the criterion. Validity metrics were examined to establish each method's performance. Body fat % values produced by MFBIA (r = 0.913), F2FBIA (r = 0.695), and HHBIA (r = 0.876) were strongly associated (p < 0.001) with criterion BF% measures. However, MFBIA, F2FBIA, and HHBIA all significantly (p < 0.001) underestimated BF% when compared with the criterion measure. Constant error ranged between 4.0 and 5.5% across all BIA devices. Despite strong associations between the BIA devices included in the current study and the criterion measure, all BIA devices underestimated BF%, which resulted in an overestimation of fat-free mass. In addition, proportional bias was observed in which BF% was overestimated at lower values and underestimated at higher values.

The energy intake, nutritional status, menarche at age, and premenstrual syndrome in female adolescents

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;At present, many female adolescents experience faster growth and faster development phase, including menstruation (menarche). According to 2010 Riskesdas data, 21.3 % of female adolescents in Jambi experienced menarche at the age of ≤12 years, and disorder during menstrual cycle often experienced by female adolescents is premenstrual syndrome (PMS) with a prevalence ranging from 80-90 %. &lt;/p&gt;&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This research was conducted to analyze any differences from energy intake, nutritional status, age at menarche, and PMS incidence along with finding dominant factors of age at menarche and PMS in female adolescents in urban and rural areas of Jambi.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Method: &lt;/strong&gt;This research employed a cross sectional study design involving 200 female adolescents selected from State Junior High schools in urban and rural areas of Jambi province by a simple random sampling technique. The energy intake data collected by 2 x 24 food recall, whereas nutritional status data was collected through anthropometric measurements using Bioelectrical Impedance Analysis (BIA) and a microtoise, and age at menarche and PMS data were collected by a questionnaire. Bivariate data analysis was taken by Independent t-test, Mann-Whitney test and Spearman Rank test, while the multivariate data analysis was taken by the Logistic Regression. &lt;strong&gt; &lt;/strong&gt;&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; There were significant differences found in age at menarche, energy intake, and nutritional status (HAZ and BAZ) of female adolescents in urban and rural areas (p&amp;lt;0.05). A significant negative relationship was found between nutritional status and age at menarche (p&amp;lt;0.05) and a significant positive relationship was found between nutritional status and the incidence of PMS (p&amp;lt;0.05). The Logistic Regression Test revealed that residence area was the dominant factor related to age at menarche (OR: 2.591 CI 95%: 1.415-4.744) and body fat percentage was the dominant factor related to the incidence of PMS (OR: 2.468 CI 95%: 1.159-5.254) .&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion&lt;/strong&gt;: There are differences found in age of menarche, energy intake, and nutritional status (HAZ and BAZ) between female adolescents from urban and rural areas. There is a significant relationship between nutritional status and age at menarche to the incidence of PMS. Residential area becomes the dominant factor related to age at menarche and body fat percentage becomes the dominant factor related to the incidence of PMS.&lt;/p&gt;&lt;p&gt; &lt;/p&gt;&lt;p&gt;&lt;strong&gt;KEYWORDS&lt;em&gt;: &lt;/em&gt;&lt;/strong&gt;&lt;em&gt;age at menarche; energy intake; female adolescents; nutritional status; PMS &lt;/em&gt;&lt;/p&gt;

Bioelectrical impedance phase angle combined with physical function predicts pre-frailty in maintenance hemodialysis patients: a prospective study

BackgroundThe prevalence of pre-frailty is notably high among maintenance hemodialysis (MHD) patients. Pre-frailty, an early and reversible condition between non-frailty and frailty, can lead to adverse outcomes such as increased unplanned hospital admissions and a higher risk of other chronic diseases. Early identification and intervention of pre-frailty in MHD patients are crucial. This study aimed to establish a simple and effective model for screening and identifying MHD patients at high risk of pre-frailty by using 50 kHz-Whole Body Phase Angle (PhA) measured by bioelectrical impedance analysis (BIA), hand grip strength (HGS), the Five-Times-Sit-to-Stand Test (FTSST), and laboratory parameters, 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, comprising 128 non-frail and 116 pre-frail individuals. Data were collected prospectively, including demographic information, physical measurements, and laboratory test results. All participants provided informed consent before enrollment. The FRAIL scale (FS) was used to assess pre-frailty in MHD patients. Grip strength was measured using an electronic grip strength tester, physical function was assessed using the Five-Times-Sit-to-Stand Test, and whole-body phase angle was measured using the InBody S10 device.ResultsA total of 244 MHD patients with a mean age of 53.75 ± 0.90 years were enrolled, including 130 males with a mean age of 54.12 ± 1.26 years and 114 females with a mean age of 53.32 ± 1.29 years. ROC curve analysis showed that in male patients, the AUC of PhA for predicting pre-frailty was 0.919, with a sensitivity of 94.5% and specificity of 91.3%, and a cutoff value of 6.05°; in female patients, the AUC of PhA was 0.870, with a sensitivity of 70.5% and specificity of 90.6%, and a cutoff value of 5.25°. The AUC of FTSST for screening pre-frailty in male patients was 0.827, with a sensitivity of 62.3% and specificity of 96.2%, and a cutoff value of 12.95 s; in female patients, the AUC of FTSST was 0.784, with a sensitivity of 67.3% and specificity of 84.0%, and a cutoff value of 12.95 s. Additionally, in male patients, the combination of PhA and FTSST resulted in an AUC of 0.930, with a sensitivity of 96.4% and specificity of 81.3%; in female patients, the AUC was 0.911, with a sensitivity of 78.7% and specificity of 92.5%.ConclusionPhA measured by BIA, in combination with the Five-Times-Sit-to-Stand Test, serves as an effective screening tool and predictor of pre-frailty in MHD patients. The combination of PhA and FTSST shows enhanced diagnostic value in female patients, while PhA alone is sufficient for predicting pre-frailty in male patients.Trial registrationChinese Clinical Trial Registry (ChiCTR2100051111), registered on 2021–09-13.

Digital Biometry as an Obesity Diagnosis Tool: A Review of Current Applications and Future Directions.

Obesity is a chronic relapsing disease and a major public health concern due to its high prevalence and associated complications. Paradoxically, several studies have found that obesity might positively impact the prognosis of patients with certain existing chronic diseases, while some individuals with normal BMI may develop obesity-related complications. This phenomenon might be explained by differences in body composition, such as visceral adipose tissue (VAT), total body fat (TBF), and fat-free mass (FFM). Indirect measures of body composition such as body circumferences, skinfold thicknesses, and bioelectrical impedance analysis (BIA) devices are useful clinically and in epidemiological studies but are often difficult to perform, time-consuming, or inaccurate. Biomedical imaging methods, i.e., computerized tomography scanners (CT scan), dual-energy X-ray absorptiometry (DEXA), and magnetic resonance imaging (MRI), provide accurate assessments but are expensive and not readily available. Recent advancements in 3D optical image technology offer an innovative way to assess body circumferences and body composition, though most machines are costly and not widely available. Two-dimensional optical image technology might offer an interesting alternative, but its accuracy needs validation. This review aims to evaluate the efficacy of 2D and 3D automated body scan devices in assessing body circumferences and body composition.

Exploring the association between hypocretin-1 levels and bone mineral content in patients with narcolepsy: A cross-sectional study

IntroductionRecent studies suggest the existence of a physiologic basis for bone rarefaction and increased risk for fractures. This study aimed to address anthropometric differences between patients with narcolepsy type 1 (NT1) and type 2 (NT2) and discrepancies in bone mineral content (BMC) as a function of hypocretin-1 (Hcrt-1) measured in cerebrospinal fluid (CSF). MethodsWe have evaluated 31 adult patients (aged 18–65 years) with NT1 and 18 patients with NT2, comparing the groups in terms of anthropometric variables – body mass index (BMI) and waist-to-hip ratio (WHR) – and percentage of bone mineral content (%BMC), measured by bioelectrical impedance analysis (BIA). Statistical analysis assessed the effects of Hcrt-1 levels on CSF, dietary intake, and medication use over these variables. Statistical significance was achieved with a confidence interval of 95 % and p < 0.05. ResultsPatients with NT1 presented with higher BMI (32.04 ± 6.95 vs. 25.38 ± 4.26 kg/m2; p < 0.01) and WHR (0.89 ± 0.09 vs. 0.83 ± 0.09; p = 0.02) compared to NT2, in detriment of %BMC, which was lower for NT1 (4.1 ± 1.02 vs. 4.89 ± 0.59; p < 0.01). Hcrt-1 in CSF showed a positive correlation with %BMC (r = +0.48, p < 0.01) and a negative correlation with anthropometric features (BMI: r = −0.54, p < 0.01; WHR: r = −0.37, p = 0.01). There was a correlation between WHR and diary caloric intake (r = +0.42, p < 0.01). ConclusionThe evaluation of patients with narcolepsy presupposes a syndromic approach comprising symptoms that go far beyond excessive daytime sleepiness. The integrated follow-up, including nutritional profile and anthropometric features, should add value in reducing morbidity in this population.

Deteksi Dini Obesitas melalui Pemeriskaan Komposisi Tubuh pada Populasi Usia Produktif di SMAN 75, Jakarta Utara

Body composition, which consists of the proportion of fat, bone, water and muscle, is very important for adolescent health. Adolescence is characterized by significant changes in body composition that are influenced by genetics, hormones, physical activity, and nutrition. Bioelectrical impedance analysis (BIA), a non-invasive and cost-effective method, is widely used to assess body composition, including fat mass and fat-free mass. Excess body fat in adolescence is associated with cardiovascular disease, type 2 diabetes, and obesity. This activity uses the PDCA (Plan-Do-Check-Action) methodology, which involves the facial skin analysis of 163 participants. According to the examination results, the average total body fat, total subcutaneous fat, visceral fat, and total muscle mass were 24.9%, 21%, 2.5%, and 27.5%, respectively. Early assessment and intervention are essential to prevent health complications. Promoting healthy lifestyles and regularly monitoring body composition can improve adolescent health and prevent future obesity-related morbidity and mortality.

Maximal Oxygen Consumption Is Negatively Associated with Fat Mass in Facioscapulohumeral Dystrophy.

Facioscapulohumeral dystrophy (FSHD) leads to progressive changes in body composition such as loss of muscle mass and increase in adiposity. In healthy subjects, anthropometric parameters are associated with the maximum volume of oxygen consumed per minute (VO2max), which is a health and function indicator in several populations of subjects, both healthy and pathological. Since VO2max can be difficult to test in patients with FSHD due to exercise intolerance, the identification of associated anthropometric parameters could provide new easily obtainable elements for the patients' clinical stratification. The aim of this study was to evaluate whether anthropometric and body composition parameters are associated with VO2max in patients with FSHD. A total of 22 subjects with a molecular genetics-based diagnosis of FSHD (6 females, 16 males, mean age of 35.18 years) were recruited for the study. VO2max was measured by cardiopulmonary exercise tests (CPETs) on a cycle ergometer, utilizing a step incremental technique (15 Watts (W) every 30 s). Weight (Kg) and height (m) were obtained and utilized to calculate body mass index (BMI). Body composition parameters (fat mass (FM), fat free mass (FFM), and body cell mass (BCM)) were obtained by bioelectrical impedance analysis (BIA). Significant negative associations were found between VO2max and FM (Spearman correlation coefficient (SCC) -0.712), BMI (SCC -0.673), age (SCC -0.480), and weight (SCC -0.634), unlike FFM and BCM. Our results indicate that FM, BMI, age, and body weight are negatively associated with VO2max in patients with FSHD. This evidence may help practitioners to better stratify patients with FSHD.