Can phase angle determined by bioelectrical impedance analysis assess nutritional risk? A comparison between healthy and hospitalized subjects

• Published in: Clinical nutrition (Edinburgh, Scotland) Vol. 31; no. 6; pp. 875 - 881
• Main Authors: Kyle, Ursula G., Soundar, Esther P., Genton, Laurence, Pichard, Claude
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.12.2012; Elsevier
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; analysis; bioelectrical impedance; Bioelectrical impedance analysis; Biological and medical sciences; Body Composition; Body Mass Index; Body Weight; Case-Control Studies; diagnosis; Electric Impedance; Feeding. Feeding behavior; Female; Fundamental and applied biological sciences. Psychology; Gastroenterology and Hepatology; Hospitalization; Humans; Male; Malnutrition; Malnutrition - diagnosis; men; Middle Aged; morbidity; Nutrition Assessment; Nutritional assessment; Nutritional screening; Nutritional Status; patients; Phase angle; relative risk; Risk Factors; risk screening; screening; Sensitivity and Specificity; serum albumin; Serum Albumin - analysis; Surveys and Questionnaires; Vertebrates: anatomy and physiology, studies on body, several organs or systems; Young Adult; ROC; PhA; SGA; M; AUC; NRS-2002; Nutritional assessment; LOS; Bioelectrical impedance analysis; Phase angle; W; BIA; Nutritional screening; Malnutrition; receiver operator characteristics; length of hospital stay; subjective global assessment; area under the curve; nutritional risk screening; men; women; Healthy subject; Nutrition; Risk factor; Metabolic diseases; Risk; Impedance; Comparative study
• ISSN: 0261-5614; 1532-1983; 1532-1983
• DOI: 10.1016/j.clnu.2012.04.002

Low phase angle (PhA) by bioelectrical impedance analysis (BIA), is associated with increased morbidity and nutritional risk. This study determined the cut-off values for PhA compared to Nutritional Risk Screening (NRS-2002) and Subjective Global Assessment (SGA) in patients at hospital admission, and evaluated the association between PhA and serum albumin. PhA was determined in patients (Men (M)/Women (W)=382/267), and healthy age-, sex- and height-matched controls. Sensitivity and specificity were calculated for PhA compared to NRS-2002, SGA and serum albumin. The cut-off values were assessed by receiver operator characteristics area under the curve (ROC–AUC). The best PhA cut-offs were 5.0° and 4.6° in M/W. The sensitivity for NRS-2002 was 70.0/58.1% (M/W); SGA: 73.3/64.5%; albumin: 58.8/23.5%; specificity for NRS-2002: 85.1/81.7% (M/W); SGA: 76.6/76.1% and albumin: 93.2/96.6%. The PhA showed a ROC–AUC for NRS-2002 of 0.85/0.80 (M/W); SGA: 0.83/0.80 and albumin: 0.85/0.91. Patients with albumin levels <35g/L had a relative risk of 7.5 to have low PhA compared to patients with ≥35g/L The consistent sensitivity and specificity between PhA and three screening tools strengthens the validity of our study. PhA appears to be a useful screening tool to assess nutritional risk without having to measure weight or height.