AIM To evaluate the prognostic value of the phase angle(PA)obtained from bioelectrical impedance analysis(BIA) for mortality prediction in patients with cirrhosis. METHODS In total, 134 male cirrhotic patients prospec...AIM To evaluate the prognostic value of the phase angle(PA)obtained from bioelectrical impedance analysis(BIA) for mortality prediction in patients with cirrhosis. METHODS In total, 134 male cirrhotic patients prospectively completed clinical evaluations and nutritional assessment by BIA to obtain PAs during a 36-mo follow-up period. Mortality risk was analyzed by applying the PA cutoff point recently proposed as a malnutrition marker(PA ≤ 4.9°) in Kaplan-Meier curves and multivariate Cox regression models. RESULTS The patients were divided into two groups according to the PA cutoff value(PA > 4.9°, n = 73; PA ≤ 4.9°, n = 61). Weight, height, and body mass index were similar in both groups, but patients with PAs > 4.9° were younger and had higher mid-arm muscle circumference, albumin, and handgrip-strength values and lower severe ascites and encephalopathy incidences, interleukin(IL)-6/IL-10 ratios and C-reactive protein levels than did patients with PAs ≤ 4.9°(P ≤ 0.05). Forty-eight(35.80%) patients died due to cirrhosis, with a median of 18 mo(interquartile range, 3.3-25.6 mo) follow-up until death. Thirty-one(64.60%) of these patients were from the PA ≤ 4.9° group. PA ≤ 4.9° significantly and independently affected the mortality model adjusted for Model for End-Stage Liver Disease score and age(hazard ratio = 2.05, 95%CI: 1.11-3.77, P = 0.021). In addition, Kaplan-Meier curves showed that patients with PAs ≤ 4.9° were significantly more likely to die. CONCLUSION In male patients with cirrhosis, the PA ≤ 4.9° cutoff was associated independently with mortality and identified patients with worse metabolic, nutritional, and disease progression profiles. The PA may be a useful and reliable bedside tool to evaluate prognosis in cirrhosis.展开更多
BACKGROUND Malnutrition in cirrhotic patients is correlated with mortality and a better response to liver transplantation.However,recovery of the nutritional status in these patients is a challenge due to the difficul...BACKGROUND Malnutrition in cirrhotic patients is correlated with mortality and a better response to liver transplantation.However,recovery of the nutritional status in these patients is a challenge due to the difficulty in establishing a reliable nutritional diagnosis.The bioelectrical impedance vector analysis(BIVA)method appears as a feasible tool in clinical practice to define the physiological state of cirrhotic patients by assessing hydration and body cellularity.AIM To evaluate body composition in cirrhotic patients using BIVA.METHODS This retrospective cross-sectional study was carried out by following cirrhotic outpatients at a hospital in Porto Alegre,Brazil.A tetrapolar bioelectrical impedance analysis device was used to evaluate cellularity and hydration and to perform the BIVA.The BIVA graphic was elaborated by software and for statistical analysis a significance level of 5%(P≤0.05)was considered.RESULTS One hundred and ninety patients,61.1%males,with a mean age of 56.6±11.0 years,were evaluated.Of these,56.3%had Child-Turcotte-Pugh(CTP)A score,and the prevalent etiology was hepatitis C virus(47.4%).The patients were classified according to cellularity and hydration by the quadrants and ellipses of the BIVA method,quadrant 1(47.9%);quadrant 2(18.9%);quadrant 3(14.2%);and quadrant 4(18.9%).Those classified in quadrant 1 and 2 had a higher phase angle compared to those in quadrants 3 and 4(P<0.001).Quadrant 2 patients had a lower average age than the other groups.The association with CTP score showed that patients in quadrant 2 had a higher proportion of CTP A,and those in quadrant 4 had a higher proportion of CTP C(P<0.052).CONCLUSION The BIVA method allows identification of the cellularity and hydration status of cirrhotic patients,and its association with clinical factors determines the disease severity,age and prognostic index.展开更多
Background:Fluid overload(FO)after resuscitation is frequent and contributes to adverse outcomes among postinjury open abdomen(OA)patients.Bioelectrical impedance analysis(BIA)is a promising tool for monitoring fluid ...Background:Fluid overload(FO)after resuscitation is frequent and contributes to adverse outcomes among postinjury open abdomen(OA)patients.Bioelectrical impedance analysis(BIA)is a promising tool for monitoring fluid status and FO.Therefore,we sought to investigate the efficacy of BIA-directed fluid resuscitation among OA patients.Methods:A pragmatic,prospective,randomized,observer-blind,single-center trial was performed for all trauma patients requiring OA between January 2013 and December 2017 to a national referral center.A total of 140 postinjury OA patients were randomly assigned in a 1:1 ratio to receive either a BIA-directed fluid resuscitation(defined as BIA)protocol that included fluid administration with monitoring of hemodynamic parameters and different degrees of interventions to achieve a negative fluid balance targeting the hydration level(HL)measured by BIA or a traditional fluid resuscitation(TRD)in which clinicians determined the fluid resuscitation regimen according to traditional parameters during 30 d of intensive care unit(ICU)management.The primary outcome was the 30-day primary fascial closure(PFC)rate.The secondary outcomes included the time to PFC,postoperative 7-day cumulative fluid balance(CFB)and adverse events within 30 d after OA.The Kaplan–Meier method and the log-rank test were utilized for PFC after OA.A generalized linear regression model for the time to PFC and CFB was built.Results:A total of 134 patients completed the trial(BIA,n=66;TRD,n=68).The BIA patients were significantly more likely to achieve PFC than the TRD patients(83.33%vs.55.88%,P<0.001).In the BIA group,the time to PFC occurred earlier than that of the TRD group by an average of 3.66 d(P<0.001).Additionally,the BIA group showed a lower postoperative 7-day CFB by an average of 6632.80 ml(P<0.001)and fewer complications.Conclusions:Among postinjury OA patients in the ICU,the use of BIA-guided fluid resuscitation resulted in a higher PFC rate and fewer severe complications than the traditional fluid resuscitation strategy.展开更多
Objective Bioelectrical impedance analysis(BIA)is used to measure a patient's body composition.The phase angle(PA),the major parameter in BIA,is one of the most sensitive indicators of malnutrition.The aim of the ...Objective Bioelectrical impedance analysis(BIA)is used to measure a patient's body composition.The phase angle(PA),the major parameter in BIA,is one of the most sensitive indicators of malnutrition.The aim of the current study was to investigate whether the PA can be used to predict survival in lung cancer patients.Methods One hundred sixty-six lung cancer patients were prospectively included from January 2014 to August 2016 in Daping Hospital.Anthropometric measurements,hematological values,the nutritional risk screening(NRS 2002)score,patient generated-subjective global assessment(PG-SGA)score,Karnofsky performance status(KPS)scale,European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire(EORTC QLQ C-30)score,and BIA were investigated within 48 hours after admission to the hospital.A Spearman correlation analysis was applied to test the correlations between the study characteristics and PA.A Kaplan-Meier analysis and log-rank test were conducted to analyze the association between the overall survival(OS)and PA.Results The mean age for all patients was 63 years old(42 females and 124 males).The median PA was 5.5°(4.70°,6.23°).The PA was positively associated with the body mass index,hand grip strength,mid-arm circumference,mid-arm muscle circumference,albumin,prealbumin,C-reactive protein,red blood cells,hemoglobin and KPS score.The PG-SGA scores,QLQ-C30 score,and NRS2002 score showed a significant negative association with the PA.According to a multivariate analysis,the PA(HR=0.47;95%CI:0.27-0.81)was independent predictor of the lung cancer patients'long-term OS.Patients with a higher PA(≥5°)had better overall survival(median=426 days)compared to those with a lower PA(<5°)(median=96 days)based on the one-year follow-up data(P<0.0001).Conclusions These studies indicate that the PA is a sensitive and early indicator to predict survival in lung cancer patients.展开更多
Objective: To analyse the use of BMI and bioelectrical impedance analysis (BIA) in assessment of adiposity among young and elderly population. Materials and methods: Age, height, weight and percent body fat (PBF) of 1...Objective: To analyse the use of BMI and bioelectrical impedance analysis (BIA) in assessment of adiposity among young and elderly population. Materials and methods: Age, height, weight and percent body fat (PBF) of 101 young and 276 elder subjects were recorded. PBF was measured directly by BIA instrument (PBFb) and also calculated from BMI (PBFf). The classification of subjects into underweight, normal, overweight and obese was based on the age- and sex-specific BMI cutoff values and PBFb following standard guidelines. Results: The calculated mean BMI values of young and old age groups were statistically same. PBF was significantly high in elder subjects. There was no statistical difference in mean PBFb and PBFf in young subjects but the difference was significant in elder subjects. The PBFf values were highly correlated (r: 0.92 to 0.96) with PBFb values in young age groups unlike elder groups of both males and females. PBFb based categorization of subjects’ presented totally different scenario compared to results obtained by BMI analysis to assess adiposity. Conclusion: The cases such as increasing fatness with aging even when BMI remains constant, the causes of country or ethnic differences in BMI analysis, poor correlation in PBFb and PBFf values in elder age group emphasize on the limitations of BMI based analysis. PBFb within limitations seems to be an improved phenotypic characteristic over BMI.展开更多
To evaluate the relationship between measures of body composition in obese adolescents by the methods of bioelectrical impedance analysis, deuterium oxide dilution and anthropometric measures, proposing an equation. T...To evaluate the relationship between measures of body composition in obese adolescents by the methods of bioelectrical impedance analysis, deuterium oxide dilution and anthropometric measures, proposing an equation. The variables were weight, height, BMI, triceps and subscapular skinfold thickness, waist and arm muscle circumference, lean body mass, fat mass and total body water by bioelectrical impedance and deuterium oxide dilution methods. The study included 40 obese adolescents, 45% male, age distribution was 2.42 ± 1.19 years and females 55%, and the predominant age was 12.61 ± 1.78. Linear regression equations were developed, capable of predicting body composition from information supplied by the method of deuterium oxide dilution (gold standard), bioelectrical impedance and anthropometry. The variables gender, age, height, arm circumference, triceps and suprailiac skin fold thickness, resistance and reactance were used to estimate lean body mass, fat mass and total body water by the method of deuterium and significantly correlated with variables, resistance, reactance, sex and total body water (TBW) by bioimpedance method. Among the equations developed, five were suitable for this sample, therefore, it is suggested that more studies should be done to test the applicability of the equations in other samples so that we can validate the equations encountered in obese adolescents.展开更多
Background: The segmental multi-frequency bioelectrical impedance analysis (SMF-BIA) is a useful method for evaluating physical health and nutritional status in various clinical settings. But less is known about its r...Background: The segmental multi-frequency bioelectrical impedance analysis (SMF-BIA) is a useful method for evaluating physical health and nutritional status in various clinical settings. But less is known about its role in the preoperative assessment of breast cancer patients. Herein, we try to monitor the changes in body composition of preoperative patients by SMF-BIA and figure out its association with clinical features. Methods: The changes in body composition were monitored by SMF-BIA in 563 female patients with breast cancer. Monitor body moisture and collect relevant data on the day before surgery as a prospective study. Retrospective analysis will be conducted based on preoperative data and pathological results after lymph node resection, Spearman’s correlation coefficients were calculated to investigate the correlation among parameters. Results: We found that the body water, extracellular water ratio, and bioelectrical impedance of the affected upper limbs of patients with different tumor stages or different numbers of lymph node metastases were significantly different from those of their healthy upper limbs (P P P P P Conclusion: SMF-BIA can help monitor the changes in body composition of breast cancer patients and provide detailed information for making a personalized treatment plan and individual nursing schedule. However, the value of SMF-BIA in preoperative assessment still needs to be validated in large prospective clinical trials.展开更多
基金Supported by The Fundacao de Amparo a Pesquisa do Estado de Sao Paulo,Nos.2011/13243-3,2012/15677-3[GB]
文摘AIM To evaluate the prognostic value of the phase angle(PA)obtained from bioelectrical impedance analysis(BIA) for mortality prediction in patients with cirrhosis. METHODS In total, 134 male cirrhotic patients prospectively completed clinical evaluations and nutritional assessment by BIA to obtain PAs during a 36-mo follow-up period. Mortality risk was analyzed by applying the PA cutoff point recently proposed as a malnutrition marker(PA ≤ 4.9°) in Kaplan-Meier curves and multivariate Cox regression models. RESULTS The patients were divided into two groups according to the PA cutoff value(PA > 4.9°, n = 73; PA ≤ 4.9°, n = 61). Weight, height, and body mass index were similar in both groups, but patients with PAs > 4.9° were younger and had higher mid-arm muscle circumference, albumin, and handgrip-strength values and lower severe ascites and encephalopathy incidences, interleukin(IL)-6/IL-10 ratios and C-reactive protein levels than did patients with PAs ≤ 4.9°(P ≤ 0.05). Forty-eight(35.80%) patients died due to cirrhosis, with a median of 18 mo(interquartile range, 3.3-25.6 mo) follow-up until death. Thirty-one(64.60%) of these patients were from the PA ≤ 4.9° group. PA ≤ 4.9° significantly and independently affected the mortality model adjusted for Model for End-Stage Liver Disease score and age(hazard ratio = 2.05, 95%CI: 1.11-3.77, P = 0.021). In addition, Kaplan-Meier curves showed that patients with PAs ≤ 4.9° were significantly more likely to die. CONCLUSION In male patients with cirrhosis, the PA ≤ 4.9° cutoff was associated independently with mortality and identified patients with worse metabolic, nutritional, and disease progression profiles. The PA may be a useful and reliable bedside tool to evaluate prognosis in cirrhosis.
文摘BACKGROUND Malnutrition in cirrhotic patients is correlated with mortality and a better response to liver transplantation.However,recovery of the nutritional status in these patients is a challenge due to the difficulty in establishing a reliable nutritional diagnosis.The bioelectrical impedance vector analysis(BIVA)method appears as a feasible tool in clinical practice to define the physiological state of cirrhotic patients by assessing hydration and body cellularity.AIM To evaluate body composition in cirrhotic patients using BIVA.METHODS This retrospective cross-sectional study was carried out by following cirrhotic outpatients at a hospital in Porto Alegre,Brazil.A tetrapolar bioelectrical impedance analysis device was used to evaluate cellularity and hydration and to perform the BIVA.The BIVA graphic was elaborated by software and for statistical analysis a significance level of 5%(P≤0.05)was considered.RESULTS One hundred and ninety patients,61.1%males,with a mean age of 56.6±11.0 years,were evaluated.Of these,56.3%had Child-Turcotte-Pugh(CTP)A score,and the prevalent etiology was hepatitis C virus(47.4%).The patients were classified according to cellularity and hydration by the quadrants and ellipses of the BIVA method,quadrant 1(47.9%);quadrant 2(18.9%);quadrant 3(14.2%);and quadrant 4(18.9%).Those classified in quadrant 1 and 2 had a higher phase angle compared to those in quadrants 3 and 4(P<0.001).Quadrant 2 patients had a lower average age than the other groups.The association with CTP score showed that patients in quadrant 2 had a higher proportion of CTP A,and those in quadrant 4 had a higher proportion of CTP C(P<0.052).CONCLUSION The BIVA method allows identification of the cellularity and hydration status of cirrhotic patients,and its association with clinical factors determines the disease severity,age and prognostic index.
基金supported by grants from the National Natural Science Foundation of China(81770532,WDD)the Jiangsu Province Medical Foundation for Youth Talents(QNRC2016901,WDD)。
文摘Background:Fluid overload(FO)after resuscitation is frequent and contributes to adverse outcomes among postinjury open abdomen(OA)patients.Bioelectrical impedance analysis(BIA)is a promising tool for monitoring fluid status and FO.Therefore,we sought to investigate the efficacy of BIA-directed fluid resuscitation among OA patients.Methods:A pragmatic,prospective,randomized,observer-blind,single-center trial was performed for all trauma patients requiring OA between January 2013 and December 2017 to a national referral center.A total of 140 postinjury OA patients were randomly assigned in a 1:1 ratio to receive either a BIA-directed fluid resuscitation(defined as BIA)protocol that included fluid administration with monitoring of hemodynamic parameters and different degrees of interventions to achieve a negative fluid balance targeting the hydration level(HL)measured by BIA or a traditional fluid resuscitation(TRD)in which clinicians determined the fluid resuscitation regimen according to traditional parameters during 30 d of intensive care unit(ICU)management.The primary outcome was the 30-day primary fascial closure(PFC)rate.The secondary outcomes included the time to PFC,postoperative 7-day cumulative fluid balance(CFB)and adverse events within 30 d after OA.The Kaplan–Meier method and the log-rank test were utilized for PFC after OA.A generalized linear regression model for the time to PFC and CFB was built.Results:A total of 134 patients completed the trial(BIA,n=66;TRD,n=68).The BIA patients were significantly more likely to achieve PFC than the TRD patients(83.33%vs.55.88%,P<0.001).In the BIA group,the time to PFC occurred earlier than that of the TRD group by an average of 3.66 d(P<0.001).Additionally,the BIA group showed a lower postoperative 7-day CFB by an average of 6632.80 ml(P<0.001)and fewer complications.Conclusions:Among postinjury OA patients in the ICU,the use of BIA-guided fluid resuscitation resulted in a higher PFC rate and fewer severe complications than the traditional fluid resuscitation strategy.
基金supported by the National Natural Science Foundation of China(No:81673167 to Hongxia Xu)the Chongqing Technology Innovation and Application Dem on stration Project for Social Livelihood(cstc2018jscx-msybX0094,to Jie Liu).
文摘Objective Bioelectrical impedance analysis(BIA)is used to measure a patient's body composition.The phase angle(PA),the major parameter in BIA,is one of the most sensitive indicators of malnutrition.The aim of the current study was to investigate whether the PA can be used to predict survival in lung cancer patients.Methods One hundred sixty-six lung cancer patients were prospectively included from January 2014 to August 2016 in Daping Hospital.Anthropometric measurements,hematological values,the nutritional risk screening(NRS 2002)score,patient generated-subjective global assessment(PG-SGA)score,Karnofsky performance status(KPS)scale,European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire(EORTC QLQ C-30)score,and BIA were investigated within 48 hours after admission to the hospital.A Spearman correlation analysis was applied to test the correlations between the study characteristics and PA.A Kaplan-Meier analysis and log-rank test were conducted to analyze the association between the overall survival(OS)and PA.Results The mean age for all patients was 63 years old(42 females and 124 males).The median PA was 5.5°(4.70°,6.23°).The PA was positively associated with the body mass index,hand grip strength,mid-arm circumference,mid-arm muscle circumference,albumin,prealbumin,C-reactive protein,red blood cells,hemoglobin and KPS score.The PG-SGA scores,QLQ-C30 score,and NRS2002 score showed a significant negative association with the PA.According to a multivariate analysis,the PA(HR=0.47;95%CI:0.27-0.81)was independent predictor of the lung cancer patients'long-term OS.Patients with a higher PA(≥5°)had better overall survival(median=426 days)compared to those with a lower PA(<5°)(median=96 days)based on the one-year follow-up data(P<0.0001).Conclusions These studies indicate that the PA is a sensitive and early indicator to predict survival in lung cancer patients.
文摘Objective: To analyse the use of BMI and bioelectrical impedance analysis (BIA) in assessment of adiposity among young and elderly population. Materials and methods: Age, height, weight and percent body fat (PBF) of 101 young and 276 elder subjects were recorded. PBF was measured directly by BIA instrument (PBFb) and also calculated from BMI (PBFf). The classification of subjects into underweight, normal, overweight and obese was based on the age- and sex-specific BMI cutoff values and PBFb following standard guidelines. Results: The calculated mean BMI values of young and old age groups were statistically same. PBF was significantly high in elder subjects. There was no statistical difference in mean PBFb and PBFf in young subjects but the difference was significant in elder subjects. The PBFf values were highly correlated (r: 0.92 to 0.96) with PBFb values in young age groups unlike elder groups of both males and females. PBFb based categorization of subjects’ presented totally different scenario compared to results obtained by BMI analysis to assess adiposity. Conclusion: The cases such as increasing fatness with aging even when BMI remains constant, the causes of country or ethnic differences in BMI analysis, poor correlation in PBFb and PBFf values in elder age group emphasize on the limitations of BMI based analysis. PBFb within limitations seems to be an improved phenotypic characteristic over BMI.
文摘To evaluate the relationship between measures of body composition in obese adolescents by the methods of bioelectrical impedance analysis, deuterium oxide dilution and anthropometric measures, proposing an equation. The variables were weight, height, BMI, triceps and subscapular skinfold thickness, waist and arm muscle circumference, lean body mass, fat mass and total body water by bioelectrical impedance and deuterium oxide dilution methods. The study included 40 obese adolescents, 45% male, age distribution was 2.42 ± 1.19 years and females 55%, and the predominant age was 12.61 ± 1.78. Linear regression equations were developed, capable of predicting body composition from information supplied by the method of deuterium oxide dilution (gold standard), bioelectrical impedance and anthropometry. The variables gender, age, height, arm circumference, triceps and suprailiac skin fold thickness, resistance and reactance were used to estimate lean body mass, fat mass and total body water by the method of deuterium and significantly correlated with variables, resistance, reactance, sex and total body water (TBW) by bioimpedance method. Among the equations developed, five were suitable for this sample, therefore, it is suggested that more studies should be done to test the applicability of the equations in other samples so that we can validate the equations encountered in obese adolescents.
文摘Background: The segmental multi-frequency bioelectrical impedance analysis (SMF-BIA) is a useful method for evaluating physical health and nutritional status in various clinical settings. But less is known about its role in the preoperative assessment of breast cancer patients. Herein, we try to monitor the changes in body composition of preoperative patients by SMF-BIA and figure out its association with clinical features. Methods: The changes in body composition were monitored by SMF-BIA in 563 female patients with breast cancer. Monitor body moisture and collect relevant data on the day before surgery as a prospective study. Retrospective analysis will be conducted based on preoperative data and pathological results after lymph node resection, Spearman’s correlation coefficients were calculated to investigate the correlation among parameters. Results: We found that the body water, extracellular water ratio, and bioelectrical impedance of the affected upper limbs of patients with different tumor stages or different numbers of lymph node metastases were significantly different from those of their healthy upper limbs (P P P P P Conclusion: SMF-BIA can help monitor the changes in body composition of breast cancer patients and provide detailed information for making a personalized treatment plan and individual nursing schedule. However, the value of SMF-BIA in preoperative assessment still needs to be validated in large prospective clinical trials.
