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Published in: BMC Pulmonary Medicine 1/2024

Open Access 01-12-2024 | Sarcopenia | Research

Association of phase angle with sarcopenia and muscle function in patients with COPD: a case-control study

Authors: Neda Valisoltani, Hamed Mohammadi, Rasoul Aliannejad, Fatemeh Naeini, Asma Rajabi Harsini, Erfan Sadeghi, Pouya Mirzaee, Hossein Imani

Published in: BMC Pulmonary Medicine | Issue 1/2024

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Abstract

Background and aims

The predictive value of phase angle for sarcopenia diagnosis has been discussed for years. The present investigation was conducted to determine the association between phase angle and sarcopenia in patients with COPD.

Methods

In this case-control study, 222 smoker men were divided into healthy and COPD groups. COPD was diagnosed by a pulmonologist through spirometry. Anthropometric indices, phase angle, muscle function, sarcopenia, and dietary intake were assessed.

Results

A significant inverse association was observed between phase angle and sarcopenia after adjustment for age and energy intake (OR: 0.31, 95% CI 0.18–0.52) and after adjustment for BMI (OR: 0.31, 95% CI 0.18–0.52). A significant decrease was detected in anthropometric indices and indicators of sarcopenia and muscle function in COPD cases compared to the healthy controls.

Conclusions

Although further studies are suggested, phase angle might be considered an indicator of sarcopenia and muscle function in COPD patients.
Literature
1.
go back to reference Ntritsos G, Franek J, Belbasis L, Christou MA, Markozannes G, Altman P et al. Gender-specific estimates of COPD prevalence: a systematic review and meta-analysis. 2018;13:1507. Ntritsos G, Franek J, Belbasis L, Christou MA, Markozannes G, Altman P et al. Gender-specific estimates of COPD prevalence: a systematic review and meta-analysis. 2018;13:1507.
2.
go back to reference Soriano JB, Alfageme I, Miravitlles M, de Lucas P, Soler-Cataluña JJ, García-Río F, et al. Prevalence and determinants of COPD in Spain. EPISCAN II. 2021;57(1):61–9. Soriano JB, Alfageme I, Miravitlles M, de Lucas P, Soler-Cataluña JJ, García-Río F, et al. Prevalence and determinants of COPD in Spain. EPISCAN II. 2021;57(1):61–9.
3.
go back to reference Varmaghani M, Farzadfar F, Sharifi F, Rashidian A, Moin M, Moradi-Lakeh M et al. Prevalence of Asthma, COPD, and Chronic Bronchitis in Iran: a systematic review and meta-analysis. 2016:93–104. Varmaghani M, Farzadfar F, Sharifi F, Rashidian A, Moin M, Moradi-Lakeh M et al. Prevalence of Asthma, COPD, and Chronic Bronchitis in Iran: a systematic review and meta-analysis. 2016:93–104.
4.
go back to reference Blanco I, Diego I, Bueno P, Fernández E, Casas-Maldonado F, Esquinas C et al. Geographical distribution of COPD prevalence in Europe, estimated by an inverse distance weighting interpolation technique. 2018;13:57. Blanco I, Diego I, Bueno P, Fernández E, Casas-Maldonado F, Esquinas C et al. Geographical distribution of COPD prevalence in Europe, estimated by an inverse distance weighting interpolation technique. 2018;13:57.
5.
go back to reference Sharifi H, Ghanei M, Jamaati H, Masjedi MR, Aarabi M, Sharifpour A et al. Burden of obstructive lung Disease study in Iran: first report of the prevalence and risk factors of COPD in five provinces. 2019;36(1):14. Sharifi H, Ghanei M, Jamaati H, Masjedi MR, Aarabi M, Sharifpour A et al. Burden of obstructive lung Disease study in Iran: first report of the prevalence and risk factors of COPD in five provinces. 2019;36(1):14.
6.
go back to reference Devereux GJB. Definition, epidemiology, and risk factors. 2006;332(7550):1142–4. Devereux GJB. Definition, epidemiology, and risk factors. 2006;332(7550):1142–4.
7.
go back to reference Joshi P, Kim WJ, Lee S-AJI. The effect of dietary antioxidant on the COPD risk: the community-based KoGES (Ansan–Anseong) cohort. 2015;10:2159. Joshi P, Kim WJ, Lee S-AJI. The effect of dietary antioxidant on the COPD risk: the community-based KoGES (Ansan–Anseong) cohort. 2015;10:2159.
8.
go back to reference Viegi G, Pistelli F, Sherrill D, Maio S, Baldacci S, Carrozzi LJERJ. Definition Epidemiol Nat History COPD. 2007;30(5):993–1013. Viegi G, Pistelli F, Sherrill D, Maio S, Baldacci S, Carrozzi LJERJ. Definition Epidemiol Nat History COPD. 2007;30(5):993–1013.
9.
go back to reference Wouters EF, Creutzberg EC, Schols AMJC. Systemic Eff COPD. 2002;121(5):127S–30S. Wouters EF, Creutzberg EC, Schols AMJC. Systemic Eff COPD. 2002;121(5):127S–30S.
10.
go back to reference Benz E, Trajanoska K, Lahousse L, Schoufour JD, Terzikhan N, De Roos E et al. Sarcopenia in COPD: a systematic review and meta-analysis. 2019;28(154). Benz E, Trajanoska K, Lahousse L, Schoufour JD, Terzikhan N, De Roos E et al. Sarcopenia in COPD: a systematic review and meta-analysis. 2019;28(154).
11.
go back to reference Kilic MK, Kizilarslanoglu MC, Arik G, Bolayir B, Kara O, Dogan Varan H et al. Association of bioelectrical impedance analysis–derived phase angle and sarcopenia in older adults. 2017;32(1):103–9. Kilic MK, Kizilarslanoglu MC, Arik G, Bolayir B, Kara O, Dogan Varan H et al. Association of bioelectrical impedance analysis–derived phase angle and sarcopenia in older adults. 2017;32(1):103–9.
12.
go back to reference Mundstock E, Amaral MA, Baptista RR, Sarria EE, Dos Santos RRG, Detoni Filho A et al. Association between phase angle from bioelectrical impedance analysis and level of physical activity: systematic review and meta-analysis. 2019;38(4):1504–10. Mundstock E, Amaral MA, Baptista RR, Sarria EE, Dos Santos RRG, Detoni Filho A et al. Association between phase angle from bioelectrical impedance analysis and level of physical activity: systematic review and meta-analysis. 2019;38(4):1504–10.
13.
go back to reference de Blasio F, Scalfi L, Di Gregorio A, Alicante P, Bianco A, Tantucci C et al. Raw bioelectrical impedance analysis variables are Independent predictors of early all-cause mortality in patients with COPD. 2019;155(6):1148–57. de Blasio F, Scalfi L, Di Gregorio A, Alicante P, Bianco A, Tantucci C et al. Raw bioelectrical impedance analysis variables are Independent predictors of early all-cause mortality in patients with COPD. 2019;155(6):1148–57.
14.
go back to reference Zanella PB, Àvila CC, Chaves FC, Gazzana MB, Berton DC, Knorst MM et al. Phase angle evaluation of lung Disease patients and its relationship with nutritional and functional parameters. 2021;40(6):529–34. Zanella PB, Àvila CC, Chaves FC, Gazzana MB, Berton DC, Knorst MM et al. Phase angle evaluation of lung Disease patients and its relationship with nutritional and functional parameters. 2021;40(6):529–34.
15.
go back to reference Ding Y, Chang L, Zhang H, Wang SJN. Predictive value of phase angle in Sarcopenia in patients on maintenance hemodialysis. 2022;94:111527. Ding Y, Chang L, Zhang H, Wang SJN. Predictive value of phase angle in Sarcopenia in patients on maintenance hemodialysis. 2022;94:111527.
16.
go back to reference Ji W, Liu X, Zheng K, Yang H, Cui J, Li WJN. Correlation of phase angle with Sarcopenia and its diagnostic value in elderly men with cancer. 2021;84:111110. Ji W, Liu X, Zheng K, Yang H, Cui J, Li WJN. Correlation of phase angle with Sarcopenia and its diagnostic value in elderly men with cancer. 2021;84:111110.
17.
go back to reference Kosoku A, Uchida J, Nishide S, Kabei K, Shimada H, Iwai T et al. Association of Sarcopenia with phase angle and body mass index in kidney transplant recipients. 2020;10(1):1–8. Kosoku A, Uchida J, Nishide S, Kabei K, Shimada H, Iwai T et al. Association of Sarcopenia with phase angle and body mass index in kidney transplant recipients. 2020;10(1):1–8.
18.
go back to reference Pessoa DF, de Branco F, Dos Reis AS, Limirio LS, Borges LP, Barbosa CD et al. Association of phase angle with Sarcopenia and its components in physically active older women. 2020;32(8):1469–75. Pessoa DF, de Branco F, Dos Reis AS, Limirio LS, Borges LP, Barbosa CD et al. Association of phase angle with Sarcopenia and its components in physically active older women. 2020;32(8):1469–75.
19.
go back to reference Santana NM, Pinho CPS, da Silva CP, Dos Santos NF, Mendes RMLJNCP. Phase angle as a Sarcopenia marker in hospitalized elderly patients. 2018;33(2):232–7. Santana NM, Pinho CPS, da Silva CP, Dos Santos NF, Mendes RMLJNCP. Phase angle as a Sarcopenia marker in hospitalized elderly patients. 2018;33(2):232–7.
21.
go back to reference Han MK, Muellerova H, Curran-Everett D, Dransfield MT, Washko GR, Regan EA et al. GOLD 2011 Disease severity classification in COPDGene: a prospective cohort study. 2013;1(1):43–50. Han MK, Muellerova H, Curran-Everett D, Dransfield MT, Washko GR, Regan EA et al. GOLD 2011 Disease severity classification in COPDGene: a prospective cohort study. 2013;1(1):43–50.
22.
go back to reference Mirza S, Clay RD, Koslow MA, Scanlon PD, editors. COPD guidelines: a review of the 2018 GOLD report. Mayo Clinic Proceedings; 2018: Elsevier. Mirza S, Clay RD, Koslow MA, Scanlon PD, editors. COPD guidelines: a review of the 2018 GOLD report. Mayo Clinic Proceedings; 2018: Elsevier.
23.
go back to reference Barrea L, Muscogiuri G, Pugliese G, Laudisio D, de Alteriis G, Graziadio C et al. Phase angle as an easy diagnostic tool of meta-inflammation for the nutritionist. 2021;13(5):1446. Barrea L, Muscogiuri G, Pugliese G, Laudisio D, de Alteriis G, Graziadio C et al. Phase angle as an easy diagnostic tool of meta-inflammation for the nutritionist. 2021;13(5):1446.
24.
go back to reference Jones SE, Kon SS, Canavan JL, Patel MS, Clark AL, Nolan CM et al. The five-repetition sit-to-stand test as a functional outcome measure in COPD. 2013;68(11):1015–20. Jones SE, Kon SS, Canavan JL, Patel MS, Clark AL, Nolan CM et al. The five-repetition sit-to-stand test as a functional outcome measure in COPD. 2013;68(11):1015–20.
25.
26.
go back to reference Holland AE, Spruit MA, Singh SJJB. How to carry out a field walking test in chronic Respiratory Disease. 2015;11(2):128–39. Holland AE, Spruit MA, Singh SJJB. How to carry out a field walking test in chronic Respiratory Disease. 2015;11(2):128–39.
27.
go back to reference Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.CrossRefPubMed Cruz-Jentoft AJ, Bahat G, Bauer J, Boirie Y, Bruyère O, Cederholm T, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16–31.CrossRefPubMed
28.
go back to reference Esmaillzadeh A, Mirmiran P, Azizi, FJTAjocn. Whole-grain intake and the prevalence of hypertriglyceridemic waist phenotype in tehranian adults. 2005;81(1):55–63. Esmaillzadeh A, Mirmiran P, Azizi, FJTAjocn. Whole-grain intake and the prevalence of hypertriglyceridemic waist phenotype in tehranian adults. 2005;81(1):55–63.
29.
go back to reference Shim J-S, Oh K, Kim HCJE. health. Dietary assessment methods in epidemiologic studies. 2014;36. Shim J-S, Oh K, Kim HCJE. health. Dietary assessment methods in epidemiologic studies. 2014;36.
30.
go back to reference Maddocks M, Kon S, Jones S, Canavan J, Nolan C, Polkey M et al. Validity of phase angle as a health indicator in stable COPD. 2014;44(Suppl 58). Maddocks M, Kon S, Jones S, Canavan J, Nolan C, Polkey M et al. Validity of phase angle as a health indicator in stable COPD. 2014;44(Suppl 58).
31.
go back to reference Di Vincenzo O, Marra M, Di Gregorio A, Pasanisi F, Scalfi L. Bioelectrical impedance analysis (BIA) -derived phase angle in Sarcopenia: a systematic review. Clin Nutr. 2021;40(5):3052–61.CrossRefPubMed Di Vincenzo O, Marra M, Di Gregorio A, Pasanisi F, Scalfi L. Bioelectrical impedance analysis (BIA) -derived phase angle in Sarcopenia: a systematic review. Clin Nutr. 2021;40(5):3052–61.CrossRefPubMed
32.
go back to reference de Blasio F, Di Gregorio A, de Blasio F, Bianco A, Bellofiore B. Scalfi LJRm. Malnutrition and sarcopenia assessment in patients with Chronic Obstructive Pulmonary Disease according to international diagnostic criteria, and evaluation of raw BIA variables. 2018;134:1–5. de Blasio F, Di Gregorio A, de Blasio F, Bianco A, Bellofiore B. Scalfi LJRm. Malnutrition and sarcopenia assessment in patients with Chronic Obstructive Pulmonary Disease according to international diagnostic criteria, and evaluation of raw BIA variables. 2018;134:1–5.
33.
go back to reference Norman K, Wirth R, Neubauer M, Eckardt R, Stobäus N. The Bioimpedance Phase Angle predicts low muscle strength, impaired quality of life, and increased mortality in old patients with cancer. J Am Med Dir Assoc. 2015;16(2):173.e17–.e22.CrossRef Norman K, Wirth R, Neubauer M, Eckardt R, Stobäus N. The Bioimpedance Phase Angle predicts low muscle strength, impaired quality of life, and increased mortality in old patients with cancer. J Am Med Dir Assoc. 2015;16(2):173.e17–.e22.CrossRef
34.
go back to reference Beberashvili I, Azar A, Sinuani I, Shapiro G, Feldman L, Stav K et al. Bioimpedance phase angle predicts muscle function, quality of life and clinical outcome in maintenance hemodialysis patients. 2014;68(6):683–9. Beberashvili I, Azar A, Sinuani I, Shapiro G, Feldman L, Stav K et al. Bioimpedance phase angle predicts muscle function, quality of life and clinical outcome in maintenance hemodialysis patients. 2014;68(6):683–9.
35.
go back to reference Valentino NP, Gomes TLN, Barreto CS, Borges TC, Soares JDP, Pichard C, et al. Low phase angle is associated with the risk for Sarcopenia in unselected patients with cancer: effects of hydration. Nutrition. 2021;84:111122.CrossRefPubMed Valentino NP, Gomes TLN, Barreto CS, Borges TC, Soares JDP, Pichard C, et al. Low phase angle is associated with the risk for Sarcopenia in unselected patients with cancer: effects of hydration. Nutrition. 2021;84:111122.CrossRefPubMed
36.
go back to reference De Blasio F, Santaniello M, Mazzarella G, Bianco A, Lionetti L, Franssen F et al. Raw BIA variables are predictors of muscle strength in patients with Chronic Obstructive Pulmonary Disease. 2017;71(11):1336–40. De Blasio F, Santaniello M, Mazzarella G, Bianco A, Lionetti L, Franssen F et al. Raw BIA variables are predictors of muscle strength in patients with Chronic Obstructive Pulmonary Disease. 2017;71(11):1336–40.
37.
go back to reference Dos Reis AS, Santos HO, Limirio LS, de Oliveira EPJJRN. Phase angle is associated with handgrip strength but not with Sarcopenia in kidney transplantation patients. 2019;29(3):196–204. Dos Reis AS, Santos HO, Limirio LS, de Oliveira EPJJRN. Phase angle is associated with handgrip strength but not with Sarcopenia in kidney transplantation patients. 2019;29(3):196–204.
38.
go back to reference de Blasio F, de Blasio F, Miracco Berlingieri G, Bianco A, La Greca M, Franssen FM et al. Evaluation of body composition in COPD patients using multifrequency bioelectrical impedance analysis. 2016:2419–26. de Blasio F, de Blasio F, Miracco Berlingieri G, Bianco A, La Greca M, Franssen FM et al. Evaluation of body composition in COPD patients using multifrequency bioelectrical impedance analysis. 2016:2419–26.
39.
go back to reference Maddocks M, Kon SS, Jones SE, Canavan JL, Nolan CM, Higginson IJ et al. Bioelectrical impedance phase angle relates to function, Disease severity and prognosis in stable Chronic Obstructive Pulmonary Disease. 2015;34(6):1245–50. Maddocks M, Kon SS, Jones SE, Canavan JL, Nolan CM, Higginson IJ et al. Bioelectrical impedance phase angle relates to function, Disease severity and prognosis in stable Chronic Obstructive Pulmonary Disease. 2015;34(6):1245–50.
40.
go back to reference Pineda-Zuluaga MC, Gonzalez-Correa CH, Sepulveda-Gallego LE, editors. Sarcopenia in Patients with Chronic Obstructive Pulmonary Disease and Evaluation of Raw Bioelectrical Impedance Analysis Data. 17th International Conference on Electrical Bioimpedance: ICEBI 2019, Joinville, Santa Catarina, Brazil, 9–14 June 2019; 2020: Springer. Pineda-Zuluaga MC, Gonzalez-Correa CH, Sepulveda-Gallego LE, editors. Sarcopenia in Patients with Chronic Obstructive Pulmonary Disease and Evaluation of Raw Bioelectrical Impedance Analysis Data. 17th International Conference on Electrical Bioimpedance: ICEBI 2019, Joinville, Santa Catarina, Brazil, 9–14 June 2019; 2020: Springer.
41.
go back to reference Pessoa DF, de Branco FM, Dos Reis AS, Limirio LS, Borges LP, Barbosa CD et al. Association of phase angle with Sarcopenia and its components in physically active older women. 2020;32:1469–75. Pessoa DF, de Branco FM, Dos Reis AS, Limirio LS, Borges LP, Barbosa CD et al. Association of phase angle with Sarcopenia and its components in physically active older women. 2020;32:1469–75.
42.
go back to reference Do JY, Kim AY, Kang SHJFN. Association between phase angle and sarcopenia in patients undergoing peritoneal dialysis. 2021;8:742081. Do JY, Kim AY, Kang SHJFN. Association between phase angle and sarcopenia in patients undergoing peritoneal dialysis. 2021;8:742081.
43.
go back to reference Lukaski HC, Kyle UG. Kondrup JJCoicn, care m. Assessment of adult Malnutrition and prognosis with bioelectrical impedance analysis: phase angle and impedance ratio. 2017;20(5):330–9. Lukaski HC, Kyle UG. Kondrup JJCoicn, care m. Assessment of adult Malnutrition and prognosis with bioelectrical impedance analysis: phase angle and impedance ratio. 2017;20(5):330–9.
44.
go back to reference Gonzalez MC, Barbosa-Silva TG, Bielemann RM, Gallagher D, Heymsfield SBJTA. Phase angle and its determinants in healthy subjects: influence of body composition. 2016;103(3):712–6. Gonzalez MC, Barbosa-Silva TG, Bielemann RM, Gallagher D, Heymsfield SBJTA. Phase angle and its determinants in healthy subjects: influence of body composition. 2016;103(3):712–6.
Metadata
Title
Association of phase angle with sarcopenia and muscle function in patients with COPD: a case-control study
Authors
Neda Valisoltani
Hamed Mohammadi
Rasoul Aliannejad
Fatemeh Naeini
Asma Rajabi Harsini
Erfan Sadeghi
Pouya Mirzaee
Hossein Imani
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Pulmonary Medicine / Issue 1/2024
Electronic ISSN: 1471-2466
DOI
https://doi.org/10.1186/s12890-023-02814-9

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