Highlights
- •Malnutrition and sarcopenia are common in patients with acute stroke.
- •Phase angle is a non-invasive, simple and objective clinical indicator measured by bioelectrical impedance analysis.
- •Phase angle is independently associated with malnutrition and sarcopenia in patients with acute stroke.
- •The cutoffs for malnutrition and sarcopenia are 5.05 for men and 3.96 for women and 5.28 for men and 4.62 for women.
Abstract
Objectives
This study aimed to investigate whether phase angle is an indicator of malnutrition
and sarcopenia in acute-phase stroke patients.
Materials and Methods
We conducted a retrospective observational study of stroke patients in a single acute-care
hospital. The phase angle was measured within 5 days after admission, and the correlation
between nutritional status and sarcopenia index was investigated. The cut-off point
that distinguishes malnutrition and sarcopenia was evaluated using the receiver operating
characteristic curve. The effects of the geriatric nutritional risk index (GNRI) and
sarcopenia on the phase angle were examined using multivariate linear regression analysis.
Results
A total of 211 stroke patients (140 men) with a median age of 74 (65–83) were included
in the analysis. Malnutrition was present in 38 (18.0%) patients, and 65 (30.8%) had
sarcopenia. The phase angle significantly correlated with GNRI, grip strength, skeletal
muscle musss index, and calf circumference in both men and women. The cut-off points
for discriminating malnutrition were 5.05 for men and 3.96 for women, while the cut-off
points for discriminating sarcopenia were 5.28 for men and 4.62 for women. Multivariate
linear regression analysis showed that the GNRI and sarcopenia were independently
related to the phase angle.
Conclusions
Phase angle is a useful indicator for distinguishing malnutrition and sarcopenia in
patients with acute stroke.
Key Words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Stroke and Cerebrovascular DiseasesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Muscle mass gain is positively associated with functional recovery in patients with sarcopenia after stroke.J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2020; 29105017
- Prestroke sarcopenia and stroke severity in elderly patients with acute stroke.J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2019; 28: 2228-2231
- Relationship of malnutrition during hospitalization with functional recovery and postdischarge destination in elderly stroke patients.J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2019; 28: 1866-1872
- Sarcopenia is associated with worse recovery of physical function and dysphagia and a lower rate of home discharge in Japanese hospitalized adults undergoing convalescent rehabilitation.Nutrition. 2019; 61 (Burbank, Los Angeles County, Calif): 111-118
- Prestroke sarcopenia and functional outcomes in elderly patients who have had an acute stroke: a prospective cohort study.Nutrition. 2019; 66 (Burbank, Los Angeles County, Calif): 44-47
- Chair-stand exercise improves post-stroke dysphagia.Geriatr Gerontol Int. 2020; 20: 885-891
- Effects of a leucine-enriched amino acid supplement on muscle mass, muscle strength, and physical function in post-stroke patients with sarcopenia: a randomized controlled trial.Nutrition. 2019; 58 (Burbank, Los Angeles County, Calif): 1-6
- Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment.J Am Med Dir Assoc. 2020; 21 (e302): 300-307
- Phase angle as an indicator of sarcopenia, malnutrition, and cachexia in inpatients with cardiovascular diseases.J Clin Med. 2020; 9
- Association of bioelectrical impedance analysis-derived phase angle and sarcopenia in older adults.Nutr Clin Pract. 2017; 32: 103-109
- Impact of phase angle on physical function in patients with acute stroke.J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2021; 30105941
- Prevalence of sarcopenia and its association with activities of daily living and dysphagia in convalescent rehabilitation ward inpatients.Clin Nutr. 2018; 37 (Edinburgh, Scotland): 2022-2028
- High nutritional-related risk on admission predicts less improvement of functional independence measure in geriatric stroke patients: a retrospective cohort study.J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2016; 25: 1335-1341
- Calf circumference value for sarcopenia screening among older adults with stroke.Arch Gerontol Geriatr. 2020; 93104290
- Assessment of adult malnutrition and prognosis with bioelectrical impedance analysis: phase angle and impedance ratio.Curr Opin Clin Nutr Metab Care. 2017; 20: 330-339
- Use of bioelectrical impedance analysis for the assessment of nutritional status in critically ill patients.Clin Nutr Res. 2015; 4: 32-40
- Phase angle values, a good indicator of nutritional status, are associated with median value of hemoglobin rather than hemoglobin variability in hemodialysis patients.Ren Fail. 2021; 43: 327-334
- Relationship between nutritional status and phase angle as a noninvasive method to predict malnutrition by sex in older inpatients.Nagoya J Med Sci. 2021; 83: 31-40
- Skeletal muscle mass and distribution in 468 men and women aged 18-88 yr.J Appl Physiol. 2000; 89 (Bethesda, Md: 1985): 81-88
- Sex-related differences in the effects of nutritional status and body composition on functional disability in the elderly.PLoS One. 2021; 16e0246276
- Phase angle predicts physical function in older adults.Arch Gerontol Geriatr. 2020; 90104151
- Bioelectrical impedance analysis (BIA) -derived phase angle in sarcopenia: a systematic review.Clin Nutr. 2021; 40 (Edinburgh, Scotland): 3052-3061
- Prevalence of stroke-related sarcopenia: a systematic review and meta-analysis.J Stroke Cerebrovasc Dis Off J Natl Stroke Assoc. 2020; 29105092
- New understanding of the pathogenesis and treatment of stroke-related sarcopenia.Biomed Pharmacother. 2020; 131110721
Article info
Publication history
Published online: November 23, 2021
Accepted:
November 3,
2021
Received in revised form:
November 1,
2021
Received:
September 3,
2021
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2021.106220
Copyright
© 2021 Elsevier Inc. All rights reserved.
