title: Can phase angle determined by bioelectrical impedance analysis assess nutritional risk? A comparison between healthy and hospitalized subjects.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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 <35 g/L had a relative risk of 7.5 to have low PhA compared to patients with ≥35 g/L CONCLUSIONS: 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.
authors.affiliation: Baylor College of Medicine/Texas Children's Hospital, Pediatric Critical Care Medicine, 6621 Fannin St WT6-006, Houston, TX 77030, USA. ukyle@bcm.edu
authors.forename: Ursula G
authors.initials: UG
authors.lastname: Kyle
authors.forename: Esther P
authors.initials: EP
authors.lastname: Soundar
authors.forename: Laurence
authors.initials: L
authors.lastname: Genton
authors.forename: Claude
authors.initials: C
authors.lastname: Pichard
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001823:Body Composition; D015992:Body Mass Index; D001835:Body Weight; D016022:Case-Control Studies; D017097:Electric Impedance; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D044342:Malnutrition / Q000175:diagnosis*; D008875:Middle Aged; D015596:Nutrition Assessment; D009752:Nutritional Status; D012307:Risk Factors; D012680:Sensitivity and Specificity; D012709:Serum Albumin / Q000032:analysis; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D012709:Serum Albumin