title: Low phase angle is associated with the development of hepatic encephalopathy in patients with cirrhosis.
abstract: OBJECTIVE
  Evaluate the association between phase angle and the development of hepatic encephalopathy in the long-term follow-up of cirrhotic patients.
  
  
  METHODS
  This was a prospective cohort study. Clinical, nutritional and biochemical evaluations were performed. Mann-Whitney'sUand χ2tests were used as appropriate. Kaplan-Meier curves and Cox proportional Hazards analysis were used to evaluate the prediction and incidence of hepatic encephalopathy.
  
  
  RESULTS
  Two hundred and twenty were included; the most frequent etiology of cirrhosis was hepatitis C infection, 52% of the patients developed hepatic encephalopathy (18.6% covert and 33.3% overt); the main precipitating factors were infections and variceal bleeding. Kaplan-Meier curves showed a higher proportion of HE in the group with low phase angle (39%) compared to the normal phase angle group (13%) (P= 0.012). Furthermore, creatinine and phase angle remained independently associated to hepatic encephalopathy in the Cox regression multivariate analysis [hazard ratio = 1.80 (1.07-3.03)].
  
  
  CONCLUSIONS
  In our cohort of patients low phase angle was associated with an increased incidence of hepatic encephalopathy. Phase angle is a useful nutritional marker that evaluates cachexia and could be used as a part of the integral assessment in patients with cirrhosis.
authors.affiliation: Astrid Ruiz-Margáin, Ricardo Ulises Macías-Rodríguez, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 México City, México.
authors.forename: Astrid
authors.initials: A
authors.lastname: Ruiz-Margáin
authors.affiliation: Astrid Ruiz-Margáin, Ricardo Ulises Macías-Rodríguez, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 México City, México.
authors.forename: Ricardo Ulises
authors.initials: RU
authors.lastname: Macías-Rodríguez
authors.affiliation: Astrid Ruiz-Margáin, Ricardo Ulises Macías-Rodríguez, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 México City, México.
authors.forename: Javier
authors.initials: J
authors.lastname: Ampuero
authors.affiliation: Astrid Ruiz-Margáin, Ricardo Ulises Macías-Rodríguez, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 México City, México.
authors.forename: Francisco Javier
authors.initials: FJ
authors.lastname: Cubero
authors.affiliation: Astrid Ruiz-Margáin, Ricardo Ulises Macías-Rodríguez, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 México City, México.
authors.forename: Luis
authors.initials: L
authors.lastname: Chi-Cervera
authors.affiliation: Astrid Ruiz-Margáin, Ricardo Ulises Macías-Rodríguez, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 México City, México.
authors.forename: Silvia L
authors.initials: SL
authors.lastname: Ríos-Torres
authors.affiliation: Astrid Ruiz-Margáin, Ricardo Ulises Macías-Rodríguez, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 México City, México.
authors.forename: Andrés
authors.initials: A
authors.lastname: Duarte-Rojo
authors.affiliation: Astrid Ruiz-Margáin, Ricardo Ulises Macías-Rodríguez, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 México City, México.
authors.forename: Ángeles
authors.initials: Á
authors.lastname: Espinosa-Cuevas
authors.affiliation: Astrid Ruiz-Margáin, Ricardo Ulises Macías-Rodríguez, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 México City, México.
authors.forename: Manuel
authors.initials: M
authors.lastname: Romero-Gómez
authors.affiliation: Astrid Ruiz-Margáin, Ricardo Ulises Macías-Rodríguez, Department of Gastroenterology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 México City, México.
authors.forename: Aldo
authors.initials: A
authors.lastname: Torre
mesh_terms: D000328:Adult; D001823:Body Composition; D002100:Cachexia / Q000453:epidemiology*; D017097:Electric Impedance; D004932:Esophageal and Gastric Varices / Q000453:epidemiology; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology; D006501:Hepatic Encephalopathy / Q000453:epidemiology*; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D015994:Incidence; D007239:Infections / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000209:etiology; D008104:Liver Cirrhosis, Alcoholic / Q000453:epidemiology; D008105:Liver Cirrhosis, Biliary / Q000453:epidemiology; D008297:Male; D044342:Malnutrition / Q000453:epidemiology*; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000150:complications; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
keywords: Cachexia; Hepatic encephalopathy; Malnutrition; Phase angle; Prognosis