Hirose Suguru, Nakajima Toshiaki, Nozawa Naohiro, Katayanagi Satoshi, Ishizaka Hayato, Mizushima Yuta, Matsumoto Kazuhisa, Nishikawa Kaori, Toyama Yohei, Takahashi Reiko, Arakawa Tomoe, Yasuda Tomohiro, Haruyama Akiko, Yazawa Hiroko, Yamaguchi Suomi, Toyoda Shigeru, Shibasaki Ikuko, Mizushima Takashi, Fukuda Hirotsugu, Inoue Teruo
Department of Cardiovascular Medicine, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Tochigi 321-0293, Japan.
Department of Rehabilitation, Dokkyo Medical University Hospital, Shimotsuga-gun, Tochigi 321-0293, Japan.
J Clin Med. 2020 Aug 6;9(8):2554. doi: 10.3390/jcm9082554.
Malnutrition is associated with sarcopenia, cachexia, and prognosis. We investigated the usefulness of phase angle (PhA) as a marker of sarcopenia, cachexia, and malnutrition in 412 hospitalized patients with cardiovascular disease. We analyzed body composition with bioelectrical impedance analysis, and nutritional status such as controlling nutritional status (CONUT) score. Both skeletal muscle mass index (SMI) and PhA correlated with age, grip strength and knee extension strength ( < 0.0001) in both sexes. The SMI value correlated with CONUT score, Hb, and Alb in males. Phase angle also correlated with CONUT score, Hb, and Alb in males, and more strongly associated with these nutritional aspects. In females, PhA was correlated with Hb and Alb ( < 0.001). In both sexes, sarcopenia incidence was 31.6% and 32.4%; PhA cut-off in patients with sarcopenia was 4.55° and 4.25°; and cachexia incidence was 11.5% and 14.1%, respectively. The PhA cut-off in males with cachexia was 4.15°. Multivariate regression analysis showed that grip strength and brain natriuretic peptide (BNP) were independent determinants of SMI, whereas grip strength, BNP, and Hb were independent determinants of PhA. Thus, PhA appears to be a useful marker for sarcopenia, malnutrition, and cachexia in hospitalized patients with cardiovascular disease.
营养不良与肌肉减少症、恶病质及预后相关。我们在412例住院心血管疾病患者中研究了相位角(PhA)作为肌肉减少症、恶病质及营养不良标志物的效用。我们采用生物电阻抗分析来分析身体成分,并评估营养状况,如控制营养状况(CONUT)评分。骨骼肌质量指数(SMI)和PhA在两性中均与年龄、握力及膝关节伸展力量相关(<0.0001)。男性的SMI值与CONUT评分、血红蛋白(Hb)及白蛋白(Alb)相关。相位角在男性中也与CONUT评分、Hb及Alb相关,且与这些营养指标的关联更强。在女性中,PhA与Hb及Alb相关(<0.001)。两性的肌肉减少症发生率分别为31.6%和32.4%;肌肉减少症患者的PhA临界值分别为4.55°和4.25°;恶病质发生率分别为11.5%和14.1%。男性恶病质患者的PhA临界值为4.15°。多因素回归分析显示,握力和脑钠肽(BNP)是SMI的独立决定因素,而握力、BNP和Hb是PhA的独立决定因素。因此,PhA似乎是住院心血管疾病患者肌肉减少症、营养不良及恶病质的有用标志物。