Di Vincenzo Olivia, Pagano Ermenegilda, Ballarin Giada, Pasanisi Fabrizio, Scalfi Luca
Department of Public Health, Federico II University of Naples, Italy.
Santa Maria del Pozzo Hospital, Somma Vesuviana, Naples, Italy.
Nutrition. 2025 Mar;131:112637. doi: 10.1016/j.nut.2024.112637. Epub 2024 Nov 15.
Malnutrition in stroke is associated with poor clinical outcomes. Bioelectrical impedance analysis-derived phase angle (PhA) is widely used for assessing nutritional status as an index of muscle quality. This study aimed to evaluate the associations between whole body and limb PhAs and nutritional risk in stroke patients. PhA predictors were also identified.
Consecutive subacute stroke patients aged ≥50 y at the beginning of rehabilitation participated in this retrospective analysis. Nutritional risk was assessed using the Geriatric Nutritional Risk Index, the Prognostic Nutritional Index, and the Controlling Nutritional Status score. PhAs at 50 kHz for both whole body and limbs were measured. The associations between PhA and nutritional risk were examined through univariate/multivariate analyses.
Overall, 272 subacute stroke patients were studied (age, 70.1 ± 12.4 y, body mass index, 26.8 ± 3.9 kg/m²). Both whole body and limb PhAs were associated with Geriatric Nutritional Risk Index, Prognostic Nutritional Index, and Controlling Nutritional Status score, and this was also true in patients aged ≥75 y (P < 0.001). Low PhA values were observed in patients at high nutritional risk. The general linear model identified age, female sex, hypertension, diabetes, dysphagia, and time from stroke onset as independent predictors of PhA (R² = 0.468, P < 0.001). Furthermore, PhA emerged as a significant predictor of high nutritional risk according to each screening tool. Finally, optimal cutoffs of whole body PhA for predicting high nutritional risk were around 4.08°.
In stroke patients, low PhA values were associated with high nutritional risk. PhA at the beginning of rehabilitation may serve as a reliable parameter to be considered in the evaluation of nutritional status.
卒中患者的营养不良与不良临床结局相关。生物电阻抗分析得出的相位角（PhA）作为肌肉质量指标，被广泛用于评估营养状况。本研究旨在评估卒中患者全身和肢体PhA与营养风险之间的关联，并确定PhA的预测因素。
康复开始时年龄≥50岁的连续亚急性卒中患者参与了这项回顾性分析。使用老年营养风险指数、预后营养指数和控制营养状况评分评估营养风险。测量全身和肢体在50kHz时的PhA。通过单因素/多因素分析检查PhA与营养风险之间的关联。
总体而言，研究了272例亚急性卒中患者（年龄70.1±12.4岁，体重指数26.8±3.9kg/m²）。全身和肢体PhA均与老年营养风险指数、预后营养指数和控制营养状况评分相关，≥75岁的患者也是如此（P<0.001）。高营养风险患者的PhA值较低。一般线性模型确定年龄、女性、高血压、糖尿病、吞咽困难和卒中发病时间为PhA的独立预测因素（R²=0.468，P<0.001）。此外，根据每种筛查工具，PhA是高营养风险的重要预测因素。最后，预测高营养风险的全身PhA最佳临界值约为4.08°。
在卒中患者中，低PhA值与高营养风险相关。康复开始时的PhA可作为评估营养状况时应考虑的可靠参数。
