• Nutrition · Feb 2020

    Phase angle as a severity indicator for liver diseases.

    • Ana Paula Pagano, Juliana Maria Faccioli Sicchieri, Isabela Laurencio Schiavoni, Daniel Barbeiro, Camila Sanches Manca, Bruna Ramos da Silva, Amanda Escobar Bezerra, Lívia Cristina Mendonça Pinto, Roberta Chaves Araújo, Andreza Correa Teixeira, and Paula Garcia Chiarello.
    • Hospital of Clinics, School of Medicine of Ribeirão Preto, Department of Internal Medicine, Division of Nutrition and Metabolism, University of São Paulo, Brazil. Electronic address: apaula.pagano@gmail.com.
    • Nutrition. 2020 Feb 1; 70: 110607.

    ObjectiveThe aim of this study was to evaluate the applicability of phase angle (PhA) as a severity indicator of chronic liver diseases.MethodsWe examined the medical records of 54 patients-27 with hepatocellular carcinoma (HCC) and 27 with non-alcoholic fatty liver disease (NAFLD). The patients were ≥18 y of age. Clinical data, such as Child-Pugh and Barcelona Clinic Liver Cancer (HCC), aspartate aminotransferase-to-platelet ratio index (APRI) and fibrosis (FIB)-4 (NAFLD), nutritional parameters (body mass index [BMI], handgrip strength [HGS], and bioelectrical impedance [BIA] data) were collected. Nutritional Risk Index (NRI) was calculated. Analysis was performed using Mann-Whitney test and analysis of variance. Simple multiple linear regression for predictions (Child-Pugh in HCC, APRI and FIB-4 in NAFLD). Receiver operating characteristic curve was estimated to search a cutoff for PhA. For survival, we used the Kaplan-Meier estimator. To verify whether PhA affected patients' survival, we used the Mantel-Haenszel.ResultsThe prevalence of cirrhosis was high in HCC (n = 25) and low in the NAFLD (n = 4). No patient was classified as undernourished based on BMI; however, NRI showed that 74.1% of patients with HCC had nutritional risk. Child-Pugh was positively correlated with the edema index (extracellular water/total body water [ECW/TBW]) and negatively correlated with PhA and HGS. Higher Child-Pugh and BCLC scores were associated with worse NRI. APRI and FIB-4 were positively correlated with weight and BMI. A significant difference between groups was found for the median values of R, ECW/TBW, PhA, HGS, and albumin. There was a trend toward lower survival in patients with HCC, according to the cutoff point of 5.1 degrees for PhA.ConclusionPhA was shown to be an independent prognostic indicator for cirrhosis and may be related to survival in these patients.Copyright © 2019 Elsevier Inc. All rights reserved.

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