Phase angle as a marker for sarcopenia in cirrhosis

Background: In patients with cirrhosis nutritional disturbances can progress to sarcopenia, worsening the disease prognosis. Phase angle (PA) may be a useful marker for sarcopenia in this clinical population reflecting the cellular integrity level. This cross-sectional and prospective study evaluated the association between low PA values and clinical/nutritional variables in cirrhosis with emphasis on sarcopenia. Methods: Male patients with cirrhosis (n = 122) were grouped according their PA values (>4.9 degrees or <= 4.9 degrees) after performing electrical bioimpedance. Sarcopenia diagnosis was assessed by considering appendicular skeletal muscle mass indexes <7.0 kg/m(2) (dual-energy X-ray absorptiometry) and non-dominant handgrip strength (HGS) <27 kg (dynamometry). Logistic regression model was used to examine the correlation between clinical/nutritional variables and PA values and the ROC curve area was calculated to identify the power of PA values in predicting sarcopenia. Results: Sarcopenic patients presented lower HGS (19.57 vs. 30.55, p = 0.000), PA value (4.18 vs. 5.39, p = 0.005), SM (17.17 vs. 22.00 (p = 0.05), reactance (36.76 vs. 51.11, p = 0.023), and albumin (3.10 vs. 3.75, p = 0.037), as well as higher resistance values (512.56 vs. 457.01, p = 0.021) and CRP levels (7.89 vs. 3.53, p = 0.040) than non-sarcopenic patients. Furthermore, the PA values <= 5.05 degrees were able to predict with high sensitivity the diagnosis of sarcopenia in the studied population. Conclusion: In male patients with cirrhosis, low PA values may reflect disease prognosis by correlating to sarcopenia among other clinical/nutritional changes and performed as a good marker for this main nutritional complication when <= 5.05 degrees. (C) 2019 European Society for Clinical Nutrition and Metabolism. Published by Elsevier Ltd. All rights reserved.