Is phase angle an appropriate indicator of malnutrition in different disease states? A systematic review

Sylvia Rinaldi; Jason Gilliland; Colleen O'Connor; Bert Chesworth; Janet Madill

doi:10.1016/j.clnesp.2018.10.010

Is phase angle an appropriate indicator of malnutrition in different disease states? A systematic review

Clin Nutr ESPEN. 2019 Feb:29:1-14. doi: 10.1016/j.clnesp.2018.10.010. Epub 2018 Nov 15.

Authors

Sylvia Rinaldi¹, Jason Gilliland², Colleen O'Connor³, Bert Chesworth⁴, Janet Madill³

Affiliations

¹ Graduate Program in Health & Rehabilitation Sciences, University of Western Ontario, London, ON, Canada; School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada. Electronic address: [email protected].
² Department of Geography, University of Western Ontario, London, ON, Canada; School of Health Studies, University of Western Ontario, London, ON, Canada; Department of Paediatrics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada; Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada; Children's Health Research Institute and Lawson Health Research Institute, London, ON, Canada.
³ School of Food and Nutritional Sciences, Brescia University College, London, ON, Canada.
⁴ Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, University of Western Ontario, London, ON, Canada; School of Physical Therapy, University of Western Ontario, London, ON, Canada.

PMID: 30661671
DOI: 10.1016/j.clnesp.2018.10.010

Abstract

Background & aims: Subjective Global Assessment (SGA) classifies malnutrition severity via a simple bedside assessment. Phase angle (PhA) is an indicator of cell integrity and has been suggested to be indicator of nutritional status.

Objective: To explore the relationship between PhA and SGA.

Methods: Relevant studies published through October 31, 2017 were identified using 7 electronic databases. Articles were included for review if they included comparison data between SGA and PhA within adult disease populations. Evidence quality was assessed using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) guidelines and methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.

Results: 33 articles within four disease states (liver, hospitalization, oncology and renal) met inclusion criteria for review. Results were limited by restricting the database search to articles published in English only, and by the inherent difficulty of comparing 2 methods which are both influenced by the operator.

Conclusion: Based on GRADE guidelines, evidence quality received a grade of Low. Based on QUADAS-2, 61% of studies had high risk of bias in the index test (PhA), while all other domains had low risk. It is not possible to conclude that PhA is an accurate independent indicator of malnutrition. PROSPERO no. CRD42016050876.

Keywords: Disease; Hospitalized; Liver; Malnutrition; Oncology; Phase angle; Renal; Subjective global assessment.

Publication types

Meta-Analysis
Systematic Review

MeSH terms

Databases, Factual
Disease*
Hospitalization
Humans
Indicators and Reagents
Kidney
Liver
Malnutrition / classification
Malnutrition / diagnosis*
Nutrition Assessment
Nutritional Status*

Substances

Indicators and Reagents