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Phase angle derived from bioelectrical impedance analysis and postoperative fluid balance
stay in the emergency care unit, drug consumption and ability in ADL-functions were collected from patients’ medical records. The patients’ condition was assessed by a modified Norton scale on admission. Results: The marital status and type of dwelling were equal in both groups. The mean hospital stay in the acute care unit was 25.8 days (SD 16.4) for the malnourished group and 26.2 days (SD 14.5) for the wellnourished group. The malnourished patients had a greater consumption of diuretics (p <: 0.05) and a lower consumption of analgesics (p i 0.05) than the wellnourished patients. In the malnourished group disturbed conditions in activity (83%; p < 0.05) and general physical condition (78%; p < 0.01) were observed compared to the wellnourished group (69% and 60% resp). Conclusions: This study indicates that demographical characteristics and primary ADL-functions have minor importance for development of protein-energy malnutrition in geriatric patients. The patient’s physical condition and drug consumption seemed more important to be observed on admission.
to predict hydration status in postoperative patients with gastrointestinal disease. Methods: Fourteen postoperative patients (9M, 5F; age range 35-75 years) were studied. All patients received total parenteral nutrition. Postoperative fluid input and output were recorded daily and fluid balance was calculated. BIA was performed with a body composition analyzer (RJL systems, Model BIA-106) pre- and postoperatively, and daily afterwards to postoperative day (POD) 7. Relationship between daily fluid balance and BIA parameters - resistance (R), reactance (Xc), phase angle-were evaluated statistically using linear regression analysis. Results: Preoperative measurements of R (Ohm), Xc (Ohm), and phase angle (degree) were 559 & 48.3, 48.9 k 13.6, 5.0 + 1.44, respectively. These parameters decreased postoperatively (Minimum; R = 495 + 38.8 on POD 0, Xc = 41.5 + 14.3 on POD 1, phase angle = 4.5 & 1.61 on POD 2). Then these parameters gradually returned to baseline. R did not correlate with fluid balance (r = -0.198, p < 0.1). But both Xc (r = 0.319, p < 0.01) and phase angle (r = 0.436, p i 0.01) correlated significantly with fluid balance. Conclusion: Our data suggest that phase angle derived from BIA is useful predictor of hydration status in postoperative gastrointestinal patients.
P.142 Estimation of body fat composition. Comparison of dual-energy X ray absortiometry, anthropometry and impedance M. Leon-Sanz, I. Gomez, M.A. Valero, G. Martinez, F. Hawkins Hospital 12 de Octobre, Madrid, Spain
P.144 Body impedance analysis (BIA) is not a reliable method for assessing body composition in cirrhotics with ascites
Dual-energy X ray absortiometry (DEXA) is primarily used in the assessment of bone mineral. However, the transmissions of the two different energy beams in nonbone areas can be processed to calculate the amount of fat and free-fat mass of the soft tissues. We have compared the estimation of body fat mass (FM) by DEXA with data derived from anthropometric (A) (Durnin & Womersley formula) and impedance (BIA) measurements. We have studied 10 subjects, 8 female and 2 male, age 39 & 17. weight 97.4 +_ 17.2 kg. DEXA was measured with Hologic QDR-1000/W (S/N 970 P) Whole body Version 5.35 and BIA with BES 2002 (Bioelectrical Sciences, La Jolla, Ca, USA). The results were: FM (kg) 444+_8.5 40.6k6.3 38.4k9.8
LBM (kg) 52.1+14.1 56.8f13.9 58.8? 13.6
Correlations DEXA 0.8828 0.7708
E. Cab& R. de Ledn, R. Planas. E. Dom6nech. M. Guilera. X. Bertra’n and M.A. Gas&l Dept. of Gastroenterology, Hosp. Germans Trias i Pujol, Badalona, Spain BIA has been proven to be a reliable method for assessing body composition in healthy and malnourished subjects as it estimates total body water (TBW), lean body mass (LBM), body fatty mass (BFM) and body cell mass (BCM). However, its usefulness in cirrhotics with ascites, a situation with high prevalence of malnutrition, has not been investigated. Aim: To assess the reliability of BIA in evaluating changes in body composition in cirrhotics with ascites. Methods: BIA (tetrapolar method, BIA-109 Akern SRL, Firenze) was measured in 55 cirrhotics (42M, 13F, 57 + 3 yrs; 32 with and 23 without ascites) and in 42 healthy wellnourished subjects (31 M, 11 F, 52.5 f 1.4 yrs). Routine liver and renal function tests, as well as nutritional parameters (TSF, MAMC, serum albumin) were measured in all cases. In addition, in 13 ascitic patients, BIA was measured prior and 24 h after a large volume (5.6 + 3.0 L) paracentesis associated to i.v. albumin infusion was performed. Results: MAMC and serum albumin were lower in ascitic than in both non-ascitic patients and controls (p 4 0.05 in both). TSF was lower in either group of cirrhotics than in controls (p < 0.05). No differences were found in TBW, LBM, and BFM as assessed by BIA among the three groups. In contrast, BCM was lower in ascitic than in both nonascitic patients and healthy subjects (20.0 + 1.2 vs 25.0 & 1 .I vs 30.7 + 1 .O kg; p < 0.05). Although TBW significantly decreased after paracentesis (32.4 & 1.8 vs 34.3 + 2.0 kg, p = 0.002), in no patient this decrease coincided with the amount of ascites removed. In spite that mean BCM did not change after paracentesis, the 95% Cl of the change ranged from gaining 1 .l kg to losing 2.7 kg. Conclusion: BIA is not a reliable method for the assessment of changes in body composition in cirrhotics with ascites.
for Fat anthropometry 1 0.7245
BIA results change depending on the equation used to derive Lean Body Mass (LBM) according to different authors. DEXA measurements are independent from the explorer, whereas A and BIA determinations can change in separate occasions with the same or different observer. Therefore, DEXA method seems more reliable than BIA for the assessment of FM. If DEXA technology is not available, our results support the use of anthropometric over impedance measurements.
P.143 Phase angle derived from bioelectrical impedance analysis and postoperative fluid balance C. Kawai. T. Tomiyama and H. Ueki Department of Surgery. The Nippon Niigata, Japan
Dental
University,
Bioelectrical impedance analysis (BIA) is considered a useful method for predicting body composition in healthy subjects. But its validity in postoperative patients is controversial. This study assessed the validity of phase angle derived from BIA 99
to predict hydration status in postoperative patients with gastrointestinal disease. Methods: Fourteen postoperative patients (9M, 5F; age range 35-75 years) were studied. All patients received total parenteral nutrition. Postoperative fluid input and output were recorded daily and fluid balance was calculated. BIA was performed with a body composition analyzer (RJL systems, Model BIA-106) pre- and postoperatively, and daily afterwards to postoperative day (POD) 7. Relationship between daily fluid balance and BIA parameters - resistance (R), reactance (Xc), phase angle-were evaluated statistically using linear regression analysis. Results: Preoperative measurements of R (Ohm), Xc (Ohm), and phase angle (degree) were 559 & 48.3, 48.9 k 13.6, 5.0 + 1.44, respectively. These parameters decreased postoperatively (Minimum; R = 495 + 38.8 on POD 0, Xc = 41.5 + 14.3 on POD 1, phase angle = 4.5 & 1.61 on POD 2). Then these parameters gradually returned to baseline. R did not correlate with fluid balance (r = -0.198, p < 0.1). But both Xc (r = 0.319, p < 0.01) and phase angle (r = 0.436, p i 0.01) correlated significantly with fluid balance. Conclusion: Our data suggest that phase angle derived from BIA is useful predictor of hydration status in postoperative gastrointestinal patients.
P.142 Estimation of body fat composition. Comparison of dual-energy X ray absortiometry, anthropometry and impedance M. Leon-Sanz, I. Gomez, M.A. Valero, G. Martinez, F. Hawkins Hospital 12 de Octobre, Madrid, Spain
P.144 Body impedance analysis (BIA) is not a reliable method for assessing body composition in cirrhotics with ascites
Dual-energy X ray absortiometry (DEXA) is primarily used in the assessment of bone mineral. However, the transmissions of the two different energy beams in nonbone areas can be processed to calculate the amount of fat and free-fat mass of the soft tissues. We have compared the estimation of body fat mass (FM) by DEXA with data derived from anthropometric (A) (Durnin & Womersley formula) and impedance (BIA) measurements. We have studied 10 subjects, 8 female and 2 male, age 39 & 17. weight 97.4 +_ 17.2 kg. DEXA was measured with Hologic QDR-1000/W (S/N 970 P) Whole body Version 5.35 and BIA with BES 2002 (Bioelectrical Sciences, La Jolla, Ca, USA). The results were: FM (kg) 444+_8.5 40.6k6.3 38.4k9.8
LBM (kg) 52.1+14.1 56.8f13.9 58.8? 13.6
Correlations DEXA 0.8828 0.7708
E. Cab& R. de Ledn, R. Planas. E. Dom6nech. M. Guilera. X. Bertra’n and M.A. Gas&l Dept. of Gastroenterology, Hosp. Germans Trias i Pujol, Badalona, Spain BIA has been proven to be a reliable method for assessing body composition in healthy and malnourished subjects as it estimates total body water (TBW), lean body mass (LBM), body fatty mass (BFM) and body cell mass (BCM). However, its usefulness in cirrhotics with ascites, a situation with high prevalence of malnutrition, has not been investigated. Aim: To assess the reliability of BIA in evaluating changes in body composition in cirrhotics with ascites. Methods: BIA (tetrapolar method, BIA-109 Akern SRL, Firenze) was measured in 55 cirrhotics (42M, 13F, 57 + 3 yrs; 32 with and 23 without ascites) and in 42 healthy wellnourished subjects (31 M, 11 F, 52.5 f 1.4 yrs). Routine liver and renal function tests, as well as nutritional parameters (TSF, MAMC, serum albumin) were measured in all cases. In addition, in 13 ascitic patients, BIA was measured prior and 24 h after a large volume (5.6 + 3.0 L) paracentesis associated to i.v. albumin infusion was performed. Results: MAMC and serum albumin were lower in ascitic than in both non-ascitic patients and controls (p 4 0.05 in both). TSF was lower in either group of cirrhotics than in controls (p < 0.05). No differences were found in TBW, LBM, and BFM as assessed by BIA among the three groups. In contrast, BCM was lower in ascitic than in both nonascitic patients and healthy subjects (20.0 + 1.2 vs 25.0 & 1 .I vs 30.7 + 1 .O kg; p < 0.05). Although TBW significantly decreased after paracentesis (32.4 & 1.8 vs 34.3 + 2.0 kg, p = 0.002), in no patient this decrease coincided with the amount of ascites removed. In spite that mean BCM did not change after paracentesis, the 95% Cl of the change ranged from gaining 1 .l kg to losing 2.7 kg. Conclusion: BIA is not a reliable method for the assessment of changes in body composition in cirrhotics with ascites.
for Fat anthropometry 1 0.7245
BIA results change depending on the equation used to derive Lean Body Mass (LBM) according to different authors. DEXA measurements are independent from the explorer, whereas A and BIA determinations can change in separate occasions with the same or different observer. Therefore, DEXA method seems more reliable than BIA for the assessment of FM. If DEXA technology is not available, our results support the use of anthropometric over impedance measurements.
P.143 Phase angle derived from bioelectrical impedance analysis and postoperative fluid balance C. Kawai. T. Tomiyama and H. Ueki Department of Surgery. The Nippon Niigata, Japan
Dental
University,
Bioelectrical impedance analysis (BIA) is considered a useful method for predicting body composition in healthy subjects. But its validity in postoperative patients is controversial. This study assessed the validity of phase angle derived from BIA 99