Clinical Study Of Bioimpedance Phase Angle In Predicting Nutritional Status Of Patients With Crohn’s Disease

Objective: Crohn’s disease(CD)is usually accompanied by malnutrition.CD-related malnutrition might affect the outcome and significantly increase the financial burden.The purpose of this study was to find a reliable indicator to evaluate CD patients’ nutritional status.Methods: A cross-sectional study was conducted among CD patients who were attending the Gastroenterology Department of Xiangya Hospital,Central South University between May 2021 and February 2022.All patients were evaluated for nutritional status by the Global Leadership Initiative on Malnutrition(GLIM)criteria.Body composition,resistance,and reactance were recorded by a body analyzer,and phase angle(Ph A)was calculated simultaneously.The Mann–Whitney U test,chi-square test,Fisher’s exact test,and univariate and multivariate logistic regression analyses were used to find differential variables.A receiver operating characteristic(ROC)curve was built to evaluate the predictive value of differential variables for malnutrition diagnosis based on the GLIM criteria.Results:1.A total of 169 CD patients were enrolled.74(accounting for58.3% of all male patients)and 32(accounting for 76.2% of all female patients)were diagnosed with malnutrition in men and women,respectively.34(accounting for 45.9% of male malnourished patients)of males and 22(accounting for 68.8% of female malnourished patients)of females were severely malnutrition.2.Compared with well-nourished patients,male malnourished patients had statistically significantly lower age,body mass index(BMI),Ph A,hemoglobin(HGB)and albumin(ALB),and higher levels of platelet count(PLT),and erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),and fibrinogen(FIB)(P < 0.05).Female malnourished patients had significantly lower BMI and Ph A(P < 0.05).3.Compared with moderate malnourished patients,male severe malnourished patients had statistically significantly lower BMI,Ph A,HGB,and ALB,and higher levels of PLT,ESR,CRP,and FIB(P < 0.05).Female severely malnourished patients had statistically significantly lower BMI、Ph A、HGB、ALB and higher levels of PLT(P < 0.05).4.Logistic regression analysis revealed that Ph A was an independent predictor for the risk of malnutrition(P < 0.05),and an independent predictor for the risk of severe malnutrition(P < 0.05).5.We determined that the optimal Ph A cut-off level of 6.11° and5.55°might predict malnutrition according to the GLIM criteria using ROC analysis in men and women,respectively.Ph A<5.53°in males or Ph A<5.12°in females indicated severe malnutrition.6.Model performance analysis showed that the AUC value of Ph A in predicting malnutrition and severe malnutrition was higher than the other included laboratory indicators.Conclusion:Ph A is a sensitive,noninvasive,portable,inexpensive indicator to monitor and manage the nutritional status of CD patients.