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The Relationship Between Phase Angle Obtained from the Maximum Reactance and Fasting Glucose, Hemoglobin A1c in Type 2 Diabetes Mellitus

Year 2023, Volume: 5 Issue: 3, 549 - 53, 18.09.2023
https://doi.org/10.37990/medr.1292694

Abstract

Aim: The phase angle obtained from the maximum reactance (PA max) is a better potential indicator than the phase angles obtained from multiple frequencies. Our aim in this study is to investigate the correlation of PA max with fasting glucose and hemoglobin A1c in Type-2 Diabetes Mellitus (T2 DM).
Material and Methods: The study was conducted prospectively, two groups were formed as T2 DM (n=75) and healthy controls (n=32) and their demographic variables were examined. Right hand, left hand, right leg, left leg, hand leg and leg leg segment measurements were taken with electrical impedance method and phase angle was obtained at maximum reactance. Correlations with fasting glucose, hemoglobin A1c and other variables were examined.
Results: Fasting glucose, glycated hemoglobin A1c, age, body mass index, body fat percentage were found to be significantly higher in the T2 DM group compared with the healthy group. However, RH PA max, RL PA max, LL PA max, H_L PA max, and L_L PA max values were found to be significantly lower than in the healthy group. In T2 DM group, hemoglobin A1c was found significantly negative correlated with PA max in all segments, while fasting glucose is negatively correlated with all segments except LH Pamax.
Conclusion: PA max is significantly reduced by the impaired glycemic index in T2 DM and is a potential marker reflecting metabolic status.

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Project Number

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References

  • 1. Galicia-Garcia U, Benito-Vicente A, Jebari S, et al. Pathophysiology of type 2 diabetes mellitus. Int J Mol Sci. 2020;21:6275.
  • 2. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37:S81-90.
  • 3. Sezer Ö, Özdoğan Lafçi N, Korkmaz S, Dağdeviren HN. Prediction of a 10-year risk of type 2 diabetes mellitus in the Turkish population: A cross-sectional study. Medicine (Baltimore). 2021;100:e27721.
  • 4. Singh S, Acharya SD, Kamath A, et al. Health literacy status and understanding of the prescription instructions in diabetic patients. J Diabetes Res. 2018:4517243.
  • 5. Barbosa-Silva MC, Barros AJ. Bioelectrical impedance analysis in clinical practice: a new perspective on its use beyond body composition equations. Curr Opin Clin Nutr Metab Care. 2005;8:311-7.
  • 6. Jaffrin MY, Morel H. Body fluid volumes measurements by impedance: A review of bioimpedance spectroscopy (BIS) and bioimpedance analysis (BIA) methods. Med Eng Phys. 2008;30:1257-69.
  • 7. Souza MF, Tomeleri CM, Ribeiro AS, et al. Effect of resistance training on phase angle in older women: A randomized controlled trial. Scand J Med Sci Sports. 2017;27:1308-16.
  • 8. Kuchnia AJ, Teigen LM, Cole AJ,et al. Phase angle and impedance ratio: reference cut-points from the United States national health and nutrition examination survey 1999-2004 from bioimpedance spectroscopy data. JPEN J Parenter Enteral Nutr. 2017;41:1310-15.
  • 9. Máttar JA. Application of total body bioimpedance to the critically ill patient.Brazilian Group for Bioimpedance Study. New Horiz. 1996;4:493-503.
  • 10. Mattiello R, Amaral MA, Mundstock E, Ziegelmann PK. Reference values for the phase angle of the electrical bioimpedance: systematic review and meta-analysis involving more than 250,000 subjects. Clin Nutr. 2020;39:1411-7.
  • 11. Jun MH, Kim S, Ku B, et al. Glucose-independent segmental phase angles from multi-frequency bioimpedance analysis to discriminate diabetes mellitus. Sci Rep. 2018;12;8:648.
  • 12. Beberashvili I, Azar A, Sinuani I, et al. Longitudinal changes in bioimpedance phase angle reflect inverse changes in serum IL-6 levels in maintenance hemodialysis patients. Nutrition. 2014;30:297-304.
  • 13. Paiva SI, Borges LR, Halpern-Silveira D, et al. Standardized phase angle from bioelectrical impedance analysis as prognostic factor for survival in patients with cancer. Support Care Cancer. 2010;19:187-92.
  • 14. Selberg O, Selberg D. Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis. Eur J Appl Physiol. 2002;86:509-16.
  • 15. Mat S, Tan MP, Mohktar MS, et al. Phase angle and diabetes in community-dwelling older adults: cross-sectional analysis from the Malaysian elders longitudinal research (MELoR) study. Eur J Clin Nutr. 2022;76:680-4.
  • 16. Zeng Y, Xu Y, Zhang B, et al. Clinical prognostic role of bioimpedance phase angle in diabetic and non-diabetic hemodialysis patients. Asia Pac J Clin Nutr. 2022;31:619-25.
  • 17. Dittmar M, Reber H, Kahaly GJ. Bioimpedance phase angle indicates catabolism in Type 2 diabetes. Diabet Med. 2015;32:1177-85.
  • 18. Yamada Y, Buehring B, Krueger D, et al. Electrical properties assessed by bioelectrical impedance spectroscopy as biomarkers of age-related loss of skeletal muscle quantity and quality. J Gerontol A Biol Sci Med Sci. 2017;1;72:1180-6.
  • 19. Buscemi S, Blunda G, Maneri R, Verga S. Bioelectrical characteristics of type 1 and type 2 diabetic subjects with reference to body water compartments. Acta Diabetol. 1998;35:220-3.
  • 20. Buffa R, Saragat B, Succa V, et al. Elderly subjects with type 2 diabetes show altered tissue electrical properties. Nutrition. 2013;29:132-7.
  • 21. Choi HN, Kim KA, Kim YS, Yim JE. Independent association of phase angle with fasting blood glucose and hemoglobin A1c in Korean type 2 diabetes patients. Clin Nutr Res. 2020;9:205-12.
  • 22. Jun MH, Ku B, Kim J, et al. Mediation effect of the duration of diabetes mellitus on the decrease in bioimpedance phase angles in ethnically Korean people: a multicenter clinical study. J Diabetes Investig. 2021;12:790-802.
  • 23. Al-Sofiani ME, Ganji SS, Kalyani RR. Body composition changes in diabetes and aging. J Diabetes Complications. 2019;33:451-9.
  • 24. Kalyani RR, Tra Y, Egan JM, et al. Hyperglycemia is associated with relatively lower lean body mass in older adults. J Nutr Health Aging. 2014;18:737-43.
  • 25. Akamatsu Y, Kusakabe T, Arai H, et al. Phase angle from bioelectrical impedance analysis is a useful indicator of muscle quality. J Cachexia Sarcopenia Muscle. 2022;13:180- 9.
Year 2023, Volume: 5 Issue: 3, 549 - 53, 18.09.2023
https://doi.org/10.37990/medr.1292694

Abstract

Project Number

None

References

  • 1. Galicia-Garcia U, Benito-Vicente A, Jebari S, et al. Pathophysiology of type 2 diabetes mellitus. Int J Mol Sci. 2020;21:6275.
  • 2. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37:S81-90.
  • 3. Sezer Ö, Özdoğan Lafçi N, Korkmaz S, Dağdeviren HN. Prediction of a 10-year risk of type 2 diabetes mellitus in the Turkish population: A cross-sectional study. Medicine (Baltimore). 2021;100:e27721.
  • 4. Singh S, Acharya SD, Kamath A, et al. Health literacy status and understanding of the prescription instructions in diabetic patients. J Diabetes Res. 2018:4517243.
  • 5. Barbosa-Silva MC, Barros AJ. Bioelectrical impedance analysis in clinical practice: a new perspective on its use beyond body composition equations. Curr Opin Clin Nutr Metab Care. 2005;8:311-7.
  • 6. Jaffrin MY, Morel H. Body fluid volumes measurements by impedance: A review of bioimpedance spectroscopy (BIS) and bioimpedance analysis (BIA) methods. Med Eng Phys. 2008;30:1257-69.
  • 7. Souza MF, Tomeleri CM, Ribeiro AS, et al. Effect of resistance training on phase angle in older women: A randomized controlled trial. Scand J Med Sci Sports. 2017;27:1308-16.
  • 8. Kuchnia AJ, Teigen LM, Cole AJ,et al. Phase angle and impedance ratio: reference cut-points from the United States national health and nutrition examination survey 1999-2004 from bioimpedance spectroscopy data. JPEN J Parenter Enteral Nutr. 2017;41:1310-15.
  • 9. Máttar JA. Application of total body bioimpedance to the critically ill patient.Brazilian Group for Bioimpedance Study. New Horiz. 1996;4:493-503.
  • 10. Mattiello R, Amaral MA, Mundstock E, Ziegelmann PK. Reference values for the phase angle of the electrical bioimpedance: systematic review and meta-analysis involving more than 250,000 subjects. Clin Nutr. 2020;39:1411-7.
  • 11. Jun MH, Kim S, Ku B, et al. Glucose-independent segmental phase angles from multi-frequency bioimpedance analysis to discriminate diabetes mellitus. Sci Rep. 2018;12;8:648.
  • 12. Beberashvili I, Azar A, Sinuani I, et al. Longitudinal changes in bioimpedance phase angle reflect inverse changes in serum IL-6 levels in maintenance hemodialysis patients. Nutrition. 2014;30:297-304.
  • 13. Paiva SI, Borges LR, Halpern-Silveira D, et al. Standardized phase angle from bioelectrical impedance analysis as prognostic factor for survival in patients with cancer. Support Care Cancer. 2010;19:187-92.
  • 14. Selberg O, Selberg D. Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis. Eur J Appl Physiol. 2002;86:509-16.
  • 15. Mat S, Tan MP, Mohktar MS, et al. Phase angle and diabetes in community-dwelling older adults: cross-sectional analysis from the Malaysian elders longitudinal research (MELoR) study. Eur J Clin Nutr. 2022;76:680-4.
  • 16. Zeng Y, Xu Y, Zhang B, et al. Clinical prognostic role of bioimpedance phase angle in diabetic and non-diabetic hemodialysis patients. Asia Pac J Clin Nutr. 2022;31:619-25.
  • 17. Dittmar M, Reber H, Kahaly GJ. Bioimpedance phase angle indicates catabolism in Type 2 diabetes. Diabet Med. 2015;32:1177-85.
  • 18. Yamada Y, Buehring B, Krueger D, et al. Electrical properties assessed by bioelectrical impedance spectroscopy as biomarkers of age-related loss of skeletal muscle quantity and quality. J Gerontol A Biol Sci Med Sci. 2017;1;72:1180-6.
  • 19. Buscemi S, Blunda G, Maneri R, Verga S. Bioelectrical characteristics of type 1 and type 2 diabetic subjects with reference to body water compartments. Acta Diabetol. 1998;35:220-3.
  • 20. Buffa R, Saragat B, Succa V, et al. Elderly subjects with type 2 diabetes show altered tissue electrical properties. Nutrition. 2013;29:132-7.
  • 21. Choi HN, Kim KA, Kim YS, Yim JE. Independent association of phase angle with fasting blood glucose and hemoglobin A1c in Korean type 2 diabetes patients. Clin Nutr Res. 2020;9:205-12.
  • 22. Jun MH, Ku B, Kim J, et al. Mediation effect of the duration of diabetes mellitus on the decrease in bioimpedance phase angles in ethnically Korean people: a multicenter clinical study. J Diabetes Investig. 2021;12:790-802.
  • 23. Al-Sofiani ME, Ganji SS, Kalyani RR. Body composition changes in diabetes and aging. J Diabetes Complications. 2019;33:451-9.
  • 24. Kalyani RR, Tra Y, Egan JM, et al. Hyperglycemia is associated with relatively lower lean body mass in older adults. J Nutr Health Aging. 2014;18:737-43.
  • 25. Akamatsu Y, Kusakabe T, Arai H, et al. Phase angle from bioelectrical impedance analysis is a useful indicator of muscle quality. J Cachexia Sarcopenia Muscle. 2022;13:180- 9.
There are 25 citations in total.

Details

Primary Language English
Subjects ​Internal Diseases
Journal Section Original Articles
Authors

Hasan Esat Yücel 0000-0001-7788-0227

Tufan Ulcay 0000-0003-2203-3850

Ozkan Gorgulu 0000-0002-6802-4450

Kağan Tur 0000-0001-5989-2099

Muhammed Hüseyin Kırındı 0000-0002-7950-234X

Elif Çömlekçi 0000-0003-1000-6548

Emre Uğuz 0000-0001-7813-3290

Berat Yağmur 0009-0002-1082-8226

Burcu Kamaşak 0000-0001-5340-1260

Ahmet Uzun 0000-0003-4147-3798

Project Number None
Early Pub Date August 23, 2023
Publication Date September 18, 2023
Acceptance Date June 2, 2023
Published in Issue Year 2023 Volume: 5 Issue: 3

Cite

AMA Yücel HE, Ulcay T, Gorgulu O, Tur K, Kırındı MH, Çömlekçi E, Uğuz E, Yağmur B, Kamaşak B, Uzun A. The Relationship Between Phase Angle Obtained from the Maximum Reactance and Fasting Glucose, Hemoglobin A1c in Type 2 Diabetes Mellitus. Med Records. September 2023;5(3):549-53. doi:10.37990/medr.1292694

17741

Chief Editors

Assoc. Prof. Zülal Öner
Address: İzmir Bakırçay University, Department of Anatomy, İzmir, Türkiye

Assoc. Prof. Deniz Şenol
Address: Düzce University, Department of Anatomy, Düzce, Türkiye

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