Bioelectrical impedance analysis–derived phase angle predicts possible sarcopenia in patients on maintenance hemodialysis: A retrospective study

Abstract

Abstract Background Early identification of possible sarcopenia in patients on maintenance hemodialysis (MHD) is important to prevent adverse outcomes and improve the quality of life of these patients. The aim of this study was to investigate the relationship between phase angle (Pha) and possible sarcopenia and to assess its performance as a predictor of possible sarcopenia in MHD patients. Methods Data were retrospectively collected from outpatient under going MHD at Wenjiang Hemodialysis Center in the Department of Nephrology in West China Hospital, Sichuan University, Chengdu, China. The 2019 consensus update by Asian working group for sarcopenia (AWGS) was used to assess whether a MHD patient had sarcopenia. A total of 244 MHD patients were collected in this study, and after excluding patients with sarcopenia, data from 122 men (56 with possible sarcopenia) and 96 women (55 with possible sarcopenia) patients were included in this study. Participants were divided into a possible sarcopenic group and a non-sarcopenic group to develop a binary classification. Results After eliminating handgrip strength (HGS), short physical performance battery (SPPB), and skeletal muscle index (SMI), the best three features for possible sarcopenia identifcation of men patients are age, body mass index (BMI), and Pha (P < 0.05). Meanwhile, age, and Pha are the best two features for Women (P < 0.05). Spearman analysis showed that Pha was significantly negatively associated with possible sarcopenia (men: r =−0.501, P < 0.001; women: r=−0.356, P < 0.001). Pha showed significant positive associations with HGS, SPPB and SMI (men: r = 0.590, P < 0.001、r = 0.485, P < 0.001、r = 0.338, P < 0.001; women: r = 0.374, P < 0.001、r = 0.360, P < 0.001、r = 0.290, P = 0.004). The results of receiver operating characteristic (ROC) curve analysis showed that the area under the receiver operating characteristic curves (AUC) of Pha in screening male possible sarcopenia was 0.790, with sensitivity of 78.57%, specificity of 74.24%, and the optimal cutoff value of 6.52°. The AUC of Pha in screening women for possible sarcopenia was 0.707, sensitivity of 58.18%, specificity of 76.74%, and optimal cutoff value of 5.60°. Conclusions Pha may be a useful and simple predictor of the risk of possible sarcopenia in patients with MHD, and more research is needed to further promote the use of Pha in possible sarcopenia.