Dataset Information

Utility of bioelectrical phase angle for cardiovascular risk assessment among individuals with and without diabetes mellitus.

ABSTRACT:

Purpose

Low values of bioimpedance-derived phase angle (PA) have been associated with various adverse outcomes. We investigated the association of PA with cardiovascular markers in individuals with and without diabetes mellitus (DM).

Methods

PA was measured in 452 adults (without DM n = 153, T1DM n = 67, T2DM n = 232). Carotid intima-media thickness (IMT), renal resistive index (RRI), ankle-brachial index (ABI) and carotid-femoral Pulse Wave Velocity (cfPWV) were estimated. Furthermore, the levels of high-sensitive Troponin-T [hsTnT], N-terminal brain natriuretic peptide [NT-pro-BNP]) were measured.

Results

PA values were lower in DM independently of age, gender, and BMI (estimated marginal means 6.21, 5.83, 5.95 for controls, T1DM, T2DM p < .05), a finding which persisted after propensity score matching. PA correlated negatively with IMT (r = -0.181), RRI (r = -0.374), cfPWV (r = -0.358), hsTnT (r = -0.238) and NT-pro-BNP (r = -0.318) (all p < .001). In multivariable analysis, the associations with RRI, cfPWV, hsTnT and NT-pro-BNP remained unchanged. PA values 6.0-6.5° for males and 5.2-5.8° for females were predictive of commonly used cutoffs. The combination of ΑCC/AHA ASCVD Score with PA outperformed either factor in predicting cfPWV, RRI for males and hsTnT, BNP for both genders.

Conclusions

PA exhibits independent correlations with various parameters pertinent to cardiovascular risk and may be useful for cardiovascular assessment.

SUBMITTER: Tsilingiris D

PROVIDER: S-EPMC10838040 | biostudies-literature | 2024 Jan-Feb

REPOSITORIES: biostudies-literature

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Publications

Utility of bioelectrical phase angle for cardiovascular risk assessment among individuals with and without diabetes mellitus.

Tsilingiris Dimitrios D Schimpfle Lukas L Κender Zoltan Z Sulaj Alba A von Rauchhaupt Ekaterina E Herzig Stephan S Szendroedi Julia J Kopf Stefan S

Diabetes & vascular disease research 20240101 1

<h4>Purpose</h4>Low values of bioimpedance-derived phase angle (PA) have been associated with various adverse outcomes. We investigated the association of PA with cardiovascular markers in individuals with and without diabetes mellitus (DM).<h4>Methods</h4>PA was measured in 452 adults (without DM <i>n</i> = 153, T1DM <i>n</i> = 67, T2DM <i>n</i> = 232). Carotid intima-media thickness (IMT), renal resistive index (RRI), ankle-brachial index (ABI) and carotid-femoral Pulse Wave Velocity (cfPWV) w ...[more]

PMID: 38305220

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Project description:BackgroundThe phase angle (PhA) in bioelectrical impedance analysis (BIA) reflects the cell membrane integrity or body fluid equilibrium. We examined how the PhA aligns with previously known markers of acute heart failure (HF) and assessed its value as a screening tool.MethodsPhA was measured in 50 patients with HF and 20 non-HF controls along with the edema index (EI), another BIA parameter suggestive of edema. Chest computed tomography-measured lung fluid content (LFC) was used to assess pulmonary congestion. A correlation analysis was conducted to evaluate the relationships between PhA and EI, NT-proBNP, and LFC. Receiver operating characteristic (ROC) curve analysis was used to determine the cut-off values for PhA and EI for classifying patients with HF. The area under the curve (AUC) was compared using the DeLong test to evaluate the performance of PhA and EI compared to that of LFC in correctly classifying HF.ResultsThe PhA levels were significantly lower in the HF group. Whole-body PhA was 4.49° in the HF group and 5.68° in the control group. Moderate and significant correlation was observed between PhA measured at 50-kHz and both NT-proBNP (-0.56 to -0.27, all p-values<0.05) and LFC (-0.52 to -0.41, all p-values <0.05). The AUC for whole-body PhA was 0.827 (confidence interval [CI] 0.724-0.931, p<0.01) and was 0.883 (CI 0.806-0.961, p<0.01) for EI, and the optimal cutoffs were estimated as 5° (sensitivity 0.84, specificity 0.80) and 0.394 (sensitivity 0.78, specificity 0.95), respectively. When both PhA and EI were included in the model, the AUC increased to 0.905, and this was comparable to that of LFC (AUC = 0.913, p = 0.857).ConclusionsPhA exhibited a correlation with known markers of HF and demonstrated its potential as a non-invasive screening tool for the early detection of HF exacerbation. The combined use of PhA and EI can provide a robust alternative for routine self-monitoring in patients with HF, thereby enhancing early intervention.

Project description:IntroductionPhase angle (PhA) is a ratio of reactance and resistance {arctangent (reactance (Xc)/resistance (R)) × (180°/π)}, which can be obtained by bioelectrical impedance analysis (BIA). PhA indicates cellular health and integrity, and it is also considered as a prognostic tool in medical disorders and an indicator of nutritional status (especially of muscle quality) in patients with obesity. However, PhA has limited usefulness in clinical practice because of a lackness of reference values for Chinese overweight and obese populations. The main aim of this study was to show PhA reference data in different age and BMI groups by sex. In addition, we also study the association of age, sex, and BMI on PhA.MethodsA total of 1729 overweight and obese participants were included in this study. PhA and body composition were measured using segmental multifrequency BIA. Differences in mean values for variables were tested by one-way analysis of variance. Multiple regression analysis was used to assess the associations of PhA with age, sex and BMI.ResultsMultiple regression analysis showed that age, sex and BMI were significant (P < 0.05) independent influence factors of PhA in Chinese overweight and obese adults when age and BMI were continues variables. The mean PhA value for all participants was 5.5°. Mean BMI, age, weight, height and 50kHz-PhA were significantly higher (P < 0.001) in male participants than female ones. In age groups and BMI groups, mean 50kHz-PhA was significantly higher (P < 0.005) in male participants than female ones. When age groups and BMI groups were categorical variables, multiple regression analysis showed that different age groups (46-55 years and ≥ 56 years) had a significantly lower (P < 0.005) PhA as compared with the baseline group (18-25 years) and different BMI groups (≥ 28 kg/m2) had a significantly higher (P < 0.05) PhA as compared with the baseline group (24-27.9 kg/m2).ConclusionPhA differed according to age, sex and BMI. Reference data in this study can be taken into consideration when deriving the reference values for overweight and obese Chinese populations.

Project description:Mothers with a history of gestational diabetes mellitus (GDM) have an increased risk of developing diabetes in the future and a lifelong cardiovascular risk. Postpartal expression profile of cardiovascular/cerebrovascular disease associated microRNAs was assessed 3-11 years after the delivery in whole peripheral blood of young and middle-aged mothers with a prior exposure to GDM with the aim to identify a high-risk group of mothers at risk of later development of diabetes mellitus and cardiovascular/cerebrovascular diseases who would benefit from implementation of early primary prevention strategies and long-term follow-up. The hypothesis of the assessment of cardiovascular risk in women was based on the knowledge that a series of microRNAs play a role in the pathogenesis of diabetes mellitus and cardiovascular/cerebrovascular diseases. Abnormal expression profile of multiple microRNAs was found in women with a prior exposure to GDM (miR-1-3p, miR-16-5p, miR-17-5p, miR-20a-5p, miR-20b-5p, miR-21-5p, miR-23a-3p, miR-24-3p, miR-26a-5p, miR-29a-3p, miR-100-5p, miR-103a-3p, miR-125b-5p, miR-126-3p, miR-130b-3p, miR-133a-3p, miR-143-3p, miR-145-5p, miR-146a-5p, miR-181a-5p, miR-195-5p, miR-199a-5p, miR-221-3p, miR-342-3p, miR-499a-5p, and-miR-574-3p). Postpartal combined screening of miR-1-3p, miR-16-5p, miR-17-5p, miR-20b-5p, miR-21-5p, miR-23a-3p, miR-26a-5p, miR-29a-3p, miR-103a-3p, miR-133a-3p, miR-146a-5p, miR-181a-5p, miR-195-5p, miR-199a-5p, miR-221-3p, and miR-499a-5p showed the highest accuracy for the identification of mothers with a prior exposure to GDM at a higher risk of later development of cardiovascular/cerebrovascular diseases (AUC 0.900, p 0.001, sensitivity 77.48%, specificity 93.26%, cut off >0.611270413). It was able to identify 77.48% mothers with an increased cardiovascular risk at 10.0% FPR. Any of changes in epigenome (upregulation of miR-16-5p, miR-17-5p, miR-29a-3p, and miR-195-5p) that were induced by GDM-complicated pregnancy are long-acting and may predispose mothers affected with GDM to later development of diabetes mellitus and cardiovascular/cerebrovascular diseases. In addition, novel epigenetic changes (upregulation of serious of microRNAs) appeared in a proportion of women that were exposed to GDM throughout the postpartal life. Likewise, a previous occurrence of either GH, PE, and/or FGR, as well as a previous occurrence of GDM, is associated with the upregulation of miR-1-3p, miR-17-5p, miR-20a-5p, miR-20b-5p, miR-29a-3p, miR-100-5p, miR-125b-5p, miR-126-3p, miR-130b-3p, miR-133a-3p, miR-143-3p, miR-145-5p, miR-146a-5p, miR-181a-5p, miR-199a-5p, miR-221-3p, and miR-499a-5p. On the other hand, upregulation of miR-16-5p, miR-21-5p, miR-23a-3p, miR-24-3p, miR-26a-5p, miR-103a-3p, miR-195-5p, miR-342-3p, and miR-574-3p represents a unique feature of aberrant expression profile of women with a prior exposure to GDM. Screening of particular microRNAs may stratify a high-risk group of mothers with a history of GDM who might benefit from implementation of early primary prevention strategies.

Dataset Information

Utility of bioelectrical phase angle for cardiovascular risk assessment among individuals with and without diabetes mellitus.

Purpose

Methods

Results

Conclusions

Publications

Utility of bioelectrical phase angle for cardiovascular risk assessment among individuals with and without diabetes mellitus.

Similar Datasets

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