Configuration of bioelectrical impedance measurements affects results for phase angle

Abstract

Objective: Phase angle (PhA) obtained by bioelectrical impedance analysis is a well-established predictor of malnutrition that reflects the amount and quality of soft tissue. However, PhA results may depend on configurations of the measurement that differ between devices. The aim was to analyze differences between devices for supine and standing measurements.

Approach: In a cross-sectional study, differences in PhA were analyzed comparing supine vs. standing positions, metal vs. adhesive electrodes and the right vs. left side of the body in 302 multi-ethnic adults (18-65y) and 1298 Mexican children and adolescents (4-20y).

Main results: PhA was higher in supine than in standing position (from 0.71°±0.22° in children to 0.97°±0.25° in adults; all p < 0.001) with approximately fifty percent of observed differences explained by electrode placement. PhA differences increased with increasing PhA (r = 0.419) and decreased with age (r = -0.346) in adults, but increased with PhA (r = 0.677), age (r = 0.752) and height (r = 0.737) in children (all p <0.001). In adults, PhA was higher on the right side of the body (standing 0.18°±0.17°; supine 0.36°±0.33°; p <0.001).

Significance: Phase angle results are influenced by posture and electrode placement. Measurement configuration must be considered when phase angle values are compared between different devices or with literature values.

Trial registration: ClinicalTrials.gov NCT01368640 NCT03779932 NCT01471938.

Keywords: Bioelectrical impedance analysis; Electrode placement; Phase angle; Position; Standing; Supine.