Bioelectrical impedance parameters and nutritional status of pediatric patients with hematological malignancies: a cross-sectional study.
In a cross-sectional comparison of 27 pediatric patients receiving active treatment for hematologic malignancies with an ethnically matched healthy reference population, patients had lower phase angle and handgrip strength despite greater adiposity, with the phase-angle difference persisting after adjustment for waist circumference.
Open original publication →What the AI sees
In a cross-sectional comparison of 27 pediatric patients receiving active treatment for hematologic malignancies with an ethnically matched healthy reference population, patients had lower phase angle and handgrip strength despite greater adiposity, with the phase-angle difference persisting after adjustment for waist circumference.
Research significance
The study provides evidence that direct bioelectrical impedance parameters, particularly phase angle, can detect nutritional and body-composition abnormalities not apparent from adiposity measures alone; it remains an inference requiring prospective validation that phase-angle-guided nutritional assessment or intervention could reduce toxicity or improve treatment outcomes.
Source abstract
BACKGROUND: treatment of pediatric patients with hematologic malignancies (HM) affects their nutritional status and body composition. Bioelectrical impedance analysis (BIA) parameters [resistance (R), reactance (Xc), phase angle (PhA)] are non-invasive tools for assessing these changes. The objective was to compare standardized BIA parameters [R/height (h), Xc/h] and PhA of pediatric patients with HM against a healthy reference population. METHODS: pediatric patients with HM (active treatment), anthropometric parameters [height, weight, mid-upper arm circumference (MUAC), waist circumference (WC), triceps skinfold thickness (TSF), handgrip strength (HGS)] and BIA parameters were measured before chemotherapy. Data were compared with an ethnically matched healthy reference population using t-tests and multivariate analysis of covariance (MANCOVA) with WC. RESULTS: twenty-seven children (99 months) participated. Compared to the reference population, patients showed higher R/ht (+47.8 ohms/m, p = 0.020), lower Xc/ht (-26.2 ohms/m, p < 0.001), and PhA (-2.79°, p < 0.001). HGS was lower (-2.36 kg, p = 0.002), while WC (+9.38 cm, p < 0.001), TSF (+1.60 mm, p = 0.041), and arm fat area (+2.98 cm², p < 0.001) were higher. After adjusting for WC, the differences persisted (Pillai trace = 0.773, p < 0.001). PhA remained lower in patients (adjusted difference -2.78°, p < 0.001) and was independent of WC (p = 0.969). CONCLUSIONS: patients showed impaired cellular health (low PhA) and muscle function (low HGS) coexisting with increased adiposity (WC, TSF). The reduction in PhA was independent of WC, reinforcing its role as a specific marker of cellular deterioration. Direct BIA parameters, particularly PhA, offer a valuable non-invasive tool for the early identification of nutritional risk.