A novel systematic review has shed light on the burgeoning role of Bioelectrical Impedance Analysis (BIA) as a pivotal clinical marker for gauging the health status of adult patients battling benign gastrointestinal (GI) diseases. The clinical study, published in the premier journal of Clinical Nutrition ESPEN, emphasizes that body composition is a critical mirror of not just the nutritional status but also the disease status, progression, and the efficacy of treatment interventions.
The importance of this review, which aggregates data compiled from multiple studies, lies in its focus on patients who are often beleaguered by disease-related changes in their body composition. These alterations can have far-reaching implications for their overall health and prognosis. Recognizing a gap in the literature, wherein the bioimpedance outcomes in benign GI disease patients have not been comprehensively evaluated before, the study sets out to analyze BIA as a robust clinical body composition marker and its association with physical health status.
Published on January 16, 2024, the study is spearheaded by a team of experts including Josephine Quist, Charlotte Lock Rud, Steven Brantlov, Leigh C. Ward, Simon Mark Dahl Baunwall, and Christian Lodberg Hvas from the Department of Hepatology and Gastroenterology at Aarhus University Hospital, Denmark, alongside a colleague from the Central Denmark Region’s Department of Procurement & Clinical Engineering, and The University of Queensland in Australia.
The study, registered under the PROSPERO registration CRD42021265866, launches into a systematic and thorough search across esteemed databases like PubMed, Scopus, Web of Science, Embase, and CINAHL. The time span for this data curation extends from the inception of these databases to October 2023.
From a broad collection of 971 studies put through the screening process, 26 studies of merit made it to the evaluative stage, incorporating data from a pool of 2398 adult patients diagnosed with benign GI diseases. The primary outcome revolved around raw impedance data which facilitates an in-depth appraisal of the body’s composition.
A striking observation from the analysis is the frequent reporting of phase angle (PhA), highlighted in 18 of the analyzed studies, followed by fat-free-mass (FFM), which finds mention in 13 studies. These commonalities draw attention to the significant correlation between low PhA and FFM levels with heightened nutritional risk, altered physical characteristics, and an increased risk of mortality.
The magnitude of these findings cannot be understated as they provide a compelling argument for the adoption of BIA as an instrumental tool in the clinical evaluation of body composition for patients suffering from benign GI ailments. Nonetheless, to truly capitalize on the potential of BIA, the review advocates for the development of standardized protocols that cater specifically to the benign GI disease cohort. Furthermore, it underscores the need for prospective studies to delineate cut-offs and ranges that would enhance the accuracy of BIA and enrich the guidance it offers for classifying disease status.
The systematic review has immense implications for clinical practice. It aspires to transform the landscape of health assessment, nudging it towards non-invasive, reliable, and patient-specific methodologies. The findings are poised to revolutionize treatment strategies and follow-up care for individuals with benign GI diseases.
Integrity in scientific research remains paramount; hence, the review discloses that Leigh Ward is an advisor for ImpediMed Ltd., though the company did not influence the preparation of the manuscript. Similarly, Christian Lodberg Hvas has disclosed receiving lecture fees from Baxter. The other researchers have declared no conflicts of interest regarding their contribution to this work.
The groundbreaking research not only serves as a beacon for clinicians worldwide but also underscores the nuances of navigating through patient care while aligning with the most innovative and effective diagnostic tools.
For further information, the research is accessible via its DOI: 10.1016/j.clnesp.2023.12.145 and the involved parties retain their copyright © 2023 The Author(s).
Keywords
1. Bioelectrical Impedance Analysis BIA
2. Gastrointestinal Diseases Nutrition
3. Phase Angle Body Composition
4. Nutritional Risk Biomarkers
5. Non-Invasive Clinical Assessment
References
1. Journal Article: Clinical Nutrition ESPEN. “Bioelectrical impedance analysis as a clinical marker of health status in adult patients with benign gastrointestinal disease: A systematic review.” (2024): doi:10.1016/j.clnesp.2023.12.145.
2. Kyle, U. G., et al. “Bioelectrical impedance analysis—part I: review of principles and methods.” Clinical nutrition 23.5 (2004): 1226-1243.
3. Sergi, G., et al. “Assessment of body composition by bioelectrical impedance in a population of elderly and middle-aged people.” Journal of the American Geriatrics Society 45.12 (1997): 1479-1485.
4. Steinfeldt, L., et al. “Bioelectrical phase angle and impedance vector analysis—clinical relevance and applicability of impedance parameters.” Clinical Nutrition 31.6 (2012): 854-861.
5. Schwenk, A., et al. “Bioelectrical impedance analysis as a predictor of survival in patients with human immunodeficiency virus infection.” Journal of acquired immune deficiency syndromes and human retrovirology 17.3 (1998): 187-191.