Bioelectrical impedance vector analysis evaluates cellularity and hydration in cirrhotic patients

摘要

BACKGROUND Malnutrition in cirrhotic patients is correlated with mortality and a better response to liver transplantation.However,recovery of the nutritional status in these patients is a challenge due to the difficulty in establishing a reliable nutritional diagnosis.The bioelectrical impedance vector analysis(BIVA)method appears as a feasible tool in clinical practice to define the physiological state of cirrhotic patients by assessing hydration and body cellularity.AIM To evaluate bodycomposition in cirrhotic patients using BIVA.METHODS This retrospective cross-sectional study was carried out by following cirrhotic outpatients at a hospital in Porto Alegre,Brazil.A tetrapolar bioelectrical impedance analysis device was used to evaluate cellularity and hydration and to perform the BIVA.The BIVA graphic was elaborated by software and for statistical analysis a significance level of 5%(P≤0.05)was considered.RESULTS One hundred and ninety patients,61.1%males,with a mean age of 56.6±11.0 years,were evaluated.Of these,56.3%had Child-Turcotte-Pugh(CTP)A score,and the prevalent etiology was hepatitis C virus(47.4%).The patients were classified according to cellularity and hydration by the quadrants and ellipses of the BIVA method,quadrant 1(47.9%);quadrant 2(18.9%);quadrant 3(14.2%);and quadrant 4(18.9%).Those classified in quadrant 1 and 2 had a higher phase angle compared to those in quadrants 3 and 4(P<0.001).Quadrant 2 patients had a lower average age than the other groups.The association with CTP score showed that patients in quadrant 2 had a higher proportion of CTP A,and those in quadrant 4 had a higher proportion of CTP C(P<0.052).CONCLUSION The BIVA method allows identification of the cellularity and hydration status of cirrhotic patients,and its association with clinical factors determines the disease severity,age and prognostic index.