Bioelectrical impedance vector analysis evaluates cellularity and hydration in cirrhotic patients

Sabrina Alves Fernandes; Lara Rigon Leonhardt; Daniella Miranda da Silva; Fernanda Donner Alves; Cláudio Augusto Marroni

doi:10.4254/wjh.v12.i12.1276

Bioelectrical impedance vector analysis evaluates cellularity and hydration in cirrhotic patients

World J Hepatol. 2020 Dec 27;12(12):1276-1288. doi: 10.4254/wjh.v12.i12.1276.

Authors

Sabrina Alves Fernandes¹, Lara Rigon Leonhardt², Daniella Miranda da Silva³, Fernanda Donner Alves⁴, Cláudio Augusto Marroni²

Affiliations

¹ Department of Nutrition, Centro Universitário Metodista IPA, Porto Alegre 90420-060, RS, Brazil. sabrinaafernandes@gmail.com.
² Gastroenterology and Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 91760-470, RS, Brazil.
³ Postgraduate Program in Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil.
⁴ Department of Nutrition, Centro Universitário Ritter dos Reis - Uniritter, Porto Alegre 90840-440, Rio Grande do Sul, Brazil.

Abstract

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 body composition 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.

Keywords: Bioelectrical impedance vector analysis; Body composition; Cellularity; Electrical Bioimpedance; Hepatic cirrhosis; Hydration.