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Bioelectrical spectroscopy impedance phase angle is not associated with nutritional status in a stable cohort of paediatric inflammatory bowel disease patients

Bioelectrical spectroscopy impedance phase angle is not associated with nutritional status in a stable cohort of paediatric inflammatory bowel disease patients
Bioelectrical spectroscopy impedance phase angle is not associated with nutritional status in a stable cohort of paediatric inflammatory bowel disease patients

Background & aims: Nutritional assessment in paediatric inflammatory bowel disease (IBD) is key to supporting growth whilst minimising adiposity. Bedside assessment using bioelectrical impedance spectroscopy (BIS) has previous identified patients with declining cellular and nutritional health. We aimed to assess BIS measures in stable paediatric IBD patient. Methods: Stable IBD patients were recruited at routine hospital visits. All patients underwent BIS, anthropometry and disease activity assessment. Multivariable regression and receiver operator curve (ROC) analyses were undertaken to assess the utility of BIS phase angle 50 KHz (PA-50) and 200/5 KHz impedance ratio (IR) in nutritional assessment. Results: There were 140 study visits from 97 patients, mean age 14.49 years, 62.9% Crohn's disease. Mean BMI Z-score (BMIZ) was 0.31 (range −2.97 to 3.99), 33% of patients were overweight (BMIZ>1) and 13.8% of patients were underweight (BMIZ < −1). Crohn's disease patients had a lower mean BMIZ score 0.14, compared to ulcerative colitis, 0.68, p = 0.007. There was no relationship between PA-50 and BMIZ or disease activity. IR was not related to disease activity but was negatively related to BMIZ in a multivariable regression, accounting for age, sex and disease subtype (beta −0.331, p = 0.001). ROC analyses did not identify a clinically useful cut off for either PA-50 or IR to identify patients with active disease, biologic use or BMIZ>1 or < -1. Conclusion: BIS appears to have limited added value in nutritional assessment of stable paediatric IBD patients. Nearly 1/3 patients were overweight and personalised approach to supplementation is vital to avoid overnutrition.

Bioelectrical impedance, Children, Inflammatory bowel disease, Nutrition, Phase angle
2405-4577
276-281
Ashton, James J.
03369017-99b5-40ae-9a43-14c98516f37d
Marino, Luise V.
3051053b-f60e-4a8e-9ab6-920dab3dea0b
Johnson, Mark J.
1abcfaab-0c1d-40b5-94e2-b1eb8c4657aa
Newell, Colin
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Price, Gabrielle
9225b2ed-71bc-48ba-be08-b16d44ed98a2
Dewar, Helen
811b243a-a478-4b9e-b430-9bf98b17b197
Brampton, Rachel
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Ennis, Sarah
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Griffiths, Mark
bb6ddffa-7184-4e1f-a6a3-37729aa85c54
Coelho, Tracy
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Batra, Akshay
822f891e-87ca-41d9-b68d-27c395e88809
Afzal, Nadeem
5148f35e-6788-4dbd-a50f-c303a4948d60
Beattie, R. Mark
55d81c7b-08c9-4f42-b6d3-245869badb71
Ashton, James J.
03369017-99b5-40ae-9a43-14c98516f37d
Marino, Luise V.
3051053b-f60e-4a8e-9ab6-920dab3dea0b
Johnson, Mark J.
1abcfaab-0c1d-40b5-94e2-b1eb8c4657aa
Newell, Colin
1fd1cf80-1487-4c59-8999-e84dd54fc5ee
Price, Gabrielle
9225b2ed-71bc-48ba-be08-b16d44ed98a2
Dewar, Helen
811b243a-a478-4b9e-b430-9bf98b17b197
Brampton, Rachel
f802db99-19e6-4b85-a059-3ad7f9347114
Ennis, Sarah
7b57f188-9d91-4beb-b217-09856146f1e9
Griffiths, Mark
bb6ddffa-7184-4e1f-a6a3-37729aa85c54
Coelho, Tracy
83bbf944-8998-4f1f-ae32-ad2315bb5f8f
Batra, Akshay
822f891e-87ca-41d9-b68d-27c395e88809
Afzal, Nadeem
5148f35e-6788-4dbd-a50f-c303a4948d60
Beattie, R. Mark
55d81c7b-08c9-4f42-b6d3-245869badb71

Ashton, James J., Marino, Luise V., Johnson, Mark J., Newell, Colin, Price, Gabrielle, Dewar, Helen, Brampton, Rachel, Ennis, Sarah, Griffiths, Mark, Coelho, Tracy, Batra, Akshay, Afzal, Nadeem and Beattie, R. Mark (2021) Bioelectrical spectroscopy impedance phase angle is not associated with nutritional status in a stable cohort of paediatric inflammatory bowel disease patients. Clinical Nutrition ESPEN, 44, 276-281. (doi:10.1016/j.clnesp.2021.06.003).

Record type: Article

Abstract

Background & aims: Nutritional assessment in paediatric inflammatory bowel disease (IBD) is key to supporting growth whilst minimising adiposity. Bedside assessment using bioelectrical impedance spectroscopy (BIS) has previous identified patients with declining cellular and nutritional health. We aimed to assess BIS measures in stable paediatric IBD patient. Methods: Stable IBD patients were recruited at routine hospital visits. All patients underwent BIS, anthropometry and disease activity assessment. Multivariable regression and receiver operator curve (ROC) analyses were undertaken to assess the utility of BIS phase angle 50 KHz (PA-50) and 200/5 KHz impedance ratio (IR) in nutritional assessment. Results: There were 140 study visits from 97 patients, mean age 14.49 years, 62.9% Crohn's disease. Mean BMI Z-score (BMIZ) was 0.31 (range −2.97 to 3.99), 33% of patients were overweight (BMIZ>1) and 13.8% of patients were underweight (BMIZ < −1). Crohn's disease patients had a lower mean BMIZ score 0.14, compared to ulcerative colitis, 0.68, p = 0.007. There was no relationship between PA-50 and BMIZ or disease activity. IR was not related to disease activity but was negatively related to BMIZ in a multivariable regression, accounting for age, sex and disease subtype (beta −0.331, p = 0.001). ROC analyses did not identify a clinically useful cut off for either PA-50 or IR to identify patients with active disease, biologic use or BMIZ>1 or < -1. Conclusion: BIS appears to have limited added value in nutritional assessment of stable paediatric IBD patients. Nearly 1/3 patients were overweight and personalised approach to supplementation is vital to avoid overnutrition.

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Untracked_28_05_21_JJA_BIS paper - Accepted Manuscript
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Accepted/In Press date: 2 June 2021
e-pub ahead of print date: 23 June 2021
Published date: 1 August 2021
Additional Information: Funding Information: The ESPEN personal fellowship funding this project is acknowledged (JJA, and this study, were funded by a 2018 ESPEN personal fellowship.). There is no accompanying grant ID. Publisher Copyright: © 2021 European Society for Clinical Nutrition and Metabolism Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
Keywords: Bioelectrical impedance, Children, Inflammatory bowel disease, Nutrition, Phase angle

Identifiers

Local EPrints ID: 450826
URI: http://eprints.soton.ac.uk/id/eprint/450826
ISSN: 2405-4577
PURE UUID: 75d45929-bbe2-4fd3-ba18-f69371937eb3
ORCID for Sarah Ennis: ORCID iD orcid.org/0000-0003-2648-0869

Catalogue record

Date deposited: 13 Aug 2021 16:30
Last modified: 26 Nov 2021 02:42

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Contributors

Author: James J. Ashton
Author: Luise V. Marino
Author: Mark J. Johnson
Author: Colin Newell
Author: Gabrielle Price
Author: Helen Dewar
Author: Rachel Brampton
Author: Sarah Ennis ORCID iD
Author: Mark Griffiths
Author: Tracy Coelho
Author: Akshay Batra
Author: Nadeem Afzal
Author: R. Mark Beattie

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