Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Dec 27, 2020; 12(12): 1276-1288
Published online Dec 27, 2020. doi: 10.4254/wjh.v12.i12.1276
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
Sabrina Alves Fernandes, Department of Nutrition, Centro Universitário Metodista IPA, Porto Alegre 90420-060, RS, Brazil
Lara Rigon Leonhardt, Cláudio Augusto Marroni, Gastroenterology and Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 91760-470, RS, Brazil
Daniella Miranda da Silva, Postgraduate Program in Hepatology, Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre 90050-170, RS, Brazil
Fernanda Donner Alves, Department of Nutrition, Centro Universitário Ritter dos Reis - Uniritter, Porto Alegre 90840-440, Rio Grande do Sul, Brazil
Author contributions: Fernandes SA contributed to the writing of the research project, data collection and writing and reviewing the scientific article; Leonhardt LR participated in the data collection, tabulation, statistical analysis and writing of the scientific article; da Silva DM assisted in data collection; Alves FD and Marroni CA contributed to writing and reviewing the scientific article.
Institutional review board statement: This project was approved by the Research Ethics Committee of the Federal University of Health Sciences of Porto Alegre, No. 398/08.
Informed consent statement: Patients who participated in the study signed an informed consent form.
Conflict-of-interest statement: All authors declare no conflicts of interest related to this article.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Sabrina Alves Fernandes, PhD, Research Scientist, Teacher, Department of Nutrition, Centro Universitário Metodista IPA, Porto Alegre, Porto Alegre 90420-060, RS, Brazil. sabrinaafernandes@gmail.com
Received: July 28, 2020
Peer-review started: July 28, 2020
First decision: August 22, 2020
Revised: September 7, 2020
Accepted: November 5, 2020
Article in press: November 5, 2020
Published online: December 27, 2020
ARTICLE HIGHLIGHTS
Research background

One of the main clinical complications of liver cirrhosis is protein-calorie malnutrition, the prevalence of which can vary from 10% to 100%, regardless of the stage and etiology of the disease, but which negatively interferes with the general prognosis of the disease. Therefore, determining the behavior of body composition (cellularity and hydration) using the bioelectrical impedance vector analysis (BIVA) method, seems to be a promising method for improving the health of patients with liver cirhosis, expanding their life expectancy and quality of life.

Research motivation

There are few studies on the assessment of body composition and functioning in cirrhotic patients, which directly impacts the overall clinical management of these patients. We believe that with the BIVA method we can gain a new tool for analyzing body homeostasis in this population.

Research objectives

The aim of this study was to evaluate the results of the BIVA regarding hydration and cellularity, and compare them with the phase angle and other clinical parameters in cirrhotic patients.

Research methods

This was a retrospective cross-sectional study with data collected between May 2007 and December 2015, at the Santa Casa de Misericórdia Hospital Complex in Porto Alegre, RS, Brazil. The data obtained were related to the protocol for routine pre- and postoperative care at the service’s outpatient clinic. Quantitative variables were described by the mean and standard deviation and the categorical variables by absolute and relative frequencies. One-way ANOVA was used to compare the means, complemented by Tukey’s test. In the comparison of proportions, the Chi-square test was applied along with the analysis of adjusted residuals. For control of confounding factors, the Poisson regression analysis was applied to the factors that presented a P < 0.10 in the bivariate analysis.

Research results

A total of 190 patients with cirrhosis undergoing outpatient follow-up were included for data collection. The BIVA method showed an association with the staging of cirrhosis, showing worsening of cellularity (integrity and functionality) and worsening of the hydroelectrolytic distribution in patients with greater disease severity.

Research conclusions

The BIVA method makes it possible to identify the cellularity and hydration status of cirrhotic patients, being associated with clinical factors that determine the severity of the disease, such as age, staging and PA.

Research perspectives

The BIVA method is a new tool for evaluating body composition in cirrhotic patients, especially in those with asymmetry, allowing an early and specific nutritional assessment in each case, and helps to improve the clinical condition of these patients.