Cemil SERT, Gökhan UNUTMAZ, Süda KORUK TEKİN

Determination of changes in the basal metabolic rate and body composition of patients with chronic active and inactive hepatitis B infection using bioelectrical impedance analysis

Amaç: Çalışmada, kronik inaktif ve aktif hepatit B enfeksiyonlu hastalarda tek frekans Biyoelektrik Empedans Analiz (BIA) yöntemiyle bazal metabolik hızın ve vücut kompozisyonunun değişiminin saptanması ve bu yöntemin bu grup hastaların takibinde uygulanabilirliğinin araştırılması amaçlandı. Yöntem ve gereç: Çalışmaya, kronik inaktif HBV enfeksiyonlu 20 hasta ve kronik aktif HBV enfeksiyonlu 22 hasta ile 43 sağlıklı kontrol kişi dahil edildi. BIA yöntemi ile her gruptaki katılımcıların, bazal metabolik hız (BMR), rezistans ve vücut kompozisyonları ölçüldü. Bulgular: Çalışmaya yaş ortalaması 35,1 ± 11,4 yıl olan toplam 85 kişi (31’i kadın ve 54’ü erkek) katıldı. Çalışma grupları yaş, boy ve vücut ağırlıkları açısından karşılaştırıldığında istatistiksel olarak farklılık yoktu (P > 0,05). Katılımcıların ortalama vücut kitle indeksi (VKİ) 26,55 kg/m² idi. Kronik inaktif hastalarda BMR düşük iken rezistans yüksek bulundu (ikisi için P < 0,05). Kronik inaktif hastalarda vücut yağ oranı daha yüksek olmakla beraber aradaki fark istatistiksel olarak anlamlı değildi (P > 0,05). BMR ile rezistans ve beden yağ indeksi arasında negatif yönde güçlü bir korelasyon bulundu (sırasıyla, rho = –0,804, P < 0,01; rho = –0,337, P < 0,01). BMR ile VKİ arasında pozitif yönde bir korelasyon vardı (rho = 0,408, P < 0.05). Gruplar VKİ, faz açısı ve diğer ölçülen vücut kompozisyonları açısından karşılaştırıldığında anlamlı bir farklılık görülmedi (P > 0,05). Sonuç: Sonuç olarak, çalışmamızın sonuçları bu grup hastalarda kullanılan tek frekans BİA yönteminin kronik hepatit B enfeksiyonu olan hastaların izleminde daha az yararlı olduğu düşünülmektedir.

Kronik aktif ve inaktif hepatit B enfeksiyonlu hastalarda biyoelektrik empedans analizi ile bazal metabolik hız ve vücut kompozisyonu değişimi

Aim: To examine changes in the basal metabolic rate and body composition of patients with chronic inactive and active hepatitis B (HBV) infection as measured using single frequency bioelectrical impedance analysis (BIA) and to investigate the convenience of this method for follow-up with these patients. Materials and methods: Twenty patients with chronic inactive HBV infection, 22 with chronic active HBV infection, and 43 healthy subjects were enrolled in the study. Using single frequency BIA and basal metabolic rate (BMR), the resistance and body composition of all participants were measured. Results: A total of 85 subjects (31 female and 54 male) with a mean age of 35.1 ± 11.4 years were enrolled. There was no significant difference between the groups in terms of mean age, height, or body weight (P > 0.05). The mean body mass index (BMI) of the participants was 26.55 kg/m². While the BMR was found to be lower, resistance was higher in patients in the inactive group (P < 0.05 for both). The body fat index was higher in the inactive group than in the active group, but the difference was not statistically significant (P > 0.05). A strong negative correlation was found between BMR and resistance, and the body fat index (rho = –0.804, P < 0.01; rho = –0.337, P < 0.01, respectively). There was a positive correlation between BMR and BMI (rho = 0.408, P < 0.05). There was no significant difference between the groups BMI, phase angle, and other body components (P > 0.05). Conclusion: This study suggests that single frequency BIA is less useful in the follow-up with the aforementioned group of patients.

PDF

___

1. Dienstag JL. Chronic Viral Hepatitis. Mandell GL, Bennett JE, Dolin R (eds). Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Churchill Livingstone; 2010. p. 1593-617.
2. Obesity and overweight. World Health Organization (WHO); 2005. www.who.int/mediacentre/factsheets/fs311/en/index. html.
3. Liew PL, Lee WJ, Lee YC, Wang HH, Wang W, Lin YC. Hepatic histopathology of morbid obesity: concurrence of other forms of chronic liver disease. Obes Surg 2006; 16: 1584-93.
4. Chen CL, Yang HI, Yang WS, Liu CJ, Chen PJ, You SL et al. Metabolic factors and risk of hepatocellular carcinoma by chronic hepatitis B/C infection: a follow-up study in Taiwan. Gastroenterology 2008; 135: 111-21.
5. Kendall MD, Harmel PA. The metabolic syndrome, type 2 diabetes and cardiovascular disease: Understanding the role of insulin resistance. Am J Manag Care 2002; 8: 635-53.
6. Liedtke RJ. Principles of bioelectrical impedance analysis. RJL Systems Publications, 1997. http://www.rjlsystems.com/ research/bia-principles.html.
8. WHO. Obesity: Preventing and managing the global epidemic. Report of a WHO consultation on obesity. Geneva, 3-5 June 1997. (Geneva: World Health Organisation, 1998; who/nut/ ncd/98: 1.)
9. Piccoli A. Identification of operational clues to dry weight prescription in hemodialysis using bioimpedance vector analysis. The Italian Hemodialysis-Bioelectrical Impedance Analysis (HD-BIA) Study Group. Kidney Int 1998; 53:1036-43.
10. Liedtke RJ. Fundamentals of bioelectrical impedance analysis. RJL Systems publications. 1998. http://www.rjlsysterns.com/ research/biafundamentals. html.
11. World Health Organization. Introduction of Hepatitis B Vaccine into Childhood Immunization Services. Geneva, WHO, 2001.
12. Hatemi H, Turan N, Arık N, Yumuk V. The obesity and hypertension results in Turkey (TOHTA). J Endocrinol Directions 2002; 11: 1-16 (in Turkish).
13. Yumuk VD. National prevalence of obesity prevalence of obesity in Turkey. Obesity Reviews 2005; 6: 9-10.
14. Sencer E. 2001. Endocrinology, Metabolism and Nutrition Disorders. 1st. Ed., Nobel Bookstores, İstanbul, 2001 (in Turkish).
15. Segal KR, Van Loan M, Fitzgerald PI, Hodgdon JA, Van Itallie TB. Lean body mass estimation by electrical impedance analysis. A four site cross validation study. Am J Clin Nutr 1988; 47: 7-14.
16. Cortez-Pinto H. Concluding remarks: metabolic syndrome, liver and HCV. Aliment Pharmacol Ther 2005; 22: 83-5.
17. Altiparmak E, Koklu S, Yalinkilic M, Yuksel O, Cicek B, Kayacetin E et al. Viral and host causes of fatty liver in chronic hepatitis B. World J Gastroenterol 2005; 11: 3056-9.
18. Guida B, Laccetti R, Gerardi C, Trio R, Perrino NR, Strazzullo P et al. Bioelectrical impedance analysis and age-related differences of body composition in the elderly. Nutr Metab Cardiovasc Dis 2007; 17: 175-80.
19. Barbosa-Silva MC, Barr os AJD, Wang J, Heymsfield SB, Pierson RN. Bioelectrical impedance analysis: population reference values for phase angle by age and sex. Am J Clin Nutr 2005; 82: 49-52.
20. Selberg O, Selberg D. Norms and correlates of bioimpedance phase angle in healthy human subjects, hospitalized patients, and patients with liver cirrhosis. Eur J Appl Physiol 2002; 86: 509-16.
21. Pirlich M, Schütz T, Spachos T, Ertl S, Weiss ML, Lochs H et al. Bioelectrical impedance analysis is a useful bedside technique to assess malnutrition in cirrhotic patients with and without ascites. Hepatology 2000; 32: 1208-15.
22. Panella C, Guglielmi FW, Mastronutti T, Francavilla A. Wholebody and segmental bioelectrical parameters in chronic liver disease: Effect of gender and disease stages. Hepatology 1995; 21: 352-8.
23. Antaki F, French MM, Moonka DK, Gordon SC. Bioelectrical impedance analysis for the evaluation of hepatic fibrosis in patients with chronic hepatitis C infection. Dig Dis Sci 2008; 53: 1957-60
24. Kahraman A, Hilsenbeck J, Nyga M, Ertle J, Wree A, Plauth M et al. Bioelectrical impedance analysis in clinical practice: implications for hepatitis C therapy BIA and hepatitis C. Virol J 2010; 7: 191.
25. Manns MP, Wedemeyer H, Cornberg M. Treating viral hepatitis C: efficacy, side effects, and complications. Gut 2006; 55: 1350-9.
26. Garrow JS, Webster J. Qutelet’s index (W/H2) as a measure of fatness. Int J Obes 1985; 9: 147-53.
27. Baumgartner RN, Chumlea C, Roche AF. Bioelectric impedance phase angle and body composition. Am J Clin Nutr 1988; 48: 16-23.
28. Oshima Y, Shiga T. Within-day variability of whole-body and segmental bioelectrical impedance in a standing position. Eur J Clin Nutr 2006; 60, 938-41.
29. Gallagher M, Walker KZ, O’Dea K. The influence of a breakfast meal on the assessment of body composition using bioelectrical impedance. Eur J Clin Nutr 1998; 52: 94-7.