Hemoglobin, phase angle, and clinical and nutritional characteristics in patients with advanced chronic liver...

Patients with advanced chronic liver disease (ACLD) frequently exhibit hematological abnormalities such as anemia, which worsen the clinical course and increase morbidity and mortality. Bioelectrical impedance analysis, particularly the phase angle (PhA), has emerged as a promising, noninvasive tool for indirectly assessing cellular health, potentially correlating with serum hemoglobin (Hb) levels.

To evaluate the correlation between Hb levels, PhA, and clinical and nutritional characteristics in patients with ACLD and to establish clinically relevant cut-off points.

This cross-sectional study included ACLD patients attending the outpatient clinic of a university hospital in Brazil. Patients included in the study had a diagnosis of ACLD of any etiology, were aged 18 y or older, and spontaneously agreed to participate in the research by signing the Free and Informed Consent Form. Low Hb was defined according to World Health Organization criteria (≤13.0 g/dL for men and ≤12.0 g/dL for women). PhA was measured using tetrapolar, multisegmental portable bioelectrical impedance analysis. Predictive performance was assessed using receiver operating characteristic curves.

A total of 110 individuals (mean age 55.9 ± 12.8 y; 50.9% female) were evaluated. The mean PhA was 5.3° ± 0.9, with no significant sex differences (P = 0.466). Low PhA (≤5.25°) was observed in 49.1% of patients. Mean Hb was 12.89 ± 1.95 g/dL, with no sex differences (P = 0.668). Low Hb values were found in 46.4% of patients. Low Hb levels showed a significant associated with PhA ≤ 5.25° (sensitivity 60.8%, specificity 61.0%, Youden index 0.22).

This pioneering study identified a significant correlation between PhA and Hb levels in patients with ACLD. The clinical application of this marker can aid in the early identification of hematological impairment, serving as an indicator of cellular and nutritional compromise.