Bioelectrical Impedance Phase Angle and its Relationship with Anthropometric and Body Composition Parameters in Hospitalized Children with Severe Acute Malnutrition: A Longitudinal Follow-up Study.

Of 141 enrolled children with SAM, 136 were successfully discharged and 106 (75.2%) completed nutritional rehabilitation and 11-week follow-up.

• Study population: hospitalized children aged 12-59 months with SAM treated at a Nutrition Rehabilitation Centre
• Longitudinal observational follow-up study design with assessments at admission, discharge, and 11-weeks post-discharge
• Median (q1, q3) hospital stay was 10 (6, 14) days
• Mean (SD) daily weight gain was 3.50 (-1.8) g/kg/day during hospitalization

Lower Phase Angle values were observed in children aged 24-59 months, those with edema, and those from low-income households.

• Age group 24-59 months was associated with lower PhA compared to 12-23 months
• Presence of edema was associated with lower PhA values
• Socioeconomic status (low-income households) was associated with lower PhA
• PhA reflects cellular health as measured by bioelectrical impedance analysis

Phase Angle positively correlated with weight-for-height Z-score and body-cell-mass-index, and negatively with extracellular water.

• Higher WHZ scores were associated with higher PhA values
• Higher body-cell-mass-index was associated with higher PhA values
• Higher extracellular water was associated with lower PhA values
• These correlations suggest PhA reflects both nutritional status and cellular integrity in SAM children

There was no significant difference in Phase Angle at baseline or follow-up between children who achieved complete cure, partial cure, or remained SAM.

• Complete cure was achieved in 30.2% of children
• Partial cure was achieved in 51.9% of children
• 17.9% of children remained SAM at follow-up
• PhA did not significantly differentiate between these three nutritional outcome groups at either baseline or 11-week follow-up

A multivariable linear regression model identified age 12-23 months, higher WHZ, and lower BMI-Z score as independent predictors of higher Phase Angle.

• The multivariable linear regression model had an R² = 0.234, explaining 23.4% of variance in PhA
• Children aged 12-23 months had significantly higher PhA (P = 0.019) compared to older children
• Higher weight-for-height Z-score was independently associated with higher PhA (P = 0.036)
• Lower BMI-Z score was independently associated with higher PhA (P = 0.018)