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World J Gastroenterol. Nov 14, 2026; 32(42): 121556
Published online Nov 14, 2026. doi: 10.3748/wjg.121556
Phase angle as a predictor of malnutrition, sarcopenia, and adverse clinical outcomes in hospitalized patients with ulcerative colitis
Hong-Ying Wang, Ren-Juan Liu, Yue-Yuan Wang, Dan-Dan Wang, Hao Zhang, Li-Jun Zhang, Xue Jing, Ying-Jie Guo, Han-Qing Li, Ai-Ling Liu, Xue-Li Ding
Hong-Ying Wang, Yue-Yuan Wang, Hao Zhang, Xue Jing, Ying-Jie Guo, Ai-Ling Liu, Xue-Li Ding, Department of Gastroenterology, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Ren-Juan Liu, Department of Gastroenterology, Weifang Yidu Central Hospital, Weifang 262500, Shandong Province, China
Dan-Dan Wang, Department of Clinical Nutrition, The Affiliated Hospital of Qingdao University, Qingdao 266003, Shandong Province, China
Li-Jun Zhang, Department of Population and Quantitative Health Sciences, School of Medicine, Case Western Reserve University, Cleveland, OH 44106, United States
Han-Qing Li, Department of Gastroenterology, Qingdao Chengyang District People’s Hospital, Qingdao 266107, Shandong Province, China
Co-first authors: Hong-Ying Wang and Ren-Juan Liu.
Co-corresponding authors: Ai-Ling Liu and Xue-Li Ding.
Author contributions: Wang HY, Liu RJ, Jing X, Liu AL, and Ding XL participated in the conception and design of the study; Wang YY and Wang DD provided the research materials and patients; Wang HY, Liu RJ, Li HQ, Guo YJ, and Zhang H were involved in the collection, analysis or interpretation of the data; Wang HY and Liu RJ wrote the manuscript as co-first authors; Zhang LJ performed the statistical review and validation of the data analysis; Liu AL and Ding XL contributed equally as co-corresponding authors. All authors have read and approve the final manuscript.
AI contribution statement: AI tools (ChatGPT and DeepSeek) were used solely for linguistic refinement and formatting assistance. No AI tool was involved in the generation of research data, interpretation of results, or formulation of conclusions. All AI-generated outputs were critically reviewed and revised by the authors.
Supported by Beijing New Journey Foundation, No. 5503; and Clinical Medicine + X Research Project of the Affiliated Hospital of Qingdao University in 2024, No. QDFY+X2024212.
Institutional review board statement: This work was approved by the Ethics Committee of the Affiliated Hospital of Qingdao University, No. QYFY WZLL 42205.
Clinical trial registration statement: This study is a purely observational study without any health-related interventions, and therefore, trial registration was not required.
Informed consent statement: All participants offered informed written consent before enrollment.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CONSORT 2010 statement: The authors have read the CONSORT 2010 Statement, and the manuscript was prepared and revised according to the CONSORT 2010 Statement.
Data sharing statement: All data are available from the corresponding author on reasonable request.
Corresponding author: Xue-Li Ding, MD, Department of Gastroenterology, The Affiliated Hospital of Qingdao University, No. 16 Jiangsu Road, Qingdao 266003, Shandong Province, China.
dingxueli@qdu.edu.cn
Received: March 30, 2026
Revised: May 1, 2026
Accepted: June 24, 2026
Published online: November 14, 2026
Processing time: 178 Days and 13.4 Hours
BACKGROUND
Malnutrition and sarcopenia are underrecognized yet clinically consequential comorbidities in hospitalized patients with ulcerative colitis (UC), each independently associated with poor clinical outcomes.
AIM
To evaluate phase angle (PhA) as a predictor of nutritional status, sarcopenia, and clinical outcomes in hospitalized patients with UC.
METHODS
This study prospectively enrolled 122 hospitalized patients with UC. PhA was measured by bioelectrical impedance analysis; nutritional status and sarcopenia were evaluated using the Global Leadership Initiative on Malnutrition criteria and the Asian Working Group for Sarcopenia 2019 criteria, respectively. Sex-specific PhA cut-off values for malnutrition and sarcopenia were derived from receiver operating characteristic curve analysis, and clinical outcomes were assessed at 12 and 54 weeks.
RESULTS
Mean PhA was 4.59° ± 0.97° in females and 5.55° ± 0.90° in males. Lower PhA was significantly associated with higher rates of malnutrition and sarcopenia (P < 0.001 for all) and correlated negatively with Global Leadership Initiative on Malnutrition grades (r = -0.578, P < 0.001) and Asian Working Group for Sarcopenia 2019 grades (r = -0.532,P < 0.001). On multivariate analysis, PhA independently predicted both conditions; optimal sex-specific cut-off values were 4.57° and 4.21° in females and 5.47° and 4.53° in males for malnutrition and sarcopenia, respectively. A combined PhA and prealbumin model achieved an area under the curve of 0.922 for sarcopenia detection. At 12 and 54 weeks, low PhA was associated with significantly worse clinical outcomes (P < 0.05).
CONCLUSION
PhA provides an objective, integrated assessment of nutritional status, sarcopenia, and clinical prognosis in hospitalized patients with UC and, in combination with prealbumin, achieves high predictive accuracy for sarcopenia.
Core Tip: Among hospitalized patients with ulcerative colitis, lower phase angle (PhA) values, derived from bioelectrical impedance analysis, were independently associated with greater prevalence of malnutrition and sarcopenia and with worsened disease outcomes. Sex-specific PhA cut-off values were established for identifying both conditions. Collectively, these findings position PhA as a practical, objective, and reliable clinical marker for nutritional and functional assessment in ulcerative colitis patient management.
