Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
Artif Intell Gastroenterol. Aug 28, 2021; 2(4): 111-123
Published online Aug 28, 2021. doi: 10.35712/aig.v2.i4.111
Phase angle through electrical bioimpedance as a predictor of cellularity in inflammatory bowel disease
Sabrina A Fernandes, Carina Rossoni, Vivian W Koch, Marcello Imbrizi, Rosana Evangelista-Poderoso, Letícia Pereira Pinto, Daniéla Oliveira Magro
Sabrina A Fernandes, Letícia Pereira Pinto, Postgraduate Program in Hepatology, Federal University of Health Sciences of Porto Alegre (UFCSPA), Porto Alegre 90050-170, Brazil
Carina Rossoni, Institute of Environmental Health (ISAMB), Faculty of Medicine, University of Lisbon, Lisbon 1649-028, Portugal
Vivian W Koch, Gastroenterology Department, Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 90020-090, Brazil
Vivian W Koch, Gastroenterology Department, Grupo Hospitalar Conceição, Porto Alegre 91350-250, Brazil
Marcello Imbrizi, Coloproctology Department, State University of Campinas (UNICAMP-SP), São Paulo 13056-405, Brazil
Rosana Evangelista-Poderoso, Library Faculty of Medical Sciences, State University of Campinas (UNICAMP-SP), São Paulo 13083-887, Brazil
Daniéla Oliveira Magro, Department of Surgery, State University of Campinas (UNICAMP-SP) and Faculty of Medical Sciences (FCM), São Paulo 13056-405, Brazil
Author contributions: All authors contributed to the writing of the article and review of the scientific article; Fernandes SA organized the structure of the article regarding the order of the subheadings covered; Fernandes SA and Pinto LP wrote the introduction; Fernandes SA wrote the conclusion.
Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.
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:
Corresponding author: Sabrina A Fernandes, PhD, Senior Researcher, Postgraduate Program in Hepatology, Federal University of Health Sciences of Porto Alegre (UFCSPA), R. Sarmento Leite, 245 - Centro Histórico, Porto Alegre 90050-170, Brazil.
Received: May 28, 2021
Peer-review started: May 28, 2021
First decision: June 16, 2021
Revised: June 19, 2021
Accepted: July 26, 2021
Article in press: July 26, 2021
Published online: August 28, 2021

It is estimated in Western industrialized countries that inflammatory bowel disease (IBD) has a prevalence of 1 for every 200 inhabitants. In the past, the fat mass disproportionate increase in relation to the fat-free mass was considered uncommon in patients with IBD, due to the observation of the disease being more common with weight loss and malnutrition. However, more in-depth investigations demonstrate that the fat/lean mass disproportion stands out both in prevalence in patients with new diagnoses of ulcerative colitis or Crohn's disease as well as a factor of poor prognosis to the natural evolution of the disease or to the therapeutic response. Another important aspect associated with obesity in IBD is the increased risk of drug clearance [including anti-tumor necrosis factor (TNF) and anti-integrin agents], resulting in short half-life and low trough drug concentrations, since the levels of TNF secreted by adipocytes sequester anti-TNF agents, which could result in suboptimal response to biologics. In view of these characteristic aspects of the inflammatory process of IBD, the identification of cellular functioning is necessary, which can be associated with the staging of the underlying disease, biochemical parameters, and body composition, helping as an indicator for a more accurate clinical and nutritional conduct.

Keywords: Inflammatory bowel disease, Crohn's disease, Ulcerative colitis, Phase angle, Cellularity, Bioelectrical impedance

Core Tip: Inflammatory bowel disease (IBD) patients have a severe inflammatory process that negatively reflects their absorption of vitamins and minerals, resulting in poor nutritional status. Even though it has already been described that these patients need a greater supply of calories and proteins, how will we know if the cells of this patient will be able to metabolize and absorb these nutrients to avoid worsening their nutritional status by overfeeding? Having a tool that serves as a guide for cellular functionality and integrity, such as the phase angle through electrical bioimpedance, is of great relevance in the clinical and nutritional management of patients with IBD.