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| Home > Publications database > Associations of the bioimpedance-derived phase angle with early and advanced stages of dysglycemia: Cross-sectional findings from a large population-based study. |
| Home > Publications database > Associations of the bioimpedance-derived phase angle with early and advanced stages of dysglycemia: Cross-sectional findings from a large population-based study. |
| Journal Article | DKFZ-2026-01907 |
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2026
Elsevier
Amsterdam [u.a.]
Abstract: Bioelectrical impedance analysis (BIA) has been widely applied for assessing body composition. The phase angle (PhA), a raw parameter derived from BIA, reflects body cell mass, cellular hydration, and cell membrane integrity. Although the PhA has been proposed as a potential marker for various aspects of diseases, its role in dysglycemia remains uncertain. We therefore aimed to investigate its associations with early and advanced stages of dysglycemia in a large population-based sample.This cross-sectional study used data from participants (19-74 years) enrolled at the baseline assessment (2014-2019) from a large population-based cohort. The whole-body PhA at 50 kHz was obtained from multi-frequency BIA. Two samples were analyzed. In the main sample (N = 178,097), the types of known diabetes (type 1, type 2, and a history of gestational diabetes vs. no diabetes) were ascertained. Among individuals with known type 2 diabetes, data on disease duration, current treatment, glycemic control (hemoglobin A1c levels), and diabetes-related microvascular complications were further analyzed. Additionally, in a random subsample without known diabetes (N = 16,153), oral glucose tolerance tests (OGTT) were performed to ascertain early stages of glucose dysregulation (prediabetes and newly detected diabetes vs. normoglycemia). Logistic regression was applied to assess sex-specific associations of the PhA with glucose dysregulation at different stages.In the main sample (mean age: 49.5 years; 50.1% men), 309 individuals (0.2%) reported having known type 1 diabetes, 8234 (4.6%) type 2 diabetes, and 1044 (1.2% of women) a history of gestational diabetes. In the OGTT subsample, 2662 participants (16.5%) had prediabetes and 534 (3.3%) had newly detected diabetes. A higher PhA (per 1°) was associated with a lower odds of known type 1 diabetes (relative risk ratio [RRR] and 95% confidence intervals [CIs], men: 0.33 [0.27, 0.40]; women: 0.39 [0.29, 0.52]) and known type 2 diabetes (RRR [95% CIs], men: 0.72 [0.69, 0.76]; women: 0.88 [0.81, 0.96]) after adjustment for age, lifestyle factors, obesity, and disease markers. Stronger inverse associations of the PhA with known type 2 diabetes were observed for those with longer disease duration (i.e., > 10 years), advanced-stage treatment (i.e., insulin only), poorer glycemic control (i.e., hemoglobin A1c ≥ 64 mmol/mol), or microvascular complications. Men showed stronger inverse associations with advanced dysglycemia than women (psex-interaction < 0.001). In contrast to the inverse associations observed for known type 1 and type 2 diabetes, the PhA showed positive associations with early dysglycemia. Specifically, a higher PhA (per 1°) was associated with a higher odds of a history of gestational diabetes (RRR [95% CIs]: women: 1.69 [1.51, 1.88]), prevalent prediabetes (RRR [95% CIs]: men: 1.45 [1.32, 1.59]; women: 1.34 [1.13, 1.58]) and newly detected diabetes (RRR [95% CIs]: men: 1.33 [1.11, 1.60]; women: 1.37 [1.05, 1.79]).The bioimpedance-derived PhA showed positive cross-sectional associations with early dysglycemia and inverse cross-sectional associations with advanced dysglycemia. The observed associations may partly reflect reverse causation and disease-related changes in body composition accompanying advanced dysglycemia. Longitudinal studies are warranted to assess temporal relationships between the PhA and dysglycemia.
Keyword(s): Bioelectrical impedance analysis ; Dysglycemia ; Oral glucose tolerance test ; Phase angle ; Population-based cohort study ; Prevalent diabetes
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