Title: Phase Angle from Bia in Patients with Fanconi Anemia Undergoing Hematopoietic Stem Cell Transplantation
Abstract: Patients with Fanconi Anemia (FA) often have compromised nutritional status, especially low birth weight and short stature. Once the Hematopoietic Stem Cell Transplantation (HSCT) causes loss of appetite and increased energy expenditure, nutritional status of these patients may be further compromised. Knowing that the phase angle (PA) has been considered a prognostic and nutritional status indicator in several clinical situations, considering its use as an body cell mass estimate value, the aim of this study was to evaluate the PA in patients with FA undergoing HSCT and the association between PA and nutritional parameters. The nutritional status of 24 patients and 25 controls, aged from 5 to 16 years old, was assessed by bioelectric impedance analysis (BIA) and anthropometric measurements before patients started conditioning for HSCT and 30 and 180 days after HSCT. The PA was calculated (reactance/resistance) and expressed in degrees. Dietary intake was assessed by 24-hour recall. Of the 24 patients studied, 11 (45.8%) were male, with an average age 9.74 ± 3.2 years and mean PA of 5.8° ± 0.82. The patients had lower PA values than the control (5.8°± 0.16 versus 6.3°± 0.13, respectively, p = 0.02). Was observed a decrease of 17.3% in the value of AF 30 days after transplantation (p = 0.02). On the other hand, there was no reduction in mean BMI and FFM after transplantation (p>0.05). Lower values of AF were found in patients classified as malnourished according to weight / age (p = 0.007) as well as patients with weight loss 180 days after transplantation (p = 0.002). The PA was positively correlated with age (r = 0.660 p <0.001), protein intake (r = 0.663 p = 0.003), BMI (r = 0.762 p <0.001), Triceps skinfold thickness (r = 0.457 p = 0.02), Arm muscle circunference (r = 0.754 p<0,001) and Fat free mass (r = 0.694 p <0.001). The present study demonstrated that PA can be used as an indicator of nutritional status in children with AF undergoing HSCT.