{"id":6177,"date":"2020-08-18T16:45:37","date_gmt":"2020-08-18T14:45:37","guid":{"rendered":"https:\/\/aminogram.com\/bio-impedancemetrie\/pha-angle-de-phase-et-ir-ratio-dimpedance\/"},"modified":"2025-12-20T13:41:14","modified_gmt":"2025-12-20T12:41:14","slug":"pha-angle-de-phase-et-ir-ratio-dimpedance","status":"publish","type":"page","link":"https:\/\/aminogram.com\/en\/pha-angle-de-phase-et-ir-ratio-dimpedance\/","title":{"rendered":"PhA (Phase angle) and IR (Impedance ratio)"},"content":{"rendered":"\t\t
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In addition to body composition, bioimpedance analysis provides raw bioelectric values, including phase angle and impedance ratio, which are very useful in the day-to-day practice of healthcare professionals.<\/p>

Phase angle (PhA)<\/h4>

The phase angle (PhA) is a raw bioelectric value measured by bioimpedance analysis devices in two ways:<\/p>

  • directly as the difference between the voltage and the current curves (Fig. 1A).<\/li>
  • from the resistance (R) and reactance (Xc) by the calculation: arctan\"\"\u00a0(Fig 1B).<\/li><\/ul>\t\t\t\t\t\t\t\t<\/div>\n\t\t
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    A<\/h5>\t\t\t\t<\/div>\n\t\t\t\t
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    B<\/h5>\t\t\t\t<\/div>\n\t\t\t\t
    \n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t
    \n\t\t\t\t\t\t\t\t\tFigure 1 : Determination of phase angle by direct measurement (A) or from resistance and reactance (B). P\u00e9riode : Period ; Imp\u00e9dance : impedance; Angle de phase: phase angle; Donn\u00e9es brutes ; raw data ; Mod\u00e8le math\u00e9matique : mathematical model ; Centre de demi-cercle : half circle\u2019s center.\n\nThe resistance R is related to the tissue hydration, while the reactance Xc is linked to the integrity of the cell membrane, and these two parameters form the impedance Z. As a result, the value of PhA will be altered by physiological and pathological processes that can change the state of hydration and\/or the integrity of the cell membrane. (1). More specifically, high hydration values will be associated with a decrease in resistance and high reactance is related to excellent membrane integrity, which will be represented by a high PhA value. On the opposite, when hydration decreases and\/or cellular integrity is altered, PhA value decreases and can reach critical values, particularly in chronic pathologies.\n\nIndeed, inflammation, chronic pathology, malnutrition or an unbalanced lifestyle can alter the electrical properties of tissues and, as a result, cause a decrease in the phase angle (2). On the contrary, a higher PhA value suggests a high body cell mass with a large quantity of intact cell membranes, which is associated with an excellent health status (3).\n\nFrom a physiological point of view, PhA is dependent on sex, age, body mass index, nutritional status and the presence of pathological processes influencing hydration, nutrition or tissue conformation. (1). For example:\n
      \n \t
    • The PhA value is lower in women than in men, which can be explained by their lower cell mass, but this does not mean that they are in poorer health.<\/li>\n \t
    • Athletes who have built up a significant skeletal muscle mass will have higher PhA values than untrained individuals of the same sex.<\/li>\n \t
    • From the age of 60, PhA begins to decline progressively with cell ageing.<\/li>\n<\/ul>\nIn addition, PhA can be used as a prognostic biomarker of body composition in healthy adults (4) and cardiovascular risk in several populations (5\u20137). It is also used as a prognostic biomarker of survival in many chronic diseases:\n
        \n \t
      • Chronic degenerative diseases (8\u201310)<\/li>\n \t
      • overweight and obesity (11,12)<\/li>\n \t
      • chronic kidney disease (13)<\/li>\n \t
      • liver cirrhosis (14) as well as other liver diseases (15)<\/li>\n \t
      • cancer (16\u201318)<\/li>\n \t
      • systemic sclerosis (19)<\/li>\n \t
      • malnutrition (20,21)<\/li>\n \t
      • sarcopenia (22,23)<\/li>\n \t
      • rheumatoid arthritis (24)<\/li>\n \t
      • frailty in elders (25,26)<\/li>\n \t
      • ICU patients (27)<\/li>\n \t
      • as a screening tool for nutritional management in hospitals (28)<\/li>\n \t
      • anorexia nervosa (29)<\/li>\n \t
      • AIDS (30)<\/li>\n \t
      • Covid-19 (31)<\/li>\n \t
      • In children (32)<\/li>\n \t
      • In patients undergoing surgery (33)<\/li>\n<\/ul>\nIn healthy subjects and athletes, it has also been used as a prognostic biomarker of body cell mass (28), of muscle power (34) and strength (35), to evaluate the body composition of young athletes (36) or to measure sport performance (37).\n\nIn conclusion, the PhA is an interesting paramter for monitoring the health status of people over time, whether they are healthy or with a chronic pathology, but it is still necessary to know the reference values for the PhA. From the population data published by Bosy-Westphal et al. (38), reference values can be obtained listed in the tables below:\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
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        Biody XpertZM<\/sup> and Biody XpertZM<\/sup>II<\/h4>\t\t\t\t<\/div>\n\t\t\t\t
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        Men<\/p>
        IMC 18,5-25<\/th>Lower limit<\/th>Vulnerability state<\/th>Normal values<\/th><\/tr>
        18-29 ans<\/td>6,05<\/td>6,05 – 6,86<\/td>6,86 – 8,30<\/td><\/tr>
        30-59 ans<\/td>5,73<\/td>5,37 – 6,63<\/td>6,63 – 8,03<\/td><\/tr>
        \u2265 60 ans<\/td>4,30<\/td>4,30 – 5,53<\/td>5,53 – 7,17<\/td><\/tr><\/tbody><\/table>
        IMC 25-30\u00a0 \u00a0<\/th>Lower limit<\/th>Vulnerability state<\/th>Normal values<\/th><\/tr>
        18-29 ans<\/td>6,32<\/td>6,32 – 7,08<\/td>7,08 – 8,48<\/td><\/tr>
        30-59 ans<\/td>5,94<\/td>5,94 – 6,92<\/td>6,92 – 8,30<\/td><\/tr>
        \u2265 60 ans<\/td>4,77<\/td>4,77 – 5,86<\/td>5,86 – 7,36<\/td><\/tr><\/tbody><\/table>
        IMC >30 \u00a0 \u00a0 \u00a0 \u00a0<\/th>Lower limit<\/th>Vulnerability state<\/th>Normal values<\/th><\/tr>
        18-29 ans<\/td>6,07<\/td>6,07 – 7,01<\/td>7,01 – 8,43<\/td><\/tr>
        30-59 ans<\/td>6,19<\/td>6,19 – 6,91<\/td>6,91 – 8,35<\/td><\/tr>
        \u2265 60 ans<\/td>4,82<\/td>4,82 – 5,87<\/td>5,87 – 7,39<\/td><\/tr><\/tbody><\/table>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
        \n\t\t\t\t\t\t\t\t\t

        Women<\/p>
        IMC 18,5-25<\/th>Lower limit<\/th>Vulnerability state<\/th>Normal values<\/th><\/tr>
        18-29 ans<\/td>4,73<\/td>4,73 – 5,80<\/td>5,80 – 7,16<\/td><\/tr>
        30-59 ans<\/td>5,14<\/td>5,14 – 5,96<\/td>5,96 – 7,30<\/td><\/tr>
        \u2265 60 ans<\/td>4,23<\/td>4,23 – 5,28<\/td>5,28 – 6,84<\/td><\/tr><\/tbody><\/table>
        IMC 25-30\u00a0 \u00a0<\/th>Lower limit<\/th>Vulnerability state<\/th>Normal values<\/th><\/tr>
        18-29 ans<\/td>5,33<\/td>5,33 – 6,03<\/td>6,03 – 7,39<\/td><\/tr>
        30-59 ans<\/td>5,29<\/td>5,29 – 6,12<\/td>6,12 – 7,46<\/td><\/tr>
        \u2265 60 ans<\/td>4,47<\/td>4,47 – 5,43<\/td>5,43 – 6,87<\/td><\/tr><\/tbody><\/table>
        IMC >30 \u00a0 \u00a0 \u00a0 \u00a0<\/th>Lower limit<\/th>Vulnerability state<\/th>Normal values<\/th><\/tr>
        18-29 ans<\/td>5,41<\/td>5,41 – 6,12<\/td>6,12 – 7,48<\/td><\/tr>
        30-59 ans<\/td>5,45<\/td>5,45 – 6,21<\/td>6,21 – 7,55<\/td><\/tr>
        \u2265 60 ans<\/td>4,51<\/td>4,51 – 5,45<\/td>5,45 – 6,91<\/td><\/tr><\/tbody><\/table>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
        \n\t\t\t\t\t

        Impedance ratio<\/h4>\t\t\t\t<\/div>\n\t\t\t\t
        \n\t\t\t\t\t\t\t\t\t

        The impedance ratio is defined as the ratio of the impedance measured at 200 kHz (Z200) to the one measured at 5 kHz (Z5). These frequencies were chosen because of the particular characteristics of the cell membrane. Currents with frequencies below 7 kHz are not capable of crossing the cell membrane and therefore of penetrating the intracellular space, so these currents are only sensitive to the composition of the extracellular compartment. On the opposite, at 200 kHz, the current is able to cross the cell membrane and will therefore be sensitive to the composition of the body as a whole.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

        \n\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t\"\"\t\t\t\t\t\t\t\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t
        \n\t\t\t\t\t\t\t\t\t

        Figure 2 :<\/em> <\/span>Diagram showing current propagation as a function of frequency within the cell space (Extracted from Moonen et al. 2021, DOI: 10.1097\/MCC.0000000000000840)<\/p>

        This specificity means that the impedance ratio is sensitive to the distribution of water between the intra- and extracellular compartment, particularly in situation like inflammation. Inflammation is associated with a degradation of the cell membrane, resulting in a transfer of intracellular water to the interstitial space, which will modify the impedance at 200 and 5 kHz. More precisely, as the cell is less hydrated, the impedance at 200 kHz will increase, whereas as the extracellular space is more hydrated, the impedance at 5 kHz will decrease. Mathematically, the impedance ratio will therefore be higher when the individual is in an inflammatory state, which has been verified by the positive correlation between this parameter and CRP, a biomarker of inflammation. (39).<\/p>

        There are currently no published reference values for this parameter in the scientific literature, but empirically it seems that above 0.80 for men and 0.82 for women, there is a low-grade inflammatory state in the individual. If the inflammatory state worsens, the impedance ratio will increase, while conversely, if the inflammation subsides, the impedance ratio will decrease. Generally, the normal values are:<\/p>

        • Between 0.75 and 0.80 in men, but lower values can be found in sporty individuals.<\/li>
        • Between 0.77 and 0.82 in women, but lower values can also be observed in sportswomen.<\/li><\/ul>

          Interestingly, there is a significant inverse relationship between phase angle and impedance ratio, so when an individual is in good health, their phase angle will be high and their impedance ratio low. On the opposite, when an individual’s health status deteriorates, the value of the phase angle will decrease and that of the impedance ratio will increase, generally caused by an increase in oxidative stress and inflammation. Conversely, when the patient’s health status improves, the phase angle and impedance ratio will return to their normal values. They are therefore two parameters of interest for monitoring an individual’s health status.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

          \n\t\t\t\t\t

          Conclusion<\/h4>\t\t\t\t<\/div>\n\t\t\t\t
          \n\t\t\t\t\t\t\t\t\t

          Phase angle and impedance ratio are two raw bioimpedancemetry values linked to membrane integrity and inflammatory state, respectively. Their main benefit is therefore that they can be used to monitor the general health status of individuals quickly, economically, and non-invasively, both for prevention or management of chronic pathologies and for athletes during training.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t

          \n\t\t\t\t\t

          References<\/h4>\t\t\t\t<\/div>\n\t\t\t\t
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          38. Bosy-Westphal A, Danielzik S, D\u00f6rh\u00f6fer RP, Later W, Wiese S, M\u00fcller MJ. Phase Angle From Bioelectrical Impedance Analysis: Population Reference Values by Age, Sex, and Body Mass Index. Journal of Parenteral and Enteral Nutrition. 2006;30(4):309\u201116.<\/li>
          39. Demirci C, A\u015fc\u0131 G, Demirci MS, \u00d6zkahya M, T\u00f6z H, Duman S, et al. Impedance ratio: a novel marker and a powerful predictor of mortality in hemodialysis patients. Int Urol Nephrol. juill 2016;48(7):1155\u201162.<\/li><\/ol>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t
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