Abstract Background Ulcerative Colitis (UC) presents with inflammatory, nutritional, and metabolic alterations. Patients with UC show significant modifications in lipid profiles associated with clinical severity, including reductions in total cholesterol, HDL-C, and LDL-C, with diagnostic utility when combined with erythrocyte sedimentation rate (ESR) for identifying severe UC1. Metabolic syndrome and systemic inflammatory activation are also linked to increased disease severity and immunometabolic dysfunction2. Similarly, insulin resistance rises during severe UC flares, with significant elevations in HOMA-IR3. Phase angle (PA) is an indicator of cellular integrity and meta-inflammation, and has been associated with metabolic inflammation, elevated CRP, and cardiometabolic abnormalities4. In UC, PA has been reported to be lower than in healthy controls5. However, it remains unknown whether PA identifies a combined inflammatory–nutritional–metabolic phenotype in UC. Methods Cross-sectional study including 26 adults with UC. PA was classified according to sex-specific cut-offs: 6.1° in men and 5.6° in women5. Biomarkers assessed included inflammatory (CRP, ESR, PLR, CRP/ALB), nutritional (BMI, hemoglobin, albumin), and metabolic parameters (triglycerides, HDL, LDL, TG/HDL, HOMA-IR). Comparisons were performed using Mann–Whitney U tests; correlations with Spearman’s rho (SPSS v27). Results Fifty percent of participants showed low PA. Compared with the normal-PA group, patients with low PA had significantly lower BMI (20.98 vs 27.74 kg/m²; p = 0.022) and hemoglobin (13.85 vs 14.90 g/dL; p = 0.033). They also exhibited markedly reduced triglycerides (76 vs 138 mg/dL; p = 0.002) and TG/HDL ratio (1.55 vs 3.22; p = 0.002). No significant differences were observed in CRP, ESR, albumin, PLR, CRP/ALB, or HOMA-IR. PA correlated positively with hemoglobin (rs = 0.599, p = 0.001), triglycerides (rs = 0.466, p = 0.017), and TG/HDL ratio (rs = 0.567, p = 0.003), and negatively with HDL (rs = −0.392, p = 0.047). Conclusion Low PA in UC is primarily associated with a nutritional-metabolic phenotype characterized by lower BMI, lower hemoglobin, and a less atherogenic lipid profile (lower TG and TG/HDL), without differences in classical inflammatory biomarkers. These findings suggest that PA may reflect the nutritional–metabolic axis rather than systemic inflammation in UC. Larger studies with disease-activity stratification are needed to determine its value for identifying metabolic and inflammatory phenotypes within UC. References: 1. Zhu L, Tian L, Li S, Huo L. Blood Lipid Levels and Their Value as Markers of Disease Activity in Severe Ulcerative Colitis. International Journal of General Medicine. 2025;18:671-80. 2. Jovanovic M, Jurišević M, Gajović N, Arsenijević N, Jocić M, Jovanovic I, et al. Increased Severity of Ulcerative Colitis in the Terminal Phase of the Metabolic Syndrome. The Tohoku journal of experimental medicine. 2021;254 3:171-82. 3. Redsted M, Grønhøj M, Brøchner LD, Fassov J, Svart M, Andersen J, et al. Metabolic stress in patients with acute severe ulcerative colitis - a single-center cohort study. Frontiers in Endocrinology. 2024;15. 4. Barrea L, Muscogiuri G, Pugliese G, Laudisio D, De Alteriis G, Graziadio C, et al. Phase Angle as an Easy Diagnostic Tool of Meta-Inflammation for the Nutritionist. Nutrients. 2021;13. 5. Mendoza-Martinez VM, Banos-Vazquez R, Melendez-Mier G, Carrillo-Rojas JI, Santoyo-Chavez MA, Ontiveros-Lopez S, et al. Phase Angle (PhA) Is an Easy and Complementary Tool for Assessing Nutritional Status in Ulcerative Colitis (UC) Patients: A Cross-Sectional Study. Life (Basel). 2024;14(11). Conflict of interest: Mrs. Rivera, Ernestina: No conflict of interest Mendoza Martinez, Viridiana Montsserrat: No conflict of interest Baños Vazquez, Roberto: No conflict of interest Santoyo Chávez, Martha Alison: No conflict of interest De Leon Rendon, Jorge Luis: No conflict of interest Bueno Hernández, Nallely: No conflict of interest
Rivera et al. (Thu,) studied this question.