Stress and inflammatory biomarkers and symptoms are associated with bioimpedance measures

Eur J Clin Invest. 2015 Feb;45(2):126-34. doi: 10.1111/eci.12388. Epub 2015 Jan 12.


Background: This large cross-sectional, multi-centre study evaluated the association of body composition measurements by a novel dual frequency bioimpedance device (BIA-ACC) with chronic stress/inflammation biomarkers and the presence of medically unexplained symptoms (MUS).

Materials and methods: Participants were adult Caucasians of both sexes and included 10,416 lean subjects with no MUS (Group A), 58,710 lean subjects with MUS (Group B) and 30,445 overweight/obese subjects with no MUS and excessive fat mass (FM) (Group C).

Results: Total body extracellular water (ECW) was higher, while intracellular water (ICW) was lower in Group B than both other groups (P < 0.01). Group A had significantly lower FM and higher skeletal mass (SK) and phase angle (PA) than Group B and lower circulating high sensitivity (hs) CRP levels than both other groups. hsCRP was higher in Group C than Group A though (P < 0.01). Salivary cortisol in Group B was lower in the morning and higher in the evening than both other groups (P < 0.001), indicating circadian rhythm obliteration or reversal in this group. ECW correlated positively with serum hsCRP and 8 p.m. salivary cortisol, but negatively with 8 a.m. salivary cortisol, while PA correlated positively with 8 a.m. and negatively with 8 p.m. salivary cortisol and serum hsCRP. Both 8 a.m. and 8 p.m. salivary cortisol and serum hsCRP were associated with the presence of MUS and BIA-ACC measurements, including ECW, ICW, FM, SK and PA.

Conclusions: MUS is an index of chronic stress and inflammation and BIA-ACC may provide a useful, bloodless and rapid tool in the clinical setting, distinguishing patients with chronic stress/inflammation from healthy subjects and monitoring their response to treatment.

Keywords: Bioimpedance; Inflammation; Medically Unexplained Symptoms; Stress.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers / metabolism
  • Body Composition / physiology*
  • Cross-Sectional Studies
  • Electric Impedance
  • Female
  • Humans
  • Hydrocortisone / metabolism
  • Inflammation / metabolism
  • Inflammation / psychology*
  • Male
  • Middle Aged
  • Psychophysiologic Disorders / metabolism
  • Psychophysiologic Disorders / psychology*
  • Saliva / chemistry
  • Stress, Psychological / etiology*
  • Stress, Psychological / metabolism
  • Young Adult


  • Biomarkers
  • Hydrocortisone