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Clin Nutrition: 腹膜透析患者身体组成的纵向变化与全因死亡率相关

2021-01-19 MedSci原创 MedSci原创

腹膜透析(PD)与许多不良的身体成分变化有关,包括脂肪增加和肌肉消失。身体成分的变化是否与长期预后有关尚不确定。本项研究的目的是分析身体组成的纵向变化对PD患者全因死亡率的影响。

背景与目标

腹膜透析(PD)与许多不良的身体成分变化有关,包括脂肪增加和肌肉消失。身体成分的变化是否与长期预后有关尚不确定。本项研究的目的是分析身体组成的纵向变化对PD患者全因死亡率的影响。

 

 

方法

PD患者在基线时和2年后接受生物阻抗测试(BIS)和握力(HGS)测试。在160名患者中,有131名患者接受了重复的BIS和HGS测试。瘦组织指数(LTI)的损失和脂肪组织指数(FTI)的增加分别定义为2年后LTI下降10%,FTI增加10%。然后研究人员对所有患者2年来的身体成分变化进行了研究。

 

 

结果

研究结果显示:患者在基线时存在肌肉减少症的患病率为13.8%。两年后,分别在40(30.5%)和58(44.3%)的患者中观察到LTI丧失和FTI的增加。基线临床因素不能预测身体纵向组成的变化,LTI和FTI的变化之间呈负相关(r = -0.574, p <0.001)。在调整了人口统计学和生化参数之后,基线时的低LTI和低HGS是全因死亡率的重要预测指标,但是当多因素分析中包括血管因素时,则不是。但是,在调整了人口统计,生化和心血管参数后,LTI丢失和FTI增益是全因死亡率的独立危险因素。

 

 

 

结论

在PD患者中,LTI和FTI的纵向变化与全因死亡率存在相关,瘦肉组织的损失和脂肪组织的增加会明显增加患者的死亡率。

 

 

原始出处 :

Cheolsu Kim. Et al. Longitudinal changes in body composition are associated with all-cause mortality in patients on peritoneal dialysis. Clinical Nutrition.2021.

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