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J Renal Nutr:肾功能减退对机体代谢率的影响有多大?

2021-11-05 MedSci原创 MedSci原创

肾小球滤过率较低时能量代谢的差异更可能是由年龄、身体成分和体力活动等因素造成的。

肾脏的主要功能是清除代谢废物,但慢性肾病(CKD)患者的代谢率尚不清楚。晚期CKD与肌肉质量低和营养不良有关,且常伴炎症。目前还不清楚CKD本身是否会改变代谢率,或者身体成分的变化是否与年龄和相关的共病有关。了解CKD代谢变化的机制可能有助于更好的营养建议和支持。

为此研究者使用双标记水技术和间接量热法,来确定肾小球滤过率降低是否与总能量消耗(TEE)和静息能量消耗(REE)的改变有关。

研究人员评估了80名CKD患者,其病程范围为1至5期,肾小球滤过率(eGFR)由(CKD-EPI)计算。TEE是使用双标记水同位素排泄超过14天(TEEDLW),REE是通过间接量热法(ReeIndirectal)和体力活动水平使用斯坦福7天回顾问卷进行测量的。

不同阶段CDK体重调节后的REEIndirectCal,每个栏中的数字代表每组的受试者。使用方差分析比较,两组之间没有显著差异

由实验结果可以看出eGFR与TEEDLW和ReeIndirectal无相关性,体重调整后的能量测量结果与之相似。eGFR<50 mL/min/1.73 m2 的患者和eGFR水平较高的患者TEEDLW和ReeIndirectal均显著降低。在体重调整后的能量测量方面也有类似的发现。在多变量分析中,年龄、性别和体重是TEEDLW和reeindirectical的独立预测因子。在这两种模型中,在这两种模型中,eGFR均不能预测TEE或REE。

 

不同CKD阶段体重调整后的TEEDLW。每个栏中的数字代表每组的受试者。使用方差分析比较,两组之间没有显著差异

因此可以得知肾功能减退与代谢率无直接关系。肾小球滤过率较低时能量代谢的差异更可能是由年龄、身体成分和体力活动等因素造成的。

参考文献:Enric Vilar, Sivakumar Sridharan, Jonathan Wong, Jocelyn Berdeprado, Ken Farrington,
Effect of Chronic Kidney Disease on Metabolic Rate: Studies Using Doubly Labelled Water, Journal of Renal Nutrition, Volume 31, Issue 5, 2021, Pages 475-483, ISSN 1051-2276, https://doi.org/10.1053/j.jrn.2020.08.010.

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    2022-04-22 yese
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    2022-06-04 jml2020
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    2021-11-05 xuna1110

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