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AJKD:上臂中部周径(MAC)下降与血液透析(HD)患者的全因死亡率和心血管事件明显相关

2013-07-20 MedSci MedSci原创

一项Hemodialysis(HEMO)研究发现,上臂中部周径(MAC)下降与血液透析(HD)患者的全因死亡率和心血管事件明显相关,这种相关性在体重指数(BMI)低的患者中更加显著(BMI≤25)。该研究由新墨西哥大学Mark L. Unruh和同事完成,已在线发表于American Journal of Kidney Diseases研究概述研究共纳入1846名HD患者,观察两项营养状态指标——

一项Hemodialysis(HEMO)研究发现,上臂中部周径(MAC)下降与血液透析(HD)患者的全因死亡率和心血管事件明显相关,这种相关性在体重指数(BMI)低的患者中更加显著(BMI≤25)。该研究由新墨西哥大学Mark L. Unruh和同事完成,已在线发表于American Journal of Kidney Diseases

研究概述

研究共纳入1846名HD患者,观察两项营养状态指标——MAC和皮褶厚度的变化与全因死亡率、心血管事件死亡、住院及感染相关死亡的关联。

该研究中位随访时间为2.5年,期间发生死亡845例患者MAC和皮褶厚度下降分为0.26厘米和1.1毫米/年。
BMI低的患者中,每年MAC下降1cm将导致HD患者全因死亡率增加2.4倍;在BMI>25的患者中,二者无明显相关性。不管BMI高低,每年MAC下降1cm可导致心血管死亡和住院分别增加54%和47%。在BMI低的患者中,感染相关死亡增加5倍。在BMI低的患者中,皮褶厚度每降低1mm,全因死亡率增加22%,感染相关死亡增加83%。

研究者指出,高 BMI在透析患者被认为是一个生存的保护性指标,这曾被称为“肥胖悖论”。营养状况不良与透析患者生存率有关。BMI≤25的患者,肌肉含量和身体脂肪的下降可能会影响死亡风险;而在超重或肥胖的HD患者中,没有观察到上述关系。

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    2013-08-15 yb6560
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    2013-07-21 habb

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