Gu Yue, Cheng Li-Tao, Chen Hui-Min, Sun Xiao-Yan, Tang Li-Jun, Guo Li-Juan, Axelsson Jonas, Wang Tao
Division of Nephrology, Peking University Third Hospital, Beijing, China.
Blood Purif. 2008;26(4):340-6. doi: 10.1159/000132465. Epub 2008 May 16.
Malnutrition is a predictor of cardiovascular disease in dialysis patients, but the mechanisms remain unknown. We investigated links between nutritional markers and arterial stiffness in continuous ambulatory peritoneal dialysis patients.
We evaluated the relationship between arterial stiffness evaluated by pulse-wave velocity (PWV) and four estimates of nutritional status (serum albumin, handgrip strength [HGS], subjective global assessment [SGA], and bioelectrical impedance analysis phase angle [PA]) in 124 PD patients.
Malnourished patients exhibited a significantly higher PWV than those classified as well-nourished by SGA (p < 0.05). Furthermore, PWV correlated negatively with albumin, HGS and PA (p < 0.001, respectively). PWV was also correlated with age, systolic blood pressure, and C-reactive protein. In multivariate regression analysis, albumin, HGS, SGA and PA were each independently associated with PWV after adjustment.
The significant association between each nutritional marker and PWV in PD patients was independent of inflammation and diabetic state, suggesting that malnutrition may contribute to vascular dysfunction.
营养不良是透析患者心血管疾病的一个预测指标,但其机制尚不清楚。我们研究了持续非卧床腹膜透析患者营养指标与动脉僵硬度之间的联系。
我们评估了124例腹膜透析患者中通过脉搏波速度(PWV)评估的动脉僵硬度与四种营养状况评估指标(血清白蛋白、握力[HGS]、主观全面评定[SGA]和生物电阻抗分析相角[PA])之间的关系。
营养不良患者的PWV显著高于SGA分类为营养良好的患者(p < 0.05)。此外,PWV与白蛋白、HGS和PA呈负相关(分别为p < 0.001)。PWV还与年龄、收缩压和C反应蛋白相关。在多变量回归分析中,调整后白蛋白、HGS、SGA和PA各自独立与PWV相关。
腹膜透析患者中各营养指标与PWV之间的显著关联独立于炎症和糖尿病状态,提示营养不良可能导致血管功能障碍。