Division of Nephrology, Department of Medicine, Tufts Medical Center, Boston, Massachusetts 02111, USA.
Kidney Int. 2010 Apr;77(7):624-9. doi: 10.1038/ki.2009.524. Epub 2010 Jan 13.
A higher body mass index is associated with better outcomes in hemodialysis patients; however, this index does not differentiate between fat and muscle mass. In order to clarify this, we examined the relationship between measures of fat and muscle mass and mortality in 1709 patients from the Hemodialysis Study. Triceps skin-fold thickness was used to assess body fat and mid-arm muscle circumference was used to assess muscle mass. Cox regression was used to evaluate the relationship between measures of body composition with all-cause mortality after adjustments for demographic, cardiovascular, dialysis, and nutrition-related risk factors. During a median follow-up of 2.5 years, there were 802 deaths. In adjusted models with continuous covariates, higher triceps skin-fold thickness and higher body mass index were significantly associated with decreased hazards of mortality, while higher mid-arm muscle circumference showed a trend toward decreased mortality. In adjusted models, lower quartiles of triceps skin-fold thickness, mid-arm muscle circumference, and body mass index were all significantly associated with higher all-cause mortality. These studies show that body composition in end-stage renal disease bears a complex relationship to all-cause mortality.
更高的体重指数与血液透析患者的更好结局相关；然而，该指数不能区分脂肪和肌肉量。为了阐明这一点，我们检查了 1709 名血液透析研究患者的脂肪和肌肉量测量值与死亡率之间的关系。三头肌皮褶厚度用于评估体脂，上臂中部肌肉周长用于评估肌肉量。Cox 回归用于评估在调整人口统计学、心血管、透析和营养相关危险因素后，身体成分测量值与全因死亡率之间的关系。在中位数为 2.5 年的随访期间，有 802 人死亡。在包含连续协变量的调整模型中，较高的三头肌皮褶厚度和较高的体重指数与死亡率降低显著相关，而较高的上臂中部肌肉周长则显示出死亡率降低的趋势。在调整模型中，较低的四分位数的三头肌皮褶厚度、上臂中部肌肉周长和体重指数都与全因死亡率升高显著相关。这些研究表明，终末期肾病的身体成分与全因死亡率之间存在复杂的关系。
