Nutrition Program, Federal University of São Paulo, São Paulo, Brazil.
Nephrol Dial Transplant. 2012 Feb;27(2):790-5. doi: 10.1093/ndt/gfr361. Epub 2011 Sep 23.
Waist circumference (WC) has been well recognized as a surrogate marker of abdominal adiposity. In peritoneal dialysis (PD) patients, however, aspects related to this dialysis modality, such as abdominal distension, presence of catheter and frequent hernia, raise questions regarding the reliability of WC measurements. Herein, we investigated for the first time whether WC is a reliable marker of abdominal adiposity in PD population.
This study included 107 prevalent PD patients [56% male, age 52 ± 17 years, 35% diabetics, body mass index (BMI) 24.8 ± 3.9 kg/m(2)]. WC measured at umbilicus level was evaluated against the trunk fat assessed by dual-energy x-ray absorptiometry at baseline and after 6 months. All measurements were taken with the empty abdominal cavity.
At baseline, a strong correlation of WC with trunk fat (r = 0.81; P < 0.001) was observed. Adjusting for gender, age, dialysis vintage and BMI, WC was independently associated with trunk fat (β = 0.30; P < 0.001; R(2) = 0.77). The agreement between WC and trunk fat was 0.59 (kappa statistic) and the area under the curve was 0.90. In the prospective evaluation, we observed that changes in WC correlated with changes in trunk fat as well (r = 0.49; P < 0.001). The kappa statistic of 0.48 remained indicative of a moderate agreement between the methods. The receiver operating characteristic curve analysis showed that WC was sensitive to detect changes in trunk fat (area under the curve 0.76). In the logistic regression analysis adjusting for gender, age and BMI, changes in WC were independently associated with changes in trunk fat.
The simple anthropometric method of WC is a reliable marker of abdominal adiposity in PD patients.
腰围（WC）已被广泛认为是腹部肥胖的替代标志物。然而，在腹膜透析（PD）患者中，与这种透析方式相关的方面，如腹部膨胀、导管存在和频繁疝，使得 WC 测量的可靠性受到质疑。在此，我们首次研究了 WC 是否是 PD 人群中腹部肥胖的可靠标志物。
本研究纳入了 107 例持续性 PD 患者[56%为男性，年龄 52 ± 17 岁，35%为糖尿病患者，BMI 为 24.8 ± 3.9 kg/m2]。在基线和 6 个月时，用双能 X 线吸收仪测量脐水平的 WC，并评估躯干脂肪。所有测量均在空腹时进行。
基线时，WC 与躯干脂肪呈强相关（r = 0.81；P < 0.001）。在校正性别、年龄、透析年限和 BMI 后，WC 与躯干脂肪独立相关（β = 0.30；P < 0.001；R2 = 0.77）。WC 与躯干脂肪的一致性为 0.59（kappa 统计量），曲线下面积为 0.90。在前瞻性评估中，我们观察到 WC 的变化与躯干脂肪的变化也相关（r = 0.49；P < 0.001）。0.48 的 kappa 统计量表明两种方法之间存在中度一致性。ROC 曲线分析显示，WC 能敏感地检测到躯干脂肪的变化（曲线下面积 0.76）。在调整性别、年龄和 BMI 的逻辑回归分析中，WC 的变化与躯干脂肪的变化独立相关。
简单的人体测量学方法 WC 是 PD 患者腹部肥胖的可靠标志物。
