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体脂与腹膜透析炎症的关系。

Association of body fat with inflammation in peritoneal dialysis.

机构信息

Department of Internal Medicine, Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, Brazil.

出版信息

Inflammation. 2013 Jun;36(3):689-95. doi: 10.1007/s10753-013-9593-3.

Abstract

Peritoneal dialysis (PD) frequently leads to body weight gain, which appears to be a potential cause of the chronic inflammation frequently present in these patients. The consequences of this inflammation are impaired nutritional status, accelerated atherosclerosis, and increased mortality. To assess the association between inflammation and body fat in female patients treated with PD. Nineteen female patients on PD for at least 6 months with no infectious complications or malignant or acute inflammatory diseases. Nutritional status was determined by measuring weight, height, body mass index (BMI), waist (WC), and mid-arm circumferences (MAC), mid-arm muscle area, and tricipital fold (TCF). Bioelectrical impedance (BIA) was used to determine body composition. Biochemical evaluation included the determination of serum albumin, urea, creatinine, and C-reactive protein (CRP). The glucose absorbed from the dialysis solution was quantitated. According to BMI, two patients were classified as malnourished and ten as overweight/obese. Sixteen individuals had high WC measurements and 12 had excess body fat (BF) as measured by BIA. High CRP levels were observed in 12 patients, who had higher WC, MAC, BMI, TCF, and BF measurements compared to non-inflamed patients. Positive associations were detected between CRP and BMI, MAC, WC, and TCF. Associations between BF and CRP suggest that adiposity may be a potent exacerbating factor of inflammation in this population, especially visceral fat. Thus, obesity may be considered to be one more factor responsible for the early atherosclerosis and high cardiovascular mortality observed in these patients.

摘要

腹膜透析(PD)常导致体重增加,这似乎是这些患者常发生慢性炎症的潜在原因。这种炎症的后果是营养状况受损、动脉粥样硬化加速和死亡率增加。评估接受 PD 治疗的女性患者炎症与体脂肪之间的关系。19 名女性 PD 患者至少 6 个月,无感染并发症或恶性或急性炎症性疾病。营养状况通过测量体重、身高、体重指数(BMI)、腰围(WC)和上臂中部周长(MAC)、上臂中部肌肉面积和三头肌皮褶(TCF)来确定。生物电阻抗(BIA)用于确定身体成分。生化评估包括血清白蛋白、尿素、肌酐和 C 反应蛋白(CRP)的测定。从透析液中吸收的葡萄糖被定量。根据 BMI,两名患者被归类为营养不良,十名患者超重/肥胖。16 名个体 WC 测量值较高,12 名个体 BIA 测量值脂肪过多(BF)。12 名患者 CRP 水平较高,与无炎症患者相比,这些患者的 WC、MAC、BMI、TCF 和 BF 测量值更高。CRP 与 BMI、MAC、WC 和 TCF 之间存在正相关。BF 与 CRP 之间的关联表明,肥胖可能是该人群炎症的一个潜在加重因素,尤其是内脏脂肪。因此,肥胖可能被认为是导致这些患者早期动脉粥样硬化和高心血管死亡率的另一个因素。

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