Matsuura Sayaka, Shirai Yumiko, Kubo Miyu, Nayama Chisako, Okitsu Masami, Oiwa Yuu, Yasui Sonoko, Suzuki Yoshiko, Murata Tomohiro, Ishikawa Eiji, Miki Chikao, Hamada Yasuhiro
Department of Therapeutic Nutrition, Institute of Biomedical Sciences, Tokushima University Graduate School.
Department of Nutrition, Iga City General Hospital.
J Med Invest. 2017;64(3.4):222-227. doi: 10.2152/jmi.64.222.
Serum transthyretin (TTR), also known as prealbumin, is a reliable nutritional indicator and an independent prognostic factor for maintenance hemodialysis patients. However, we recently reported that serum TTR levels did not affect protein-energy wasting (PEW). In this study, we investigated factors affecting serum TTR levels in 60 maintenance hemodialysis patients. The patients were divided into High-TTR and Low-TTR groups according to the median serum TTR level. Albumin levels were significantly higher and C-reactive protein (CRP) levels were significantly lower in the High-TTR group than in the Low-TTR group. Although body fat mass was significantly higher in the High-TTR group than in the Low-TTR group, no significant difference in body fat ratio were observed. These findings suggest that body fat mass is related to serum TTR levels, apart from factors such as albumin and CRP levels, which showed correlations with serum TTR levels. Because body fat mass is related to better survival in maintenance hemodialysis patients, it may contribute to the prognostic value of serum TTR levels. In addition, in such patients, it may be important to evaluate body fat mass rather than body fat ratio and to maintain the minimum necessary body fat mass. J. Med. Invest. 64: 222-227, August, 2017.
血清转甲状腺素蛋白(TTR),也称为前白蛋白,是维持性血液透析患者可靠的营养指标和独立的预后因素。然而,我们最近报道血清TTR水平并不影响蛋白质能量消耗(PEW)。在本研究中,我们调查了60例维持性血液透析患者血清TTR水平的影响因素。根据血清TTR水平中位数将患者分为高TTR组和低TTR组。高TTR组的白蛋白水平显著高于低TTR组,而C反应蛋白(CRP)水平显著低于低TTR组。尽管高TTR组的体脂量显著高于低TTR组,但体脂率未见显著差异。这些发现表明,除了与血清TTR水平相关的白蛋白和CRP水平等因素外,体脂量也与血清TTR水平有关。由于体脂量与维持性血液透析患者更好的生存率相关,它可能有助于血清TTR水平的预后价值。此外,在此类患者中,评估体脂量而非体脂率并维持最低必要体脂量可能很重要。《医学调查杂志》64:222 - 227,2017年8月。