Li Q, Deng K H, Long Y J, Lin X, Qie S W, Zhou C M, Yang X, Zha Y
Department of Nephrology, Guizhou Provincial People's Hospital, Guiyang 550002, China.
Department of Nephrology, the Second Affiliated Hospital of Guizhou Medical University, Kaili 556000, Guizhou, China.
Zhonghua Yi Xue Za Zhi. 2019 May 28;99(20):1567-1571. doi: 10.3760/cma.j.issn.0376-2491.2019.20.010.
To analyze the influencing factors of protein energy wasting (PEW) in maintenance hemodialysis (MHD) patients. A multicenter cross-sectional study was conducted in eleven hemodialysis centers of Guizhou province between June and August 2018. Clinical data, physical parameters, body composition data and laboratory values of MHD patients were collected. Analysis of variance was used to assess the impact of the indicators on the prevalence of PEW. Factor analysis was carried out after further classifing the factors into several common factors, and logistic regression was used to analyze the impact of common factors on PEW. The results of univariate analysis showed that somatic cell mass, lean weight, fat content, body mass index (BMI), grip strength, leg circumference, hip circumference, waist circumference, midpoint circumference of upper arm, triceps skin fold thickness, hemoglobin, albumin, prealbumin, serum calcium, phosphorus, serum magnesium, creatinine, parathyroid hormone were the influential factors of PEW (all 0.05). Factor analysis indicated that the above indicators can be classified into five common factors. Logistic regression model showed that with the increase of the prevalence of PEW, the scores of common factors decreased, the absolute value of regression coefficient beta in sequence, was common factor 2 (β=-2.258, 0.001), common factor 4 (β=-1.589, 0.001), common factor 1 (β=-1.144, 0.001) and common factor 3 (β=-0.740, 0.016). The reduction of fat content, anemia, hypoproteinemia, disorder of calcium and phosphorus metabolism were important factors influencing PEW.
分析维持性血液透析（MHD）患者蛋白质能量消耗（PEW）的影响因素。2018年6月至8月间，在贵州省11个血液透析中心开展了一项多中心横断面研究。收集MHD患者的临床资料、身体参数、身体成分数据和实验室检查值。采用方差分析评估各指标对PEW患病率的影响。将影响因素进一步分类为几个共同因素后进行因子分析，并采用逻辑回归分析共同因素对PEW的影响。单因素分析结果显示，体细胞质量、瘦体重、脂肪含量、体重指数（BMI）、握力、腿围、臀围、腰围、上臂中点周长、三头肌皮褶厚度、血红蛋白、白蛋白、前白蛋白、血清钙、磷、血清镁、肌酐、甲状旁腺激素是PEW的影响因素（均P<0.05）。因子分析表明，上述指标可分为5个共同因素。逻辑回归模型显示，随着PEW患病率升高，共同因素得分降低，回归系数β绝对值依次为共同因素2（β=-2.258，P=0.001）、共同因素4（β=-1.589，P=0.001）、共同因素1（β=-1.144，P=0.001）和共同因素3（β=-0.740，P=0.016）。脂肪含量降低、贫血、低蛋白血症、钙磷代谢紊乱是影响PEW的重要因素。
