Kidney Center, Shirasagi Hospital , Osaka , Japan.
Department of Nephrology, Osaka City University Graduate School of Medicine , Osaka , Japan.
Ren Fail. 2019 Nov;41(1):808-813. doi: 10.1080/0886022X.2019.1659819.
Glycated albumin (GA), which is independent of anemia and/or use of erythropoiesis-stimulating agents, might provide a more precise measure than glycated hemoglobin (HbA1c) in hemodialysis patients. The present study examines whether body composition is associated with GA besides glycemic control in hemodialysis patients. This study included 90 hemodialysis patients with diabetes mellitus (DM) and 86 hemodialysis patients without DM. We examined blood parameters after an overnight fast and body fat and lean mass using dual X-ray absorptiometry 21-24 h after completing the dialysis session. The mean body mass index (BMI) was 22.0 kg/m. BMI and truncal fat mass were significantly higher, and total fat mass tended to be higher in hemodialysis patients with DM than in those without DM. GA exhibited inverse correlations with BMI, total lean mass, total fat mass, and truncal fat mass in hemodialysis patients with and without DM; however, there was a lack of correlation with total lean mass in patients without DM. In multiple regression analysis including total fat mass and total lean mass simultaneously as independent variables, total fat mass (with DM: = -0.322, = .006) (without DM: = -0.391, < .001), but not total lean mass, in addition to log fasting plasma glucose, emerged as an independent factor associated with GA in hemodialysis patients with and without DM. When total fat mass was replaced with truncal fat mass (with DM: = -0.311, = .007) (without DM: = -0.396, < .001), the association remained significant and independent with GA in both patient groups. Higher total fat mass, particularly truncal fat mass, might be associated with lower GA levels, beside glycemic control, in hemodialysis patients with or without DM.
糖化白蛋白（GA）独立于贫血和/或红细胞生成刺激剂的使用，可能比糖化血红蛋白（HbA1c）更能准确地衡量血液透析患者的情况。本研究检查了在血液透析患者中，除了血糖控制外，身体成分是否与 GA 有关。本研究纳入了 90 例糖尿病（DM）血液透析患者和 86 例非 DM 血液透析患者。我们在透析结束后 21-24 小时，在禁食一夜后检测血液参数，并使用双能 X 线吸收法检测体脂肪和瘦体重。患者的平均体重指数（BMI）为 22.0kg/m2。DM 血液透析患者的 BMI 和躯干脂肪质量显著较高，总脂肪质量也有升高趋势。GA 与 DM 和非 DM 血液透析患者的 BMI、总瘦体重、总脂肪质量和躯干脂肪质量呈负相关；然而，在非 DM 患者中，GA 与总瘦体重之间没有相关性。在包括总脂肪质量和总瘦体重作为独立变量的多元回归分析中，总脂肪质量（DM： = -0.322， = .006）（非 DM： = -0.391， < .001），而不是总瘦体重，除了空腹血糖外，还是 DM 和非 DM 血液透析患者与 GA 相关的独立因素。当总脂肪质量被躯干脂肪质量取代时（DM： = -0.311， = .007）（非 DM： = -0.396， < .001），这种关联在两组患者中仍然具有显著性和独立性。除了血糖控制外，在 DM 和非 DM 血液透析患者中，较高的总脂肪质量，特别是躯干脂肪质量，可能与较低的 GA 水平有关。
