Department of Physical Therapy, Faculty of Health Science, Juntendo University, 3-2-12, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan.
Department of Rehabilitation, Sakakibara Heart Institute, Tokyo, Japan.
BMC Nephrol. 2020 Oct 19;21(1):438. doi: 10.1186/s12882-020-02102-2.
Phase angle (PA), measured by bioelectrical impedance analysis (BIA) has been studied as indicator of nutritional status or muscle function in hemodialysis (HD) patients. It remains unclear if the phase angle is associated protein-energy wasting (PEW) or frailty, which are common complication in hemodialysis patients. The aim of this study is to determine whether BIA-derived PA is a marker of PEW or frailty in HD patients.
This retrospective observational study included 116 adult HD patients (35% female, 64 ± 12 years of age) in a single dialysis center. Patients were classified according to the PA quartiles into four groups; 1) first quartile: PA < 3.7°, 2) second quartile: PA 3.7-4.1°, 3) third quartile: PA 4.2-4.9°and 4) forth quartile: PA ≥ 5.0°. International Society of Renal Nutrition and Metabolism (ISRNM) criteria and Japanese version of Cardiovascular Health Study (J-CHS) criteria were used to identify PEW and frailty.
The lower PA group was associated with a greater risk of PEW (35% vs. 24% vs. 21% vs. 3%; p = 0.032), frailty (59% vs. 40% vs. 21% vs. 3%; p < 0.001). In multivariate logistic regression analysis, the first quartile group was at a significantly greater risk of both PEW and frailty compared with the fourth quartile group after adjusting for other confounding factors.
Lower PA was associated with a greater risk of PEW and frailty in HD patients.
相位角（PA）通过生物电阻抗分析（BIA）测量，已被研究作为血液透析（HD）患者营养状况或肌肉功能的指标。目前尚不清楚 PA 是否与蛋白能量消耗（PEW）或衰弱有关，这些是血液透析患者的常见并发症。本研究旨在确定 BIA 衍生的 PA 是否是 HD 患者 PEW 或衰弱的标志物。
这是一项回顾性观察研究，纳入了一家透析中心的 116 名成年 HD 患者（35%为女性，64±12 岁）。根据 PA 四分位数将患者分为四组：1）第一四分位数：PA<3.7°；2）第二四分位数：PA 3.7-4.1°；3）第三四分位数：PA 4.2-4.9°；4）第四四分位数：PA≥5.0°。采用国际肾脏营养代谢学会（ISRNM）标准和日本心血管健康研究（J-CHS）标准识别 PEW 和衰弱。
PA 较低的组与 PEW（35%比 24%比 21%比 3%；p=0.032）和衰弱（59%比 40%比 21%比 3%；p<0.001）的风险增加相关。在多变量逻辑回归分析中，在校正其他混杂因素后，与第四四分位组相比，第一四分位组发生 PEW 和衰弱的风险显著更高。
PA 较低与 HD 患者的 PEW 和衰弱风险增加相关。
