Timerga Abebe, Haile Kassahun
Department of Biomedical Science, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
Department of Medical Laboratory Science, College of Medicine and Health Sciences, Wolkite University, Wolkite, Ethiopia.
Diabetes Metab Syndr Obes. 2021 Mar 23;14:1349-1358. doi: 10.2147/DMSO.S300434. eCollection 2021.
Obesity is a condition characterized by abnormal or excess accumulation of fat in body tissue, which may impair health and result in electrolyte derangement. Hypercalcemia and hypochloremia are significant problems in obese patients, and can cause substantial morbidity and mortality. Determination of patterns of calcium and chloride may play a major role in the management of obese patients. Therefore, this study aimed to determine calcium and chloride disorders and their predictors among obese adults in the outpatient department at Wolkite University Specialized Hospital, southern Ethiopia from May to August 2020.
This institution-based cross-sectional study was conducted on 250 obese adults attending the outpatient department from May to August 2020. Structured questionnaires through face-to-face interviews and participants' medical records were used to collect information on determinants related to calcium- and chloride-ion disturbances. Levels of serum calcium and chloride were measured using an ion-selective electrode analyzer. Bivariate and multivariate logistic regression analyses were done to identify determinants associated with calcium and chloride disorders. Using ORs and 95% CIs,<0.05 was considered significant.
Among the 250 patients, 18% (95% CI 53.02-111) and 17.6% (95% CI 0.78-12) of study participants were hypochloremic and hypercalcemic, respectively. Age ≥50 years (AOR 3.58, 95% CI 2.57-11.10), diuretic use (AOR 2.35, 95% CI 1.31-4.23), and obesity (AOR, 6.82, 95% CI 2.26-14.62) were independent predictors of hypochloremia on multivariate logistic regression, and obesity (AOR 9.21, 95% CI 2.50-14.81), overweight (AOR 8.32, 95% CI 1.61-10.20) and physical inactivity (AOR 4.28, 95% CI 1.71-10.44) were predictors of hypercalcemia.
High burdens of hypochloremia (18%) and hypercalcemia (17.6%) were observed in these patients. Increased age, diuretic use, being overweight, and physical inactivity were predictors of electrolyte disorders. The findings of this study should be taken into consideration to implement preventive interventions on these predictors in obese patients. Promoting sufficient fruit and vegetable consumption and physical exercise and determination of serum-chloride and -calcium levels in adult overweight/obese patients are recommended to minimize the emergence of electrolyte disorders.
肥胖是一种以身体组织中脂肪异常或过度堆积为特征的状况，这可能损害健康并导致电解质紊乱。高钙血症和低氯血症是肥胖患者的重要问题，可导致严重的发病率和死亡率。钙和氯模式的测定可能在肥胖患者的管理中发挥重要作用。因此，本研究旨在确定2020年5月至8月在埃塞俄比亚南部沃尔基特大学专科医院门诊部肥胖成年人中的钙和氯紊乱情况及其预测因素。
本基于机构的横断面研究于2020年5月至8月对250名到门诊部就诊的肥胖成年人进行。通过面对面访谈的结构化问卷和参与者的病历用于收集与钙和氯离子紊乱相关的决定因素信息。使用离子选择性电极分析仪测量血清钙和氯水平。进行二元和多因素逻辑回归分析以确定与钙和氯紊乱相关的决定因素。使用比值比（OR）和95%置信区间（CI），P<0.05被认为具有统计学意义。
在250名患者中，分别有18%（95%CI 53.02 - 111）和17.6%（95%CI 0.78 - 12）的研究参与者存在低氯血症和高钙血症。多因素逻辑回归分析显示，年龄≥50岁（调整后比值比[AOR] 3.58，95%CI 2.57 - 11.10）、使用利尿剂（AOR 2.35，95%CI 1.31 - 4.23）和肥胖（AOR 6.82，95%CI 2.26 - 14.62）是低氯血症的独立预测因素；肥胖（AOR 9.21，95%CI 2.50 - 14.81）、超重（AOR 8.32，95%CI 1.61 - 10.20）和身体活动不足（AOR 4.28，95%CI 1.71 - 10.44）是高钙血症的预测因素。
在这些患者中观察到高比例的低氯血症（18%）和高钙血症（17.6%）。年龄增加、使用利尿剂、超重和身体活动不足是电解质紊乱的预测因素。本研究结果应在肥胖患者中针对这些预测因素实施预防性干预时予以考虑。建议促进成年人超重/肥胖患者充分食用水果和蔬菜、进行体育锻炼并测定血清氯和钙水平，以尽量减少电解质紊乱的发生。
