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单频电阻抗法评估腹膜透析患者瘦体重和脂肪量的一致性

Agreement of Single-Frequency Electrical Bioimpedance in the Evaluation of Fat Free Mass and Fat Mass in Peritoneal Dialysis Patients.

作者信息

Reis Nayrana Soares do Carmo, Vaninni Francieli Cristina Delatim, Silva Maryanne Zilli Canedo, de Oliveira Rogério Carvalho, Reis Fabrício Moreira, Costa Fabiana Lourenço, Martin Luis Cuadrado, Barretti Pasqual

机构信息

Internal Medicine Department, Botucatu Medical School, São Paulo State University, Botucatu, Brazil.

出版信息

Front Nutr. 2021 May 31;8:686513. doi: 10.3389/fnut.2021.686513. eCollection 2021.

Abstract

Protein-energy wasting is related to impairment of quality of life and lower survival of end-stage kidney disease (ESKD) patients. The evaluation of body composition, especially fat free mass (FFM) and fat mass (FM), is important for the prediction of outcomes in these individuals. The aim of this study was to compare the FFM and FM measurements obtained by single-frequency bioimpedance (SF-BIA) and by a multiple frequency bioimpedance (MF-BIA) device, using dual energy X-ray absorptiometry (DXA) peritoneal dialysis (PD) patients. This was a cross-sectional study involving adult patients undergoing regular PD, in which we performed SF-BIA, MF-BIA, and DXA at the same visit. To compare the bioimpedance values with DXA, we used: Person correlation (), intraclass correlation coefficient (ICC), and Bland-Altman concordance analysis. The sample consisted of 50 patients in the PD, with mean age of 55.1 ± 16.3 years. Both bioimpedance methods showed a strong correlation ( > 0.7) and excellent reproducibility (ICC > 0.75) compared to DXA. According to the Bland-Altman diagram, SF-BIA showed agreement in body compartment measurements, with no proportionality bias ( > 0.05), without systematic bias for FFM (-0.5 ± 4.9, 95% CI -1.8 to 0.9, = 0.506), and for FM (0.3 ± 4.6, = 0.543). MF-BIA did not present a proportionality bias for the FFM, but it underestimated this body compartment by 2.5 ± 5.4 kg ( = 0.002). In addition, MF-BIA presented proportionality bias for FM. SF-BIA was a more accurate assessing method than MBIA for FFM and FM measurements in PD patients. Because it is a low-cost, non-evaluator-dependent measurement and has less systematic bias, it can also be recommended for fat mass and free-fat mass evaluation in PD patients.

摘要

蛋白质能量消耗与终末期肾病(ESKD)患者的生活质量受损和较低生存率相关。评估身体成分,尤其是去脂体重(FFM)和脂肪量(FM),对于预测这些个体的预后很重要。本研究的目的是比较单频生物电阻抗(SF-BIA)和多频生物电阻抗(MF-BIA)设备在接受腹膜透析(PD)的患者中使用双能X线吸收法(DXA)测量的FFM和FM。这是一项横断面研究,纳入了接受规律PD治疗的成年患者,在同一次就诊时进行SF-BIA、MF-BIA和DXA检查。为了将生物电阻抗值与DXA进行比较,我们使用了:Person相关性()、组内相关系数(ICC)和Bland-Altman一致性分析。样本包括50例PD患者,平均年龄为55.1±16.3岁。与DXA相比,两种生物电阻抗方法均显示出强相关性(>0.7)和出色的重复性(ICC>0.75)。根据Bland-Altman图,SF-BIA在身体成分测量方面显示出一致性,无比例偏差(>0.05),FFM无系统偏差(-0.5±4.9,95%CI -1.8至0.9,=0.506),FM也无系统偏差(0.3±4.6,=0.543)。MF-BIA在FFM方面没有比例偏差,但该身体成分被低估了2.5±5.4 kg(=0.002)。此外,MF-BIA在FM方面存在比例偏差。在PD患者中,对于FFM和FM测量,SF-BIA是比MBIA更准确的评估方法。由于它是一种低成本、非评估者依赖的测量方法且系统偏差较小,因此也可推荐用于PD患者的脂肪量和去脂体重评估。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6d9d/8200407/9f678d6fa67b/fnut-08-686513-g0001.jpg

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