Department of Internal Medicine & Kidney Research Institute, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea.
Department of Family Medicine, Hallym University Sacred Heart Hospital, Anyang 14068, Republic of Korea.
Nutrients. 2023 Apr 29;15(9):2149. doi: 10.3390/nu15092149.
Obesity is a common health problem in peritoneal dialysis (PD) patients and causes high serum ferritin levels. However, mixed results have been reported on whether serum ferritin levels affect the prognosis of PD patients. We investigated the effect of increased adiposity on ferritin levels and its association with mortality in 350 well-nourished PD patients. Body composition was measured using a portable whole-body bioimpedance spectroscope, and clinical determinants of high ferritin levels were evaluated. High ferritin levels (≥600 ng/mL) were observed in 63 (18.0%) patients. Patients with high ferritin levels had a significantly higher body fat percentage and a lower lean tissue index than patients with low or normal ferritin levels. During a median follow-up of 30 months, there were 65 deaths. Ferritin ≥ 600 ng/mL was associated with significantly higher all-cause mortality compared with 200-600 ng/mL of ferritin. Multivariate analysis showed that high ferritin levels were significantly associated with a higher percentage of body fat after adjustment for lean tissue index and volume status. High ferritin increased all-cause mortality in PD patients, and increased fat mass was an important determinant of the high ferritin. Our results support that adiposity may lead to an adverse clinical outcome in PD patients.
肥胖症是腹膜透析（PD）患者常见的健康问题，会导致血清铁蛋白水平升高。然而，关于血清铁蛋白水平是否影响 PD 患者的预后，研究结果存在差异。我们研究了在 350 名营养良好的 PD 患者中，肥胖程度增加对铁蛋白水平的影响及其与死亡率的关系。使用便携式全身生物阻抗光谱仪测量身体成分，并评估导致铁蛋白水平升高的临床因素。结果发现，63 名（18.0%）患者的铁蛋白水平较高（≥600ng/mL）。与铁蛋白水平较低或正常的患者相比，铁蛋白水平较高的患者体脂百分比明显更高，而瘦组织指数则更低。在中位随访 30 个月期间，共有 65 人死亡。与铁蛋白 200-600ng/mL 相比，铁蛋白≥600ng/mL 与全因死亡率显著升高相关。多变量分析显示，在调整瘦组织指数和容量状态后，铁蛋白水平较高与体脂百分比增加显著相关。高铁蛋白增加了 PD 患者的全因死亡率，而脂肪量增加是铁蛋白升高的一个重要决定因素。我们的研究结果表明，肥胖可能导致 PD 患者的临床结局不良。
