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应用双能 X 射线吸收法评估肾移植患者、血液透析患者和健康对照组的人体成分。

Assessment of body composition by dual-energy X-Ray absorptiometry in renal transplant patients, hemodialysis patients, and a control group of healthy subjects.

机构信息

Division of Medical Sciences, University of Guanajuato-Campus León, Gto, Mexico.

Department of Sciences Applied to Work, Division of Health Sciences, University of Guanajuato - Campus León, Gto, Mexico.

出版信息

Clinics (Sao Paulo). 2024 Sep 27;79:100505. doi: 10.1016/j.clinsp.2024.100505. eCollection 2024.

Abstract

BACKGROUND

The clinical findings of patients with Chronic Kidney Disease (CKD), which is characterized by malnutrition, sedentary lifestyle, uremia, and catabolism associated with dialysis produce changes in Body Composition (BC), causing increased Fat Mass (FM), decreased in both Lean Mass (LM) and Body Mineral Density (BMD), even despite uremic reversal after a Kidney Transplant (KT); immunosuppressive medications alter BC, increasing the risk of loss of the kidney transplant and cardiovascular diseases.

OBJECTIVE

To demonstrate whether there are differences in BC between a group of patients with KT and a group of patients on Hemodialysis (HD), when comparing them with a control group without the disease.

MATERIALS AND METHODS

In the present observational study, with a comparative design; 125 patients were evaluated (46 with KT, 47 on HD, and 32 from the healthy control group). The BC was evaluated with the full-body Dual-Energy X-Ray Absorptiometry (DEXA) method.

RESULTS

The mean age and standard deviation (X±SD) of the study subjects were: 28.89 ± 5.76, 27.39 ± 5.04, and 29.63 ± 6.34 years for the HD, KT, and control subjects, respectively. The HD patients presented a total FM of 14.98 ± 6.96 kg in comparison with 20.1 ± 6.5 kg for the control group (p = 0.007), and 19.06 ± 7.94 kg for the group with KT (p = 0.02). The total LM was lower in the KT patients in comparison with the control group (p = 0.023). The content and total BMD were lower in both groups of patients with KT and HD.

CONCLUSIONS

Although a comprehensive improvement in BC was expected after kidney transplantation, the results are not close to "normal' values, when compared with those of healthy subjects of the same age.

摘要

背景

慢性肾脏病(CKD)患者的临床特征为营养不良、久坐不动的生活方式、尿毒症和与透析相关的分解代谢,这些特征导致身体成分(BC)发生变化,使脂肪量(FM)增加,瘦体重(LM)和身体矿物质密度(BMD)减少,即使在接受肾移植(KT)后尿毒症得到逆转也是如此;免疫抑制药物会改变 BC,增加肾移植和心血管疾病的风险。

目的

证明在与无疾病的对照组进行比较时,KT 组和血液透析(HD)组患者之间的 BC 是否存在差异。

材料和方法

本观察性研究采用对比设计,共评估了 125 名患者(46 名接受 KT,47 名接受 HD,32 名来自健康对照组)。BC 通过全身双能 X 射线吸收法(DEXA)进行评估。

结果

HD、KT 和对照组研究对象的平均年龄和标准差(X±SD)分别为 28.89±5.76、27.39±5.04 和 29.63±6.34 岁。HD 患者的总 FM 为 14.98±6.96kg,与对照组的 20.1±6.5kg(p=0.007)和 KT 组的 19.06±7.94kg(p=0.02)相比有所升高。与对照组相比,KT 患者的总 LM 较低(p=0.023)。KT 和 HD 两组患者的 BMC 和总 BMD 均较低。

结论

尽管肾移植后 BC 全面改善,但与同龄健康受试者相比,结果仍未接近“正常”值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6b57/11467545/a7120f0e7e2b/gr1.jpg

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