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腹膜透析1年后肥胖指数的变化:一项单中心队列研究。

Change in adiposity indices after 1 year of peritoneal dialysis: a single-center cohort study.

作者信息

Yang Zhikai, Ng Jack Kit-Chung, Fung Winston Wing-Shing, Chan Gordon Chun-Kau, Chow Kai-Ming, Szeto Cheuk-Chun

机构信息

Carol & Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong, China.

Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong, China.

出版信息

Clin Kidney J. 2024 Nov 21;18(1):sfae362. doi: 10.1093/ckj/sfae362. eCollection 2025 Jan.

Abstract

BACKGROUND

Weight gain is common after starting peritoneal dialysis (PD). Several adiposity indices have been developed recently as potential indicators of visceral adiposity and lipid accumulation. We aim to investigate the prevalence and prognostic implications of the change in adiposity indices after 1 year of PD.

METHODS

We recruited 110 patients treated with PD for 12 months. Adiposity indices, including triglyceride glucose index, lipid accumulation product, visceral adiposity index and conicity index, were measured at baseline and then 1 year after PD started. The relation between their changes (Δ) and other clinical and biochemical parameters, as well as survival and hospitalization rates were analyzed.

RESULTS

After 1 year of PD, more than half of the patients had increased adiposity indices. The change in adipose tissue mass significantly correlated with the concomitant changes in triglyceride glucose index (ΔTyGI) (r = 0.25, = .01), lipid accumulation product (ΔLAP) (r = 0.27, = .007) and visceral adiposity index (ΔVAI) (r = 0.26, = .01). ΔTyGI significantly correlated with the change in insulin resistance as represented by homeostasis model assessment of insulin resistance (HOMA-IR) (r = 0.22, = .02), while ΔLAP and change in conicity index (ΔCI) correlated with the changes in various anthropometric parameters. However, no indices variation was associated with patient survival, technique survival or hospitalization rate.

CONCLUSIONS

Increased adiposity indices were common after 1 year of PD. The changes in adiposity indices had variable correlation with the change in adipose tissue mass, insulin resistance and anthropometric parameters. Further studies are required to identify simple metabolic parameters with a prognostic impact that could be suitable for serial monitoring.

摘要

背景

开始腹膜透析(PD)后体重增加很常见。最近开发了几种肥胖指数作为内脏肥胖和脂质蓄积的潜在指标。我们旨在研究PD 1年后肥胖指数变化的患病率及其预后意义。

方法

我们招募了110例接受PD治疗12个月的患者。在基线时以及PD开始后1年测量肥胖指数,包括甘油三酯葡萄糖指数、脂质蓄积产物、内脏肥胖指数和锥度指数。分析它们的变化(Δ)与其他临床和生化参数以及生存率和住院率之间的关系。

结果

PD 1年后,超过一半的患者肥胖指数增加。脂肪组织质量的变化与甘油三酯葡萄糖指数(ΔTyGI)的伴随变化显著相关(r = 0.25,P = 0.01)、脂质蓄积产物(ΔLAP)(r = 0.27,P = 0.007)和内脏肥胖指数(ΔVAI)(r = 0.26,P = 0.01)。ΔTyGI与以胰岛素抵抗稳态模型评估(HOMA-IR)表示的胰岛素抵抗变化显著相关(r = 0.22,P = 0.02),而ΔLAP和锥度指数变化(ΔCI)与各种人体测量参数的变化相关。然而,没有指数变化与患者生存率、技术生存率或住院率相关。

结论

PD 1年后肥胖指数增加很常见。肥胖指数的变化与脂肪组织质量、胰岛素抵抗和人体测量参数的变化具有不同程度的相关性。需要进一步研究以确定具有预后影响且适合连续监测的简单代谢参数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/46c2/11704785/d11a677c938f/sfae362fig1.jpg

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