Cochat P, Braillon P, Feber J, Hadj-Aïssa A, Dubourg L, Liponski I, Saïd M H, Glastre C, Meunier P J, David L
Unité de Néphrologie Pédiatrique, Hôpital Edouard Herriot, Lyon, France.
Pediatr Nephrol. 1996 Jun;10(3):264-8. doi: 10.1007/BF00866754.
Dual energy X-ray absorptiometry (DEXA) is a non-invasive accurate method which estimates bone mineral content and density (BMD), as well as fat (FM) and lean (LM) body mass. This method was used in control children in order to establish normal values for BMD of lumbar spine and whole body composition ¿logistic curves, general equation E = k+K/[1+ alpha exp(- beta A)]¿. In children with chronic renal failure (CRF), LM correlated with the urinary excretion of creatinine (r = 0.97, P = 0.0001) independently from glomerular filtration rate. However, the assessment of LM by DEXA must take into account the hydration level, since there is a positive correlation between fluid loss and reduction in LM in children on hemodialysis (r = 0.98, P = 0.0001). After renal transplantation, a significant loss of BMD (median -9.2%) was observed at 6 months which returned to 95% of pretransplant values by the end of the 1st year. Maximal changes in LM and FM occurred during the first 3 months (-7.8% and +7.2%, respectively) and may be due to steroids; these should be influenced by physical activity since FM correlated inversely with maximal oxygen consumption (r = 0.69, P = 0.0001). Recombinant growth hormone treatment could also increase LM and decrease FM, as shown in 9 patients. DEXA appears therefore to be a reliable method for evaluating therapeutic interventions affecting nutritional status in children with CRF.
双能X线吸收法（DEXA）是一种非侵入性的准确方法，可用于估计骨矿物质含量和密度（BMD）以及脂肪（FM）和瘦体重（LM）。该方法用于对照儿童，以建立腰椎BMD和全身成分的正常值（逻辑曲线，一般方程E = k + K / [1 +αexp（-βA）]）。在慢性肾功能衰竭（CRF）儿童中，LM与肌酐尿排泄相关（r = 0.97，P = 0.0001），独立于肾小球滤过率。然而，DEXA对LM的评估必须考虑水合水平，因为血液透析儿童的液体丢失与LM减少之间存在正相关（r = 0.98，P = 0.0001）。肾移植后，6个月时观察到BMD显著下降（中位数-9.2%），到第1年末恢复到移植前值的95%。LM和FM的最大变化发生在最初3个月（分别为-7.8%和+7.2%），可能归因于类固醇；这些变化应受体育活动影响，因为FM与最大耗氧量呈负相关（r = 0.69，P = 0.0001）。如9例患者所示，重组生长激素治疗也可增加LM并减少FM。因此，DEXA似乎是评估影响CRF儿童营养状况的治疗干预措施的可靠方法。
