四部位皮褶厚度人体测量法（FSA）与生物电阻抗分析（BIA）在评估维持性血液透析患者营养状况中的应用：在常规患者护理中哪种方法更可取？

Four-site skinfold anthropometry (FSA) versus body impedance analysis (BIA) in assessing nutritional status of patients on maintenance hemodialysis: which method is to be preferred in routine patient care?

作者信息

Oe B, de Fijter C W, Oe P L, Stevens P, de Vries P M

机构信息

Department of Internal Medicine, Academic Hospital Free University, Amsterdam, The Netherlands.

出版信息

Clin Nephrol. 1998 Mar;49(3):180-5.

PMID:9543600

Abstract

BACKGROUND

Both four-site skinfold anthropometry (FSA) and bioelectrical impedance analysis (BIA) claim to be useful in routine clinical practice of maintenance dialysis as easy methods to assess nutritional status. The purpose of this study was to investigate which of these two methods is to be preferred.

METHODS

Both before and after dialysis nutritional and hydration status were evaluated by BIA in 20 stable hemodialysis patients. Variables of nutritional status as lean body mass (LBM) and body fat (BF) were assessed by four-site skinfold anthropometry (LBM-FSA and BF-FSA) and BIA (LBM-BIA and BF-BIA). Variables of hydration status were total body water (TBW), its distribution into intracellular and extracellular compartments (ICW and ECW, respectively) and ICW/ECW.

RESULTS

Weight loss during dialysis correlated with a change of LBM-FSA (r = 0.75, p <0.005) and also with that of LBM-BIA (r = 0.69, p < 0.005). To promote reliability of follow-up measurements in intervention studies it is warranted to evaluate nutritional status in an unchanged hydration status. The highly significant correlation (r = 0.93, p < 0.005) between the two techniques and the comparability between means and SD indicate that both techniques were almost equivalent to each other, although, compared to LBM-BIA, LBM-FSA was less affected by changes in fluid status. The sam held true for BF-BIA and BF-FSA. BF-FSA correlated significantly with BF-BIA (r = 0.65, p <0.005), whereas no difference of mean +/- SD was found between BF-FSA and BF-BIA.

CONCLUSION

FSA and BIA are almost comparable techniques to assess both LBM and BF, although FSA is less affected by changes in fluid status. However, assessing LBM in normohydration is mandatory. Compared with FSA, BIA is able to establish hydration status and lacks depency on operator interpretation. Therefore, in routine patient care the BIA technique is the one to be preferred.

摘要

背景

四部位皮褶厚度人体测量法（FSA）和生物电阻抗分析（BIA）都声称作为评估营养状况的简便方法，在维持性透析的常规临床实践中有用。本研究的目的是调查这两种方法中哪种更可取。

方法

对20例稳定的血液透析患者在透析前后均采用BIA评估营养和水合状态。通过四部位皮褶厚度人体测量法（瘦体重 - FSA和体脂 - FSA）和BIA（瘦体重 - BIA和体脂 - BIA）评估营养状态变量，如瘦体重（LBM）和体脂（BF）。水合状态变量包括总体水（TBW）、其在细胞内和细胞外间隙的分布（分别为ICW和ECW）以及ICW/ECW。

结果

透析期间体重减轻与LBM - FSA的变化相关（r = 0.75，p <0.005），也与LBM - BIA的变化相关（r = 0.69，p <0.005）。为提高干预研究中随访测量的可靠性，有必要在水合状态不变的情况下评估营养状态。两种技术之间高度显著的相关性（r = 0.93，p <0.005）以及均值和标准差之间的可比性表明，尽管与LBM - BIA相比，LBM - FSA受液体状态变化的影响较小，但两种技术几乎彼此等效。BF - BIA和BF - FSA也是如此。BF - FSA与BF - BIA显著相关（r = 0.65，p <0.005），而BF - FSA和BF - BIA之间未发现均值±标准差有差异。