不同年龄、性别血液透析患者体成分及营养状况分析
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摘要
目的采用生物电阻抗分析法探讨不同年龄、不同性别维持性血液透析(MHD)患者人体成分和营养状况。方法选取2016年12月13日-2017年1月19日在某院血液透析中心进行MHD的124例患者为研究对象,按年龄分为A组(<40岁)、B组(40~59岁)、C组(60~79岁)、D组(>80岁),使用人体成分分析仪测定透析后各体成分指标,收集其血清白蛋白结果,并进行PG-SGA量表评分。结果随年龄段增加,MHD患者体水分、肌肉量、营养相关指标逐渐降低,体脂肪逐渐增加,其中细胞外水分与身体总水分比值、体脂肪、体脂百分比、内脏脂肪面积、相位角以及血清白蛋白在不同年龄段组间有统计学差异(P<0.05)。男性患者体水分、肌肉量、上臂围、上臂肌围、身体细胞量高于女性(P<0.05),体脂百分比低于女性(P<0.05)。Pearson分析显示,相位角(PA)与血清白蛋白、身体细胞量、肌肉量、去脂体重、臂围有正相关关系(P<0.05),与年龄、细胞外水分与身体总水分比值、PG-SGA评分有负相关关系(P<0.05)。结论不同年龄、不同性别的MHD患者人体成分存在差异,在保证透析充分的基础上,可通过生物电阻抗法实时监测MHD患者的人体成分和营养状况。
Objective The purpose of this study was to discuss the human body composition and nutrition status among maintenance hemodialysis(MHD) patients of different age and gender by bioelectrical impedance analysis(BIA). Methods124 MHD patients in our hospital from December 13, 2016 to January 19, 2017 were enrolled in this study. All of them were divided into four groups by age: A group(<40 years old), B group(40 to 59 years old), C group(60 to 79 years old), and D group(>80 years old). The body composition was measured by human body composition analyzer with bioelectrical impedance method. Biochemical test results were collected and score was recorded by PG-SGA. Results Body water, muscle mass,nutrition related index decreased and fat mass increased with the increasing of age. And there were differences in ratio of extracellular water to total body water, fat, percent body fat, visceral fat area, phage angle, albumin among different age( P<0.05). Body water, muscle mass, arm circumference, arm muscle circumference, body cell mass of man were higher than those of woman(P <0.05). Percent body fat of man was lower than that of woman(P <0.05). PA had a positive correlation with albumin, body cell mass, muscle mass, fat free mass, arm circumference, arm muscle circumference(P<0.05), and a negative correlation with age, ratio of extracellular water to total body water, scores of PG-SGA(P<0.05). Conclusion MHD patients of different age and genders had different body composition. Under the condition of hemodialysis adequacy, bioelectrical impedance analysis can provide rapid monitoring of human body composition and nutrition status.
Objective The purpose of this study was to discuss the human body composition and nutrition status among maintenance hemodialysis(MHD) patients of different age and gender by bioelectrical impedance analysis(BIA). Methods124 MHD patients in our hospital from December 13, 2016 to January 19, 2017 were enrolled in this study. All of them were divided into four groups by age: A group(<40 years old), B group(40 to 59 years old), C group(60 to 79 years old), and D group(>80 years old). The body composition was measured by human body composition analyzer with bioelectrical impedance method. Biochemical test results were collected and score was recorded by PG-SGA. Results Body water, muscle mass,nutrition related index decreased and fat mass increased with the increasing of age. And there were differences in ratio of extracellular water to total body water, fat, percent body fat, visceral fat area, phage angle, albumin among different age( P<0.05). Body water, muscle mass, arm circumference, arm muscle circumference, body cell mass of man were higher than those of woman(P <0.05). Percent body fat of man was lower than that of woman(P <0.05). PA had a positive correlation with albumin, body cell mass, muscle mass, fat free mass, arm circumference, arm muscle circumference(P<0.05), and a negative correlation with age, ratio of extracellular water to total body water, scores of PG-SGA(P<0.05). Conclusion MHD patients of different age and genders had different body composition. Under the condition of hemodialysis adequacy, bioelectrical impedance analysis can provide rapid monitoring of human body composition and nutrition status.
引文
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[3]Malina RM.Variation in body composition associated with sex and ethnicity[EB/OL].[2018-03-06].https://www.researchgate.net/publication/286783414.
[4]Lukaski HC,Kyle UG,Kondrup J.Assessment of adult malnutrition and prognosis with bioelectrical impedance analysis:phase angle and impedance ratio[J].Current Opinion in Clinical Nutrition and Metabolic Care,2017,20(5):330-339.
[5]Hernández Morante JJ,Sánchez-Villazala A,Cutillas RC,et al.Effectiveness of a nutrition education program for the prevention and treatment of malnutrition in end-stage renal disease[J].Journal of Renal Nutrition:the Official Journal of the Council on Renal Nutrition of the National Kidney Foundation,2014,24(1):42-49.
[6]陈昭.生物人类学和人体组成学的渊源关系[J].人类学学报,2013,32(3):264-273.
[7]王自勉.人体组成学[M].北京:高等教育出版社,2008.
[8]Ohashi Y,Tai R,Aoki T,et al.The associations of malnutrition and aging with fluid volume imbalance between intra-and extracellular water in patients with chronic kidney disease[J].The Journal of Nutrition,Health&Aging,2015,19(10):986-993.
[9]崔赛赛,孙博,韩悦容,等.不同年龄、性别体检人群人体组成成分对比分析[J].临床军医杂志,2017(7):676-680.
[10]胡景敏,边姗姗,张志广.人体成分分析在临床实践中的应用[J].医学综述,2016(19):3783-3787.
[11]李月红,窦红宇.慢性肾脏病患者血脂异常特点及治疗进展[J].中华老年多器官疾病杂志,2015(7):556-560.
[12]Paixao EM,Gonzalez MC,Ito MK.A prospective study on the radiation therapy associated changes in body weight and bioelectrical standardized phase angle[J].Clinical Nutrition,2015,34(3):496-500.
[13]Kyle UG,Soundar EP,Genton L,et al.Can phase angle determined by bioelectrical impedance analysis assess nutritional risk?A comparison between healthy and hospitalized subjects[J].Clinical Nutrition(Edinburgh,Scotland),2012,31(6):875-881.