慢性肾病患者的身体组成

Anjani Bakshi, Kalyani Singh, A. Siddhu
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引用次数: 1

摘要

随着肌肉蛋白水解的加速,慢性肾脏疾病(CKD)患者的肌肉质量明显减少。这最终导致营养失调,长期以来,营养失调主要归因于营养不良。这使患者容易过早发病和死亡。因此,评估身体成分变得至关重要。在这项横断面研究中,通过体成分监测评估了2、3a、3b和4期CKD患者(n = 47)的瘦组织质量、脂肪组织质量和过度水化。瘦肉组织指数和脂肪组织指数分别用瘦肉组织质量和脂肪组织质量(单位为公斤)除以患者身高(单位为平方米)计算。通过Jamar液压手测力仪评估患者的握力(HGS),以及他们7天的饮食史。CKD患者的平均瘦组织指数为11.73±2.49 kg/m2。47例患者中有34例(72.3%)低于瘦肉组织指数参考值。各阶段瘦肉组织指数差异有统计学意义(P = 0.03)。4期患者的瘦组织指数最低。摄入蛋白质<0.6 gm/kg/天的患者的瘦组织明显减少(P = 0.03)。所有47例患者的HGS值均低于正常水平。患者平均脂肪组织指数为14.86±6.18 kg/m2,水潴留,平均过水合1.47±2.12 l, CKD患者营养不良,瘦肉组织指数明显偏低。这些患者的膳食蛋白质摄入量和HGS与瘦组织指数呈正相关。
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Body Composition of Chronic Kidney Disease Patients
With accelerated muscle proteolysis, a decrease in muscle mass is evident in chronic kidney disease (CKD) patients. This eventually leads to nutritional disturbance that for a long has been mostly attributed to malnutrition. This predisposes patients to premature morbidity and mortality. Assessing body composition, thus, becomes vital. In this cross-sectional study, CKD patients (n = 47) of stages 2, 3a, 3b and 4 were assessed for their lean tissue mass, adipose tissue mass and overhydration by body composition monitor. Lean tissue index and fat tissue index were calculated as lean tissue mass and adipose tissue mass in kilogram divided by patients’ height in square meters. Patients were assessed for their handgrip strength (HGS) by Jamar hydraulic hand dynamometer, and also for their 7-day diet history. Mean lean tissue index of CKD patients was 11.73 ± 2.49 kg/m2. About 34 (72.3%) out of 47 patients were below the reference value of lean tissue index. A significant difference in lean tissue index (P = 0.03) was observed at various stages. Patients at stage 4 had the lowest lean tissue index. Lean tissue was significantly (P = 0.03) low in patients consuming protein <0.6 gm/kg/day. All 47 patients had less than normal HGS values. Patients’ mean fat tissue index was 14.86 ± 6.18 kg/m2 and had water retention with a mean overhydration of 1.47 ± 2.12 L. CKD patients were malnourished with a significant low lean tissue index. Dietary protein intake and HGS of these patients were positively associated with lean tissue index.
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