Association of nutritional markers with physical and mental health status in prevalent hemodialysis patients from the HEMO study
Association of nutritional markers with physical and mental health status in prevalent hemodialysis patients from the HEMO study
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DOI：
10.1053/jren.2002.33512
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发表时间：
2002-07-01
影响因子：
3.2
通讯作者：
Poole, D
中科院分区：
文献类型：
--
作者：
Allen, KL;Miskulin, D;Poole, D
目的：在调整社会人口统计学和共病条件后，确定潜在可改变的营养因素与身心健康状况的相关性。设计：横断面多变量分析。设置：美国15个透析中心参与血液透析患者发病率和死亡率降低（HEMO）研究。患者：在HEMO研究中招募了1，545名血液透析患者。（预测）变量：在本分析中评估了以下营养标志物：血清白蛋白、能量摄入、蛋白质分解代谢率、血清肌酐、上臂肌围、小腿围和吸烟状况。吸烟状况，虽然不是一个营养因素本身，也包括在内，因为它是一个可改变的生活方式factor.Main结果Measures：身体和精神健康状况进行了评估，使用医务人员评估的Kamofsky指数和患者自我评估的医疗结果研究36项健康调查简表（SF-36）。在调整社会人口因素和共病情况后，血清白蛋白、血清肌酐和小腿围与Karnofsky指数评分独立相关。同样，血清肌酐和小腿围也与SF-36的身体健康总评（PCS）评分独立相关。在选择的营养变量中，没有变量与SF-36的心理健康总评（MCS）评分显著相关。结论：营养不良的标志物与身体功能评分下降相关，与病例组合无关。因此，改善营养的措施可能会产生广泛的影响，不仅可以改善发病率和死亡率，还可以改善终末期肾病患者与健康有关的生活质量。(C)2002年，美国国家肾脏基金会（National Kidney Foundation，Inc.）
Objective: To determine associations of potentially modifiable nutritional factors with physical and mental health status after adjusting for sociodemographic and comorbid conditions.Design: Cross-sectional multivariable analysis.Setting: Fifteen dialysis centers across the United States participating in the Reduction of Morbidity and Mortality Among Hemodialysis Patients (HEMO) study.Patients: Enrollment of 1,545 prevalent hemodialysis subjects in the HEMO study.Independent (Predictor) Variables: The following nutritional markers were assessed in this analysis: serum albumin, energy intake, protein catabolic rate, serum creatinine, midarm muscle circumference, calf circumference, and smoking status. Smoking status, although not a nutritional factor per se, was also included because it is a modifiable lifestyle factor.Main Outcome Measures: Physical and mental health status were assessed using the medical staff-assessed Kamofsky Index and the patient self-assessed Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36).Results: After adjusting for sociodemographic factors and comorbid conditions, serum albumin, serum creatinine, and calf circumference were independently associated with Karnofsky Index scores. Similarly, serum creatinine and calf circumference were also independently associated with the Physical Component Summary (PCS) score of the SF-36. Of the nutritional variables selected, no variables were significantly associated with the Mental Component Summary (MCS) score of the SF-36.Conclusions: Markers of poor nutrition were associated with decreased physical functioning scores, independent of case mix. Measures that improve nutrition may therefore have wide-reaching effects to improve not only morbidity and mortality but also health-related quality of life for patients with end-stage renal disease. (C) 2002 by the National Kidney Foundation, Inc.