Waist circumference as a predictor of mortality in peritoneal dialysis patients: a follow-up study of 48 months
Waist circumference as a predictor of mortality in peritoneal dialysis patients: a follow-up study of 48 months
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DOI：
10.1017/s0007114517001179
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发表时间：
2017-05-01
影响因子：
3.6
通讯作者：
Kamimura, Maria A.
中科院分区：
文献类型：
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作者：
Castro, Ana Catarina M.;Bazanelli, Ana Paula;Kamimura, Maria A.
体脂增加是腹膜透析（PD）患者的常见发现，脂肪组织的积聚主要发生在腹部区域。腰围（WC）是腹部肥胖的可靠标志物，其与非透析和血液透析患者的不良结局相关。我们的目的是调查WC测量以及WC随时间的变化是否能够预测PD患者的死亡率。这项前瞻性研究包括109例接受PD的患者（57%为男性，年龄52（sd 16）岁，32%为糖尿病患者，48%为BMI 25 kg/m2）。在脐水平（空腹腔）测量WC，女性>88 cm和男性>102 cm被认为是高值。还评估了营养状况和实验室参数。在基线和6个月后测量WC，并在48个月期间登记死亡率。基线时，55%的女性和23%的男性观察到高WC。6个月后，61%的患者显示WC增加。研究结束时，登记了27例死亡。仅在非幸存者组中观察到WC显著增加。在调整性别、年龄、透析持续时间、糖尿病、BMI、血清白蛋白和C反应蛋白的考克斯回归分析中，基线时高WC以及6个月WC增加与死亡率独立相关。这项研究表明，高WC和WC随时间的增加都是PD患者死亡率的预测因子。
Body-fat gain is a common finding among peritoneal dialysis (PD) patients, and the accumulation of adipose tissue occurs predominantly in the abdominal area. Waist circumference (WC) is a reliable marker of abdominal obesity and its association with worse outcomes has been demonstrated in non-dialysis and haemodialysis patients. We aimed at investigating whether WC measurements as well as the changes over time in WC were able to predict mortality in PD patients. This prospective study included 109 patients undergoing PD (57 % male, age 52 (sd 16) years, 32 % diabetics, 48 % BMI25 kg/m(2)). WC was measured at the umbilicus level (empty abdominal cavity), and values >88 cm for women and >102 cm for men were considered high. Nutritional status and laboratory parameters were also evaluated. WC was measured at baseline and after 6 months, and mortality was registered during a period of 48 months. High WC was observed in 55 % of women and in 23 % of men at baseline. After 6 months, 61 % of the patients showed an increased WC. At the end of the study, twenty-seven deaths were registered. A significant increase in WC was observed only in the non-survivor group. In the Cox regression analysis adjusting for sex, age, duration on dialysis, diabetes, BMI, serum albumin and C-reactive protein, high WC at baseline as well as the 6-month increase in WC were independently associated with mortality. This study demonstrated that a high WC and the increase over time in WC were both predictors of mortality in PD patients.