Body fat mass and lean mass as predictors of survival in hemodialysis patients
Body fat mass and lean mass as predictors of survival in hemodialysis patients
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DOI：
10.1038/sj.ki.5000331
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发表时间：
2006-08-01
影响因子：
19.6
通讯作者：
Nishizawa, Y.
中科院分区：
文献类型：
--
作者：
Kakiya, R.;Shoji, T.;Nishizawa, Y.
较高的体重指数（BMI）是血液透析患者生存率较好的预测因子，尽管尚未在透析人群中研究体脂和瘦体重的相对重要性。我们对808例终末期肾病维持性血液透析患者进行了一项观察性队列研究。在基线时，通过双能X线吸收法测量脂肪质量，并表示为脂肪质量指数（FMI; kg/m2）。瘦体重指数（LMI）定义为BMI减去FMI。在平均53个月的随访期间，记录了147例死亡，包括62例心血管（CV）和85例非CV致死性事件。在单变量分析中，LMI与CV或非CV死亡无显著相关性，而FMI越高，非CV死亡风险越低。采用多变量考克斯模型（将其他混杂变量作为协变量）进行的分析表明，LMI较高与CV死亡风险较低之间以及FMI较高与非CV死亡风险较低之间存在独立相关性。这些结果表明，脂肪量和瘦体重增加均与透析人群的更好结局相关。
A higher body mass index (BMI) is a predictor of better survival in hemodialysis patients, although the relative importance of body fat and lean mass has not been examined in the dialysis population. We performed an observational cohort study in 808 patients with end-stage renal disease on maintenance hemodialysis. At baseline, fat mass was measured by dual-energy X-ray absorptiometry and expressed as fat mass index (FMI; kg/m(2)). Lean mass index (LMI) was defined as BMI minus FMI. During the mean follow-up period of 53 months, 147 deaths, including 62 cardiovascular (CV) and 85 non-CV fatal events, were recorded. In univariate analysis, LMI was not significantly associated with CV or non-CV death, whereas a higher FMI was predictive of lower risk for non-CV death. Analyses with multivariate Cox models, which took other confounding variables as covariates, indicated the independent associations between a higher LMI and a lower risk of CV death, as well as between a higher FMI and a lower risk of non-CV death. These results indicate that increased fat mass and lean mass were both conditions associated with better outcomes in the dialysis population.