Hypoalbuminemia is also a marker of fluid excess determined by bioelectrical impedance parameters in dialysis patients
Hypoalbuminemia is also a marker of fluid excess determined by bioelectrical impedance parameters in dialysis patients
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DOI：
10.1111/j.1744-9987.2007.00416.x
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发表时间：
2007-04-01
影响因子：
1.9
通讯作者：
Selgas, Rafael
中科院分区：
文献类型：
--
作者：
Cigarran, Secundino;Barril, Guillermina;Selgas, Rafael
低白蛋白血症可能继发于容量扩张情况，也是心血管疾病的独立危险因素。生物电阻抗分析 (BIA) 是一种准确、非侵入性的方法，用于测量身体成分，尤其是人体的水室。本横断面研究的目的是评估血清白蛋白浓度 (SA) 与全 BIA 测量的水合状态之间的关系。该研究调查了 108 名未经选择的患者（73 名接受血液透析，35 名接受腹膜透析），平均年龄为 61.4 +/- 15.6 岁，其中 42.7% 为女性。患者根据 SA 进行分组：第 1 组，4.0 g/dL。使用的 BIA 参数包括：体内水分总量、细胞内水分 (ICW)、细胞外水分 (ECW)、相位角 (PA)、体细胞质量 (BCM)、ICW/ECW 比率以及患者/对照 ICW/ECW 比率（体液指数）。七十五名健康志愿者组成对照组。 PA 和液体指数之间（r(2) = 0.993，P < 0.001）、PA 和 SA 之间（r = 0.386，P < 0.001）以及 ICW/ECW 比值和 SA 之间（r = 0.227，P < 0.001）之间存在很强的正相关性。 ECW 与 SA 呈负相关（r = -0.330，P < 0.001）。 SA 每减少 0.1 g/dL，ECW 就会增加 0.33 L。与第 2 组和第 3 组患者相比，第 1 组患者的电抗 (P = 0.006)、PA (P < 0.001)、BCM (P = 0.012)、液体指数 (P < 0.001) 和 ICW/ECW 比率 (P = 0.015) 较低，并且 ECW (NS) 增加。我们得出结论，低蛋白血症也是液体过量的标志。 SA 与体液指数相关，而 PA 可以评估透析患者的个体化干重及其变化。
Hypoalbuminemia may be secondary to volume expansion conditions and an independent risk factor for cardiovascular disease. Bioelectrical impedance analysis (BIA) is an accurate, non-invasive method to measure body composition, especially the water compartments in humans. The aim of this cross-sectional study is to evaluate the relationship between serum albumin concentration (SA) and hydration state measured by whole BIA. The study investigated 108 non-selected patients (73 on hemodialysis, 35 on peritoneal dialysis) with a mean age of 61.4 +/- 15.6 years, 42.7% of whom were female. The patients were allotted to groups according to their SA: Group 1, 4.0 g/dL. The BIA parameters used included: total body water, intracellular water (ICW), extracellular water (ECW), phase angle (PA), body cell mass (BCM), ICW/ ECW ratio and ICW/ECW ratio patients/controls (fluid index). Seventy-five healthy volunteers formed the control group. A strong positive correlation was found between the PA and fluid index (r(2) = 0.993, P < 0.001), as well as between the PA and SA (r = 0.386, P < 0.001), and the ICW/ECW ratio and SA (r = 0.227, P < 0.001). The ECW was negatively correlated with SA (r = -0.330, P < 0.001). Every 0.1 g/dL decrease in SA was associated with a 0.33 L increase in ECW. Group 1 patients had lower reactance (P = 0.006), PA (P < 0.001), BCM (P = 0.012), fluid index (P < 0.001) and ICW/ECW ratio (P = 0.015), and an increased ECW (NS) than groups 2 and 3. We conclude that hypoalbuminemia is also a marker of fluid excess. The SA is associated to the fluid index and the PA allows assessment of the dry weight and its variations in an individualized mariner in dialysis patients.