Association of Malnutrition-Inflammation Score with quality of life and mortality in hemodialysis patients: a 5-year prospective cohort study.
Association of Malnutrition-Inflammation Score with quality of life and mortality in hemodialysis patients: a 5-year prospective cohort study.
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DOI：
10.1053/j.ajkd.2008.09.018
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发表时间：
2009-03
期刊：
影响因子：
--
通讯作者：
Kalantar-Zadeh K
中科院分区：
文献类型：
--
作者：
Rambod M;Bross R;Zitterkoph J;Benner D;Pithia J;Colman S;Kovesdy CP;Kopple JD;Kalantar-Zadeh K
营养不良炎症评分 (MIS) 是一种廉价且易于评估的 0 至 30 分值，用于检查蛋白质能量消耗 (PEW) 和炎症，包括主观总体评估、体重指数以及血清白蛋白和转铁蛋白浓度的 7 个组成部分。我们假设慢性血液透析 (HD) 患者的 MIS 风险分层在预测结果方面优于其组成部分或炎症实验室标志物。 5年队列研究。我们检查了 809 名病情稳定的 HD 门诊患者，并对他们进行了长达 5 年的随访（10/2001-12/2006）。 MIS 和其他营养和炎症标记物。通过 SF-36 预测全因死亡率、健康相关生活质量以及身体成分测试。 MIS 与血清白细胞介素 6 (IL-6)（r=+0.26，p<0.001）、C 反应蛋白（CRP）（r=+0.16，p<0.001）以及营养状况的多项指标相关。 MIS 较高的患者 SF-36 评分较低。对病例组合和其他 PEW 指标进行多变量调整后，MIS 第二（3-4）、第三（5-7）和第四（≥8）四分位数的慢性 HD 患者的生存率比第一（0-2）四分位数的慢性 HD 患者的生存率更差（p<0.001）。 MIS 每增加 2 个单位，死亡风险就会增加两倍，即调整后的死亡风险比为 2.03（95% CI：1.76-2.33，p<0.001）。三次样条生存模型证实了线性趋势。 MIS 预测 5 年死亡率的连续体的受试者工作特征曲线下面积 (0.67) 等于 IL-6 (0.67)，略优于 CRP (0.63)。选择偏差和未知的混杂因素。在慢性 HD 患者中，MIS 与炎症、营养状况、生活质量和 5 年预期死亡率相关。 MIS 的死亡率预测能力似乎与血清 IL-6 相同，略高于 CRP。有必要进行对照试验来检验改善 MIS 的干预措施是否也能改善慢性 HD 患者的临床结果。
The Malnutrition-Inflammation Score (MIS), a non-expensive and easy-to-assess score between 0 and 30 to examine protein-energy wasting (PEW) and inflammation, includes 7 components of the subjective global assessment, body mass index, and serum albumin and transferrin concentrations. We hypothesized that the MIS risk-stratification of chronic hemodialysis (HD) patients in predicting outcomes is better than its components or laboratory markers of inflammation. 5-year cohort study. We examined 809 stable HD outpatients and followed them for up to 5 years (10/2001–12/2006). MIS and other nutritional and inflammatory markers. Prospective all-cause mortality, health-related quality of life via SF-36, and tests of body composition. The MIS was correlated with serum interleukin-6 (IL-6) (r=+0.26, p<0.001), C-reactive protein (CRP) (r=+0.16, p<0.001) and several measures of nutritional status. Patients with higher MIS had lower SF-36 scores. After multivariate adjustment for case-mix and other measures of PEW, the chronic HD patients in the second (3–4), third (5–7) and fourth (≥8) quartiles of MIS had worse survival rates than those in the first (0–2) quartile (p<0.001). Each 2 unit increase in MIS was associated with two-fold higher death risk, i.e., adjusted death hazard ratio of 2.03 (95% CI: 1.76–2.33, p<0.001). Cubic spline survival models confirmed linear trends. The areas under the receiver operating characteristic curves for the continuum of MIS in predicting 5-year mortality (0.67) was equal to IL-6 (0.67) and somewhat better than CRP (0.63). Selection bias and unknown confounders. In chronic HD patients, the MIS is associated with inflammation, nutritional status, quality of life, and 5-year prospective mortality. The mortality-predictability of the MIS appears equal to serum IL-6 and somewhat greater than CRP. Controlled trials are warranted to examine whether interventions to improve MIS can also improve clinical outcomes in chronic HD patients.
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影响因子：
2
作者：
DURRLEMAN, S;SIMON, R
通讯作者：
SIMON, R
DOI：
10.2215/cjn.02010507
发表时间：
2008-03-01
影响因子：
9.8
作者：
Badiou, Stephanie;Cristol, Jean-Paul;Dupuy, Anne-Marie
通讯作者：
Dupuy, Anne-Marie
影响因子：
6.1
作者：
Kalantar-Zadeh, K;Dunne, E;Luft, FC
通讯作者：
Luft, FC
影响因子：
13.2
作者：
DeOreo, PB
通讯作者：
DeOreo, PB
影响因子：
3.2
作者：
Colman, S;Bross, R;Kalantar-Zadeh, K
通讯作者：
Kalantar-Zadeh, K