Longitudinal changes in bioimpedance phase angle reflect inverse changes in serum IL-6 levels in maintenance hemodialysis patients
Longitudinal changes in bioimpedance phase angle reflect inverse changes in serum IL-6 levels in maintenance hemodialysis patients
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DOI：
10.1016/j.nut.2013.08.017
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发表时间：
2014-03-01
期刊：
影响因子：
4.4
通讯作者：
Averbukh, Zhan
中科院分区：
文献类型：
--
作者：
Beberashvili, Ilia;Azar, Ada;Averbukh, Zhan
目的：我们假设相角（PA）的纵向变化与维持血液透析（MHD）患者的炎症参数随时间的变化有独立的关联，从而与长期生存有关。本研究的目的是确定营养和炎症参数随时间变化对MHD患者PA变化和随后死亡率的影响。方法：对91例流行HD患者（男性57例，女性34例）进行为期2年的前瞻性纵向研究，随后进行为期3年的临床观察。在基线和入组后6、12、18和24个月测量饮食摄入量、营养生化指标、身体成分和白细胞介素(IL)-6水平。结果：在基线人口统计学和临床参数调整后的线性混合效应模型中，随着时间的推移，每增加pg/mL的IL-6与PA水平降低0.001度/2-y相关（IL-6 x时间相互作用P = 0.003）。即使在控制细胞外水和脂肪量后，PA仍与IL-6的变化率相关。PA随时间的变化与IL-6呈负线性变化相关（调整后r = -0.32; P = 0.005），因此与死亡风险相关。使用具有时变风险影响的Cox模型，PA每升高1度，粗死亡率风险比和校正死亡率风险比分别为0.62（95%可信区间[CI]， 0.54-0.71）和0.61 （95% CI, 0.53-0.71）。此外，PA的纵向变化与主要营养指标随时间变化的斜率显著相关。结论：PA的纵向变化似乎在检测营养和炎症参数随时间的变化方面是可靠的，这一组合可能有助于理解其预后效用。(C) 2014爱思唯尔公司版权所有。
Objective: We hypothesize that longitudinal changes in phase angle (PA) have independent associations with changes in inflammatory parameters over time and consequently with long-term survival in patients on maintenance hemodialysis (MHD). The aim of the present study was to determine the effect of change in nutritional and inflammatory parameters over time on change in PA and on subsequent mortality in patients on MHD.Methods: A 2-y prospective longitudinal study was performed on 91 prevalent HD patients (57 men and 34 women), followed by an additional 3 y of clinical observations. Dietary intake, biochemical markers of nutrition, body composition, and interleukin (IL)-6 levels were measured at baseline and at 6, 12, 18, and 24 mo following enrollment.Results: In a linear mixed-effect model adjusted for baseline demographic and clinical parameters, each pg/mL increase in IL-6 over time was associated with a decrease in PA levels of 0.001 degrees/2-y (P = 0.003 for IL-6 x time interaction). PA remained associated with the rate of change in IL-6 even after controlling for extracellular water and fat mass. Changes in PA over time were associated with inverse linear changes in IL-6 (adjusted r = -0.32; P = 0.005) and consequently with mortality risk. For each 1 degrees increase in PA, the crude and adjusted mortality hazard ratios using Cox models with effect of time-varying risk were 0.62 (95% confidence interval [CI], 0.54-0.71) and 0.61 (95% CI, 0.53-0.71), respectively. Additionally, longitudinal changes in PA exhibited significant associations with slopes of changes over time in main nutritional markers.Conclusions: Longitudinal changes in PA appear to be reliable in detecting changes in nutritional and inflammatory parameters over time, a combination that may contribute to the understanding of its prognostic utility. (C) 2014 Elsevier Inc. All rights reserved.