Bioimpedance analysis predicts the etiology of cirrhosis in a prospective cohort study.
Bioimpedance analysis predicts the etiology of cirrhosis in a prospective cohort study.
复制标题
DOI：
10.1097/hc9.0000000000000253
复制
发表时间：
2023-10-01
影响因子：
5.1
通讯作者：
中科院分区：
文献类型：
--
作者：
肥胖与肝硬化风险增加有关。然而，身体质量指数（BMI）和腰臀比（WHR）可能不能指示易患肝硬化的身体成分参数。生物阻抗分析（BIA）是一种无创、经济有效的方法，可以更详细地估计人体成分。作为前瞻性队列研究的一部分，我们对肝硬化患者进行了BIA检查。我们检查了BIA变量、BMI和WHR之间的相关性。我们进行了性别调整、种族调整和种族特异性多变量logistic回归分析，以检验人体测量变量与危险因素[NAFLD、酒精相关性肝病（ALD）和HCV]之间的关系。我们分析了348例肝硬化患者的数据；23.3%为女性；48.3%为非西班牙裔白人；19.3%为西班牙裔；30.7%是非洲裔美国人。肝硬化病因中，NAFLD占21.8%，HCV治愈占56.9%，ALD占11.5%。几个BIA变量与BMI有良好的相关性，其他变量表现出适度的相关性，但没有一个与WHR有良好的相关性。较高的体脂质量和基础代谢率呈正相关，而较高的瘦体质量、干瘦体质量、全身总水量或骨骼肌质量与NAFLD呈负相关。这些BIA参数与ald相关肝硬化之间的关联方向相反。BIA变量的这些关联仅在西班牙裔和非西班牙裔白人患者中可见，而在非西班牙裔黑人患者中没有。BIA变量比BMI或WHR更能预测肝硬化病因。在肝硬化患者中，一些来自bia的测量表明，体脂肪和肌肉与NAFLD和ALD病因相关。与BMI或WHR相比，BIA变量与肝硬化病因的相关性以及种族/民族特异性相关性更强。
Obesity is associated with an increased risk of developing cirrhosis. However, body mass index (BMI) and waist-to-hip ratio (WHR) may not be indicative of body composition parameters that predispose to cirrhosis. Bioimpedance analysis (BIA) is a noninvasive cost-efficient method for more detailed estimation of body composition. We examined patients with cirrhosis who underwent BIA as part of enrollment into a prospective cohort study. We examined the correlation between BIA variables, BMI, and WHR. We performed sex-adjusted and race-adjusted and race-specific multivariable logistic regression analyses to examine the association between anthropometric variables and risk factors [NAFLD, alcohol-associated liver disease (ALD), and HCV]. We analyzed data from 348 cirrhosis patients; 23.3% were women; 48.3% were non-Hispanic White; 19.3% were Hispanic; and 30.7% were African American. The cirrhosis etiology was 21.8% NAFLD, 56.9% HCV mostly cured, and 11.5% ALD. Several BIA variables correlated well with BMI, and others showed modest correlations, but none correlated well with WHR. Higher body fat mass and basal metabolic rate were positively associated, while higher lean body mass, dry lean mass, total body water, or skeletal muscle mass were negatively associated with NAFLD. Associations between these BIA parameters and ALD-related cirrhosis were in the opposite direction. These associations of BIA variables were seen only in Hispanic and non-Hispanic White patients but not non-Hispanic Blacks. BIA variables were more predictive of cirrhosis etiology than BMI or WHR. Among patients with cirrhosis, several BIA-derived measurements indicative of body fat and muscle are associated with NAFLD and ALD etiology. BIA variables show stronger associations, as well as race/ethnicity-specific associations, with cirrhosis etiology than those of BMI or WHR.