Comparison of Body Mass Index, Skinfold Thickness, and Bioelectrical Impedance Analysis With Dual-Energy X-Ray Absorptiometry in Hemodialysis Patients
Comparison of Body Mass Index, Skinfold Thickness, and Bioelectrical Impedance Analysis With Dual-Energy X-Ray Absorptiometry in Hemodialysis Patients
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DOI：
10.1002/ncp.10481
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发表时间：
2020-03-05
影响因子：
3.1
通讯作者：
Wazlawik, Elisabeth
中科院分区：
文献类型：
--
作者：
de Abreu, Aline Miroski;Wilvert, Luana Cristina;Wazlawik, Elisabeth
背景 营养不良是血液透析 (HD) 患者的一个普遍现象，并且与高死亡率相关。目的是使用双能 X 射线吸收测定法 (DXA) 作为 HD 患者的参考来比较营养状况指标。方法 观察性横断面研究，纳入 42 名患者，年龄 55.8 岁 (+/- 14.6)，60% 为男性，每周 HD 2-3 次，持续≥ 3 个月。 HD 范围为 3 个月至 28 年（中位数为 17.3；四分位距为 8.73-39.0）。我们通过皮褶厚度 (SFT)、生物电阻抗分析 (BIA) 和 DXA 使用体重指数 (BMI) 和脂肪量 (FM)。统计分析使用 Bland-Altman 图、Lin 一致性相关系数、pairedt 检验以及 Pearson 或 Spearman 相关性。P< .05 具有显着性。结果SFT和DXA显示营养不良患病率最低（2.4%），BMI最高（28.6%）。 BMI、BIA FM 和 SFT FM 与 DXA FM 呈强正相关（分别为 r= 0.915；r= 0.976；r= 0.910，P< .001）。 BIA FM 和去脂体重 (FFM) 与 DXA 值基本一致（rho = 0.974 和 0.960，P< .001）。因此，根据 DXA，所使用的测量程序 SFT 和 BIA 低估了 %FM（-4.65% 和 -2.13%），高估了 FFM（3.12 kg 和 1.0 kg）。 BIA FM 和 DXA 的平均值之间没有发现差异 (P= .178)。结论 与DXA相比，BIA是最适合测量身体成分的营养指标。
Background Malnutrition is a consistent finding in hemodialysis (HD) patients and is associated with high mortality. The aim was to compare nutrition status indicators using dual-energy x-ray absorptiometry (DXA) as reference in HD patients. Methods Observational cross-sectional study with 42 patients, 55.8 years (+/- 14.6) old, 60% male, HD 2-3 times per week for >= 3 months. HD ranged from 3 months to 28 years (median, 17.3; interquartile range, 8.73-39.0). We used body mass index (BMI) and fat mass (FM) by skinfold thickness (SFT), bioelectrical impedance analysis (BIA), and DXA. Statistical analyses used Bland-Altman plots, Lin's concordance correlation coefficient, the pairedt-test, and Pearson or Spearman correlation.P< .05 was significant. Results SFT and DXA presented the lowest prevalence of malnutrition (2.4%) and BMI the highest (28.6%). BMI, BIA FM, and SFT FM presented strong positive correlations with DXA FM (r= 0.915;r= 0.976;r= 0.910,P< .001, respectively). BIA FM and fat-free mass (FFM) demonstrated substantial agreement with DXA values (rho = 0.974 and 0.960,P< .001). Thus, the measurement procedures used, SFT and BIA, underestimated %FM (-4.65% and -2.13%) and overestimated FFM (3.12 kg and 1.0 kg) according to DXA. No differences were found between mean values of BIA FM and DXA (P= .178). Conclusions Compared with DXA, BIA was the most appropriate nutrition indicator for measuring body composition.