维持性血液透析患者中伴发代谢综合征时人体成分的变化  

Body composition changes in maintenance hemodialysis patients with metabolic syndrome

作　　者：庞慧华[1] 陈永华[1,2] 朱铭力[1] 陆任华[1] 周文彦[1] 张伟明[1] 钱家麒[1] 倪兆慧[1] 严玉澄[1] 

机构地区：[1]上海交通大学医学院仁济医院肾脏科,上海200127 [2]上海市第八人民医院肾脏科,上海200235

出　　处：《中国血液净化》2010年第11期599-603,共5页Chinese Journal of Blood Purification

基　　金：上海市科委重大科研项目(08DZ1900500)

摘　　要：目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者伴发代谢综合征(metabolic syndrome,MS)时人体成分的变化。方法选择上海交通大学医学院附属仁济医院MHD患者93例。应用人体成分监测仪(body composition monitor,BCM)进行人体成分分析。同时测量身高、腰围、臀围和肱三头肌皮下脂肪厚度,并计算体质量指数(body mass index,BMI)。进行主观综合性营养评估(subjective global assessment,SGA)。记录年龄、性别、透析龄、空腹血糖、血脂、白蛋白等生化指标。根据2005年国际糖尿病联盟标准,筛选出MS患者,比较MS和非MS患者的人体成分组成情况和生化指标。结果 93例血液透析患者中伴发MS者28例(30.11%)。MS患者的空腹血糖、甘油三酯、C反应蛋白均高于非MS患者(P<0.05),而高密度脂蛋白水平相对较低(P<0.05);两组患者SGA评分相似;MS患者的体质量、BMI、腰围、臀围均高于非MS患者(P<0.05);BCM测量中,MS患者脂肪组织含量、脂肪量、脂肪组织指数高于非MS患者,差异有统计学意义(P<0.05),而瘦组织含量、瘦组织指数、水负荷则无明显差别。结论伴发MS的MHD患者存在脂肪(尤其是内脏脂肪)过度积聚,体质量增加、而肌肉量、SGA、白蛋白等营养指标和体内水分含量无明显变化。Objective To detect body composition changes in maintenance hemodialysis （MHD） patients with metabolic syndrome （MS）. Methods Ninety-three MHD patients from Renji Hospital affiliated to Shanghai Jiaotong University, School of Medicine were enrolled in this study. Body composition analysis was performed by a body composition monitor （BCM）. Body weight, waistline, hipline, triceps skinfold thickness were measured, and body mass index （BMI） was then calculated. Subjective global assessment （SGA） was used for nutrition evaluation. Age, sex, duration of dialysis, fast plasma glucose, lipid profile, albumin and other biochemical data were recorded. MS was diagnosed based on the definition of International Diabetes Federation, 2005. We then compared the biochemical data and body composition between MS and non-MS MHD patients. Results Twenty-eight MHD patients （30.1%） were diagnosed as MS. In MS patients, fast plasma glucose, triglyceride, and CRP were higher, while high density lipopro- tein was lower （P〈0.05）. SGA score was similar in MS and non-MS patients. Body weight, waistline, hipline and BMI were higher in MS patients （P〈0.05）. In BCM analysis for MS patients, adipose tissue mass, fat and fat tissue index were higher （P〈0.05）, and lean tissue mass, lean tissue index and hydration load had no significant differences compared with non-MS patients. Conclusion MHD patients with MS have excessive fat accumulation （especially in visceral fat） and increased body weight, but have little changes in body water and nutritional parameters such as muscle mass, SGA score and serum albumin.

关 键 词：血液透析 代谢综合征 人体成分 

分 类 号：R318.16[医药卫生—生物医学工程]