慢性肾脏病非透析患者瘦组织质量/脂肪组织质量比值与左心室肥厚的关系  

Relationship between lean tissue mass/adipose tissue mass ratio and left ventricular hypertrophy in non-dialysis patients with chronic kidney disease

作　　者：张承宁[1] 马玉晨 段俗言 袁杨刚[1] 毛慧娟[1] 张波[1] ZHANG Chengning;MA Yuchen;DUAN Suyan;YUAN Yanggang;MAO Huijuan;ZHANG Bo(Department of Nephrology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,China)

机构地区：[1]南京医科大学第一附属医院肾内科,江苏南京210029

出　　处：《南京医科大学学报（自然科学版）》2024年第10期1401-1407,共7页Journal of Nanjing Medical University(Natural Sciences)

基　　金：北京融和医学发展基金会(KYS2021-03-02-14)。

摘　　要：目的:探讨瘦组织质量(lean tissue mass,LTM)/脂肪组织质量(adipose tissue mass,ATM)比值对慢性肾脏病(chronic kidney disease,CKD)非透析患者左心室肥厚(left ventricular hypertrophy,LVH)的影响。方法:纳入CKD非透析患者417例,根据左心室重量指数(left ventricular mass index,LVMI)分为左心室正常组(Non-LVH组)240例、左心室肥厚组(LVH组)177例。收集基线资料及实验室指标等参数,同时收集超声心动图及生物电阻抗检测结果,比较两组之间的基线数据及LTM/ATM比值等数据。采用多因素Logistic回归分析CKD非透析患者LVH的危险因素。绘制受试者工作特征(receiver operating characteristic,ROC)曲线评价LTM/ATM对LVH的预测价值。结果:LVH组高血压患病率、年龄、女性比例、收缩压显著高于Non-LVH组,BMI、血红蛋白、血白蛋白、估算的肾小球滤过率(estimated Glomerular Filtration Rate,eGFR)显著低于Non-LVH组,差异均有统计学意义。LVH组LTM、瘦组织指数、LTM/ATM比值低于Non-LVH组,两组之间容量负荷差异无统计学意义。多因素Logistic回归分析显示年龄、BMI、收缩压、血红蛋白、LTM/ATM比值+性别均为CKD非透析患者LVH的独立危险因素。LTM/ATM比值+性别联合血红蛋白预测LVH的ROC曲线下面积为0.769。结论:低LTM/ATM比值为CKD非透析患者LVH的危险因素,该比值预测此类患者LVH的发生具有一定价值。Objective:To explore the effect of lean tissue mass(LTM)/adipose tissue mass(ATM)ratio on left ventricular hypertrophy(LVH)in non-dialysis patients with chronic kidney disease(CKD).Methods:417 non-dialysis patients with CKD were included and divided into a normal left ventricular(Non-LVH)group with 240 patients and a left ventricular hypertrophy(LVH)group with 177 patients according to the left ventricular mass index(LVMI).Baseline data and laboratory indicators were collected,along with echocardiography and bioelectrical impedance analysis results.Baseline data and LTM/ATM ratio were compared between the two groups.Multivariate logistic regression analysis was used to determine the risk factors for LVH in non-dialysis CKD patients.The receiver operator characteristic(ROC)curve was drawn to evaluate the predictive value of LTM/ATM ratio for LVH.Results:The prevalence of hypertension,age,female ratio,and systolic blood pressure in the LVH group were significantly higher than those in the Non-LVH group,while BMI,hemoglobin,albumin,and eGFR were significantly lower than those in the Non-LVH group,all with statistical differences.The LTM,lean tissue index and LTM/ATM ratio in the LVH group were lower than those in the Non-LVH group,and there was no difference in volume load between the two groups.Multivariate logistic regression analysis showed that age,BMI,systolic blood pressure,hemoglobin,and LTM/ATM ratio-gender were all independent risk factors for LVH in non-dialysis CKD patients.The area under the ROC curve of LTM/ATM ratio-gender combined with hemoglobin in predicting LVH was 0.769.Conclusion:A low LTM/ATM ratio is a risk factor for LVH in nondialysis CKD patients,and this ratio has predictive value for the occurrence of LVH in such patients.

关 键 词：慢性肾脏病 左心室肥厚 瘦组织质量/脂肪组织质量 生物电阻抗 

分 类 号：R586.12[医药卫生—内分泌]