内脏脂肪面积对腹膜透析病人心肺耐力的影响  

Effect of visceral fat area on cardiorespiratory fitness in peritoneal dialysis patients

作　　者：张紫艳 谭丹丹 黄德剑 董大宝 张颖 ZHANG Ziyan;TAN Dandan;HUANG Dejian;DONG Dabao;ZHANG Ying(Department of Nephrology,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)

机构地区：[1]徐州医科大学附属医院肾内科,江苏徐州221000

出　　处：《安徽医药》2025年第1期160-165,共6页Anhui Medical and Pharmaceutical Journal

摘　　要：目的探讨持续非卧床腹膜透析(CAPD)病人心肺耐力与内脏脂肪面积的相关性。方法共纳入2021年5月至2022年10月于徐州医科大学附属医院进行规律CAPD的52例病人,进行心肺耐力(CRF)及内脏脂肪面积(VFA)相关指标测量,以峰值耗氧量(Peak VO2)为CRF金标准,将病人分为CRF轻度受损组(Peak VO2≥20 mL·kg^(−1)·min^(−1))及CRF中重度受损组(Peak VO2<20 mL·kg^(−1)·min^(−1))。分析两组间VFA及临床指标有无差异性,探讨CRF独立危险因素。结果CRF中重度受损组VFA、脂肪组织指数、浮肿指数(ECW/TBW)、空腹血糖及三酰甘油显著高于CRF轻度受损组,CRF中重度受损组VFA为73.95(59.83,107.03)cm2,CRF轻度受损组VFA为50.75(40.68,56.85)cm2,而转铁蛋白饱和度显著低于轻度受损组(均P<0.05)。通过Pearson与Spearman相关分析发现Peak VO2分别与脂肪组织指数、内脏脂肪面积、浮肿指数、空腹血糖、CRP、糖尿病状态、服用降脂药呈负相关(均P<0.05),与转铁蛋白饱和度(r=0.32,P=0.021)呈正相关。骨骼肌指数与Peak VO2差异无统计学意义(P>0.05)。将单因素回归分析中P<0.05的指标纳入到多元线性回归分析中,发现内脏脂肪面积(β=−0.40,P=0.002)、尿素清除指数(kt/V)(β=0.31,P=0.013)及糖尿病状态(β=−0.38,P=0.026)为CRF的独立风险因素。结论内脏脂肪面积、尿素清除指数及患有糖尿病为CAPD病人低心肺耐力独立风险因素,内脏脂肪面积对心肺耐力的影响更大,加强内脏脂肪的管理可减少CAPD病人心血管疾病。Objective To investigate the correlation between cardiorespiratory fitness and visceral fat area in continuous ambulatory peritoneal dialysis(CAPD)patients.Methods A total of 52 patients who underwent regular CAPD in the Affiliated Hospital of Xuzhou Medical University from May 2021 to October 2022 were included.Cardiorespiratory fitness(CRF)and visceral fat area(VFA)related indicators were measured,with peak oxygen consumption(Peak VO2)as the gold standard for CRF,the patients were assigned into mild CRF impairment group(Peak VO2≥20 mL·kg^(−1)·min^(−1))and moderate to severe CRF impairment group(Peak VO2<20 mL·kg^(−1)·min^(−1)).The differences in VFA and clinical indicators between the two groups were analyzed and independent risk factors for CRF were explored.Results The VFA,fat tissue index,edema index(ECW/TBW),fasting glucose,and triglycerides in the moderate to severe CRF impairment group were significantly higher than those in the mild CRF impairment group.The VFA in the moderate to severe CRF impairment group was 73.95(59.83,107.03)cm2,and the VFA in the mild CRF impairment group was 50.75(40.68,56.85)cm2.While the transferrin saturation in the moderate to severe CRF impairment group was significantly lower than that in the mild CRF impairment group(all P<0.05).Pearson or Spearman correlation analysis showed that Peak VO2 was negatively correlated with fat tissue index,visceral fat area,edema index,fasting glucose,CRP,diabetes status,and taking lipid-lowering drugs,respectively(all P<0.05),and positively correlated with transferrin saturation(r=0.32,P=0.021).There was no significant correlation between skeletal muscle index and Peak VO2(P>0.05).The P<0.05 index in the single factor regression analysis was included in the multiple linear regression analysis,it was found that the visceral fat area(β=−0.40,P=0.002),urea clearance index(Kt/V)(β=0.31,P=0.013)and diabetes status(β=−0.38,P=0.026)were an independent risk factors for CRF.Conclusion Visceral fat area,urea clearance index and dia

关 键 词：腹膜透析 持续不卧床 心肺耐力 内脏脂肪面积 峰值耗氧量 心血管疾病 

分 类 号：R692[医药卫生—泌尿科学]