原著論文 利用多頻率生物電阻法測量血液透析病人體組成與營養指標之相關性 1 2,3 2 2,3 2,3 1,4 1 2 3 4 摘要 BIA bioelectric impedance analysis lean tissue mass, LTM lean tissue index, LTI 98 subjective global assessment, SGA bioelectrical Impedance, BIA midarm muscle circumference MAMC handgrip strength SGA albumin LTM p <0.05 MAMC triceps skinfold, TSF handgrip strength LTI LTM LTM LTI MAMC =0.88 p=0.001 handgrip strength =0.52 p <0.001 LTM MAC =0.38 p=0.065 SGA =3.21 p=0.064 LTM albumin LTM MAMC handgrip strength LTI kg/m 2 albumin BIA LTM LTI MAMC handgrip LTM SGA BIA LTM LTI 100 07-3121101 5341 mechhu@kmu.edu.tw TJD 2010;2(1):19-26 Taiwan Journal of Dietetics
吳玉茹等. 20. 前言 1 20-44 45-64 65-74 75 2001 2 31876 3 Ikizler 4 3,4 bioelectrical impedance, BIA BIA extracellular cell water intracellular cell water BIA 5 Donadio 6 BIA BIA fat - free mass BIA BIA BIA BIA BIA lean tissue mass, LTM lean tissue index, LTI subjective global assessment,sga 方法 97 8-9 12 98
8 1-2 BIA BIA LTM LTI BIA body composition monitor, fresenius medical care, bad homburg, Germany LTM BIA LTM LTI LTM kg/m 2 7 LTM LTI 33.3% 66% >66% LTM 16.0-27.5 27.6-37.5 38.2-62.2 LTI 7.1-11.1 11.2-14.3 14.5-23.8 body mass index, BMI waist mid arm circumference, MAC mid muscle arm circumference MAMC, MAMC cm MAC cm -3.14 TSF cm triceps skinfold,tsf lange skinfold caliper, Cambridge scientific industries Inc., Cambridge, Maryland, USA handgrip strength T.K.K.5401,Takei scientific instrument Co.,LTD, Niigata, Japan 2004 8 SGA SGA 6 SGA 6 7 3 5 1 2 prealbumin; immunoturbidimetry albumin ; bromcresol green, BCG transferrin; immunoturbidimetry cholesterol; enzymatic method triglyceride; enzymatic method blood urea nitrogen, BUN ; - GLDH creatinine ; Jaffe kinetic method fasting plasma glucose; enzymatic method Roche Integra 400 protein catabolic rate, npcr 0.22+0.036 interdialytic in blood urea nitrogen 24/interdialytic interval in hours Hope L-gluamic dehydrogenase, GLDH ANOVA LTM LTI simple linear regression LTM LTI p <0.2 multiple linear regression LTM LTI SPSS 11.5 p <0.05. 21.
吳玉茹等 結果 98 50.0% n=49 50.0% n=49 60 67 LTM LTI MAMC TSF handgrip strength albumin LTM p <0.05 p for trend MAMC 20.29 2.42 20.78 2.78 24.07 2.23cm handgrip strength 15.00 5.80 23.90 6.35 34.85 6.90 kg SGA 5.86 0.57 6.00 0.30 6.09 0.29 albumin 3.94 0.39 4.22 0.28 4.21 0.24 mg/dl LTM p <0.05 TSF 23.19 6.33 20.57 5.85 16.87 4.74 mm LTM p <0.05 MAMC TSF handgrip strength LTI LTM waist transferrin LTM LTI LTM LTI MAMC =0.88 p=0.005 handgrip strength =0.52 p <0.001 LTM MAC =0.38 p=0.065 SGA =3.21 p=0.064 LTM MAMC handgrip strength LTI kg/m 2 MAC =0.13 p=0.091 TSF =-0.09 p=0.067 albumin 1.61 p =0.062 LTI 討論 - 3 MAMC handgrip strength BIA LTM LTI BIA 1 ( n=98 ) ( n % ) 49 (50%) ( ) 60.57 (32-87) 11.67 ( ) 67.91 (2-257) 54.19 ( systolic blood pressure, SBP ) (mmhg) 135.70 (76-200) 21.89 ( diastolic blood pressure, DBP )(mmhg) 76.39 (40-105) 9.93 ( fasting plasma glucose ) ( mg/dl) 97.98 (50-208) 30.31 ( cholesterol ) ( mg/dl) 181.57 (100-275) 37.56 ( triglyceride ) ( mg/dl) 154.72 (24-404) 85.02 ( blood urea nitrogen ) (ml/dl) 75.20 (20-131) 18.83 ( creatinine) (mg/d) 10.08 (5.7-17.7) 2.20 ( protein catabolic rate, npcr ) (g/kg/d) 1.13 (0.5-1.6) 0.24 ( n % ) 29 (29.6%) 1 Data was expressed as mean SD range or n(%). 22.
Heimburger 9 10 126 80 handgrip strength lean body mass Heimburger et al 9 49 49 2-257 Heimburger et al 9 handgrip strength handgrip LTI LTM 1,2,5 (n=30) (n=36) (n=32) P 3 P 4 ( lean tissue mass, LTM) 2 (body mass index, BMI) (kg/m 2 ) 24.43 3.79 23.20 4.03 24.89 3.51 0.167 0.160 (waist) (cm) 85.00 8.03 82.43 11.45 86.72 13.05 0.427 0.590 (midarm circumference, MAC )(cm) 27.57 3.31 27.24 3.91 29.39 2.60 0.069 0.070 (midarm muscle circumference, MAMC) (cm) 20.29 2.42 20.78 2.78 24.09 2.23 <0.001 <0.001 (triceps skinfold, TSF)(mm) 23.19 6.33 20.57 5.85 16.87 4.74 0.002 0.001 (handgrip strength) (kg) 15.00 5.80 23.90 6.35 34.85 6.90 <0.001 <0.001 (subjective global assessment, SGA) 5.86 0.57 6.00 0.30 6.09 0.29 0.172 0.004 (albumin) (mg/dl) 3.94 0.39 4.22 0.28 4.21 0.24 0.001 0.001 (transferrin)(mg/dl) 196.52 53.74 200.30 43.95 194.43 41.92 0.881 0.862 (prealbumin) (mg/dl) 0.34 0.09 0.35 0.09 0.61 1.41 0.309 0.173 ( lean tissue index, LTI ) 2 (body mass index, BMI) (kg/m 2 ) 24.20 3.54 23.23 3.73 25.11 4.04 0.128 0.128 (waist) (cm) 85.45 7.52 82.29 12.87 86.15 12.24 0.479 0.812 (midarm circumference, MAC ) (cm) 27.55 3.25 27.29 3.03 29.27 3.65 0.098 0.080 (midarm muscle circumference, MAMC) (cm) 20.14 2.49 21.13 2.19 23.82 2.91 <0.001 <0.001 (triceps skinfold, TSF) (mm) 23.59 5.75 19.62 5.48 17.38 5.70 0.002 0.004 (handgrip strength) (kg) 15.61 6.20 24.34 6.53 33.82 8.05 <0.001 <0.001 (subjective global assessment, SGA) 5.86 0.56 6.00 0.32 6.08 0.28 0.187 0.018 (albumin) (mg/dl) 3.96 0.34 4.16 0.32 4.25 0.27 0.001 0.004 ( transferrin ) (mg/dl) 206.50 62.45 191.17 25.84 195.48 46.06 0.395 0.360 ( prealbumin ) (mg/dl) 0.32 0.09 0.35 0.09 0.64 1.43 0.238 <0.001 1 data is expressed as mean SD and p <0.05 is considered significantly different 2 LTM and LTI are classified as low, mid and high according to 33.3,66.6 and >66.6 percentile of distribution. 3 ANOVA test was used to test differences among 3 groups and p <0.05 is considered significantly different 4 Simple linear regression was used to test th linear trend against low,mid and high groups. 23.
吳玉茹等 handgrip strength LTM LTI Heimburger 9 <1 9 <10% 2-4 30% 4 60% handgrip strength SGA 10 handgrip strength ESRD end stage renal disease handgrip strength 11 12 DEXA BIA 13 BIA LTM LTI MAMC handgrip strength SGA - 14,15 SGA 15 SGA LTI LTM p 1 p ( lean tissue mass, LTM) (midarm circumference,mac ) (cm) 0.760 0.015 0.38 0.065 (midarm muscle circumference,mamc) (cm) 1.77 <0.001 0.88 0.001 (triceps skinfold,tsf)(mm) -0.59 0.001-0.19 0.127 (handgrip strength) (kg) 0.72 <0.001 0.52 <0.001 (subjective global assessment,sga) 5.50 0.037 3.21 0.064 (albumin) (mg/dl) 6.59 0.029 3.15 0.169 (prealbumin) (mg/dl) 2.32 0.056 1.11 0.115 ( lean tissue index, LTI ) (midarm circumference,mac )(cm) 0.24 0.017 0.13 0.091 (midarm muscle circumference,mamc) (cm) 0.55 <0.001 0.33 <0.001 (triceps skinfold,tsf) (mm) -0.18 0.001-0.09 0.067 (handgrip strength) (kg) 0.21 <0.001 0.17 <0.001 (subjective global assessment,sga) 1.71 0.044 0.96 0.147 (albumin) (mg/dl) 2.58 0.007 1.61 0.062 (prealbumin) (mg/dl) 0.69 0.074 0.35 0.196 1 Modle. 24.
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