全身骨密度与肌肉、脂肪的相关性分析

目的 旨在进一步分析脂肪、肌肉与骨密度的相关性。方法 200例受检者,男性62例,女性138例,年龄20~84 (48. 9 ± 14. 2) y,体质量 42. 5 ~ 112. 0(61. 29 ± 9. 89) kg,BMI 15. 62~33.58( 23. 03 ± 2. 93) kg/ m2,应用 DXA (dual-energy X-ray absorptiometry,DXA)测量全身骨密度、肌肉、脂肪,并分析全身骨密度与肌肉、脂肪的相关性。结果 200例受检者,全身骨密度与体重、BMI的相关性有统计学意义(分别为r = 0. 530,P<0. 01;r = 0. 221,P<0.01),进一步分析发现,全身骨密度与肌肉呈正相关(r =0. 559,P < 0. 01),与脂肪的相关性无统计学意义(r =0. 018,P = 0. 803)。按性别分析,62例男性,全身骨密度与肌肉、脂肪均呈正相关(r =0. 535,P <0. 01;r =0.274,P = 0. 031)。138例女性,全身骨密度与肌肉呈正相关(r =0. 506,P < 0.01),而与脂肪的相关性无统计学意义(r =0. 088,P =0. 305)。结论（1)全身骨密度与体重、体质量指数呈正相关,其中,起主要作用的是肌肉组织,体现了“骨肉相连”的规律。（2)全身骨密度与脂肪的关系,在男性有相关性,而在女性无相关性, 体现了“男女有别”的规律。     

绝经妇女体成分与血脂相关关系的研究

目的探讨绝经妇女体成分与血脂的相关关系。方法测定100名绝经妇女的BMI、脂肪含量、E2及血脂(TC、TG、HDL-C、LDL-C),对年龄、绝经年限、E2、体成分(BMI、脂肪含量)与血脂的相关关系进行分析。结果(1)BMI及脂肪含量与TG呈正相关,相关系数r分别为0.650、0.698(P<0.01);BMI及脂肪含量与TC呈正相关,r分别为0.426、0.430(P<0.01);BMI及脂肪含量与HDL呈负相关,r分别为-0.319、-0.385(P<0.01);年龄、绝经年限、E2与血脂均无明显相关性。(2)消除年龄、绝经年限、E2的影响,BMI及脂肪含量与TG的r分别为0.593、0.661(P<0.01),BMI及脂肪含量与TC的r分别为0.371、0.382(P<0.01),BMI及脂肪含量与HDL的r分别为-0.238(P<0.05)、-0.300(P<0.01)。(3)年龄与体成分(BMI、脂肪含量)呈正相关,r分别为0.294、0.320(P<0.01);E2与体成分(BMI、脂肪含量)呈正相关,r分别为0.236(P<0.05)、0.271(P<0.01)。(4)BMI与脂肪含量高度相关,相关系数为0.901(P<0.01)。两者关系可拟合方程脂肪含量(%)=1.477BMI(kg/m2),R值为0.998,R2为0.996(P<0.001)。结论绝经妇女体成分(BMI、脂肪含量)与血脂具有相关性,控制绝经妇女的体重(脂肪含量)过度增长将有助于预防其心血管疾病的发生。     

肥胖者骨密度与体重及其他体成分关系的研究

目的肥胖易伴发多种慢性疾病。本文探讨肥胖者体重与体成份(脂肪、肌肉)之间的关系及其对临床减重的意义。方法经临床确诊系单纯性肥胖者45例,男17例,女28例。使用美国LunarDPX-L型双能X线吸收测量仪(DXA),测量全身骨、第2~4腰椎、股骨颈骨矿密度(BMD)及体脂肪和肌肉量,并计算体重指数(BMI=W/H2)、体重(kg)/身高(m)即W/H数值进行比较分析。结果男性体重平均94.54±17.41kg,BMI33±4.87。女性体重平均124.37±14.0kg,BMI35.41±6.39。男女两性全身BMD与体重相关,分别为r=0.415,P<0.05,r=0.529,P<0.0025。女性体重与脂肪、肌肉之间呈正相关分别为r=0.522,P<0.0025、r=0.612,P<0.005。男性体重与BMI、W/H及全身肌肉量相关,与脂肪组织无明显相关。男女性W/H较BMI相关系数高。男性全身BMD与全身肌肉量正相关r=0.421,P<0.05。女性全身及股骨颈BMD与脂肪量相关r=0.360,P<0.05、r=0.323,P<0.05。女性全身肌肉量与股骨颈BMD呈正相关r=0.373,P<0.05。结论①肥胖者体重增加,男性以肌肉增加为主,女性脂肪和肌肉都增加;②男性全身骨密度增高与肌肉量增加有关,而女性则主要为脂肪量增加;③女性肌肉、脂肪量与股骨颈BMD密切相关;④体重(kg)/身高(m)比计算体重指数能更准确地反映总体肥胖的程度。     

绝经后女性腹部脂肪、椎旁肌肉和骨密度的相关性 分析

目的评价绝经后女性腹部脂肪和椎旁肌肉与骨密度的相关性。方法选取2016年4月至2016年10月就诊于我院的绝经后女性75例,年龄45~83(62.2±9.1)岁,应用DXA(dual-energy X-ray absorptiometry,DXA)测量腰椎骨密度,再对受检者行腹部CT扫描,并在后处理工作站选定平脐水平的CT片,勾画出腹部脂肪和椎旁肌肉的面积。为了进一步分析,将样本根据体重指数分为2组,A组18.5≤BMI24,B组BMI≥24。结果腰椎骨密度与体重指数、腹部皮下脂肪、腹部内脏脂肪、腹部总脂肪、腰大肌及竖脊肌均呈正相关(r=0.264,P=0.022;r=0.244,P=0.035;r=0.286,P=0.013;r=0.298,P=0.009;r=0.371,P=0.001;r=0.258,P=0.025)。通过将BMI(body Mass Index)分为2组后得到结果:A组骨密度主要与腰大肌和竖脊肌呈正相关(r=0.479,P=0.011;r=0.424,P=0.028),B组骨密度主要与内脏脂肪和总脂肪呈正相关(r=0.318,P=0.028;r=0.339,P=0.019)。结论目前研究结果表明,对于绝经后女性而言,腹部脂肪和椎旁肌肉对骨密度具有保护作用,适当的体育锻炼和保持正常的体重更有利于预防骨质疏松症。     

绝经后女性体质量指数、体成分与骨密度的变化特征及关系

目的 探讨绝经后女性年龄、体质量指数（body mass index, BMI）及体成分的变化特征及与骨质疏松症之间的关系。方法 选取广州中医药大学第三附属医院2019年12月–2021年1月门诊收集的98名绝经后女性的体成分及骨密度资料,根据受试者的年龄和BMI分组,比较各年龄组及各BMI组的体成分差别,通过Spearman分析年龄、BMI及体成分对骨质疏松情况的影响,利用多元线性回归研究整体骨密度和整体骨矿含量的影响因素。结果 各个年龄组的整体骨密度（P＜0.001）及整体骨矿含量（P＜0.05）随年龄增加而下降,而各个BMI组的整体骨矿含量（P＜0.05）、整体肌肉质量（P＜0.001）、整体脂肪质量（P＜0.001）随BMI增加而增加。Spearman相关分析显示,随着年龄增加（P=0.005,r=0.281）,骨质疏松程度越严重;而随着BMI（P=0.019,r= – 0.237）、整体骨矿含量（P＜0.001,r= – 0.719）、肌肉质量（P=0.014,r= – 0.249）和脂肪质量（P=0.013,r= – 0.249）的增加,患骨质疏松的程度越轻。多元线性回归分析结果显示,年龄与绝经后女性整体骨密度（P=0.002,B= – 0.004）及整体骨矿含量呈负相关（P=0.000,B= – 0.013）;而整体肌肉质量（P=0.018,B=0.022）和整体脂肪质量（P=0.037,B=0.027）则与绝经后女性整体骨矿含量呈正相关。结论 年龄是绝经后女性患骨质疏松症的危险因素,而BMI、肌肉质量和脂肪质量是保护因素,有助于提高整体骨密度和整体骨矿含量。     

血清抗酒石酸酸性磷酸酶-5b和组织蛋白酶K随年龄及绝经变化的分析

目的调查西南地区不同年龄组健康女性抗酒石酸酸性磷酸酶-5b(TRACP-5b)、组织蛋白酶K(CTSK)的总体趋势和分布情况,并确定绝经状态对二者的影响。方法共研究了2125名女性[包括绝经前(n=1557)和绝经后(n=568)妇女,年龄分别为20～79岁]。所有纳入研究的女性均在标准化条件下采集静脉血样,并采用ELISA法测定血清中TRACP-5b和CTSK含量,通过双能X射线吸收测定法测定腰椎(L_1-L_4)和股骨颈的骨密度(BMD)值。结果随着年龄的增加,TRACP-5b、CTSK发生适度变化,均逐渐增加,并且在60岁以后TRACP-5b和CTSK水平均保持稳定。与绝经前妇女相比,绝经后妇女的血清TRACP-5b、CTSK、完整PTH均显著增加(P0.05),而Mg水平均显著降低(P0.05)。与绝经前相比,不同绝经年限妇女的TRACP-5b、CTSK水平均显著增加(P0.05)。逐步多元线性回归分析发现,年龄、BMI、FSH、LH和PTH是TRACP-5b的影响因素,CTSK的影响因素包括年龄、BMI、FSH、LH和PTH。结论建立的TRACP-5b、CTSK参考区间值有助于在很长时期内评估该西南地区妇女骨转换情况。     

不同人种绝经后全身与局部脂肪分布的改变情况

目的为了验证脂肪中心性分布的人种因素;确定白人、黑人与亚洲妇女绝经后脂肪中心性分布的不同。方法横断面研究,通过双能X线吸收法测量全身与局部的脂肪含量并进行线性回归分析。募集了444名,年龄18~94岁的妇女,其中227名白人,128名黑人与89名亚洲人。通过对年龄、体重、身高与全身脂肪校正后,分析男性型与女性型脂肪的分布与躯干/四肢脂肪的比值。结果种族因素与男性型、女性型脂肪及躯干/下肢脂肪比值显著相关(P<0.0001)。种族-绝经也发现有显著意义(P=0.028)。每一组,局部与全身脂肪水平,特别是男性型脂肪在绝经后妇女中高于绝经前妇女。而且,绝经后男性型脂肪分布在白人有显著意义(P<0.05),但在黑人与亚洲人中无影响。结论脂肪量与其分布主要由人种决定。绝经的影响在白人中具有显著意义。     

绝经后女性的体成分与年龄和绝经的关系及其对不同部位骨密度的影响

目的 调查绝经后女性的体成分与年龄、绝经年龄、绝经年限和腰椎、髋部BMD之间的关系.方法 用双能X线骨密度仪测量919例绝经后女性的体成分、正位腰椎和髋部BMD.结果 下身脂肪量、全身脂肪量和全身瘦组织量与年龄、绝经年龄和绝经年限都相关(P＜0.05～0.01),但只有绝经年限进入体成分的多元逐步回归方程,采用复合或三次回归模型拟合优度最佳.体成分随绝经年限的延长有下降趋势.绝经10年以上女性的下身脂肪量和全身瘦组织量显著减少,分别较绝经年限5年以内女性下降8.6%和3.1%.所有部位的体成分与所测区域的BMD 均呈正相关(P＜0.05～0.01),控制体重变量后,仅有全身脂肪量与腰椎BMD 呈正相关(P＜0.05),而全身瘦组织量与髋部BMD 呈正相关(P＜0.05).多元逐步回归分析发现体成分是影响腰椎和髋部BMD的一个重要因素,但对腰椎BMD影响最大的是全身脂肪量,而对髋部BMD影响最大的是全身瘦组织量.BMD 越低者,全身脂肪量和全身瘦组织量也越低,组间比较有显著性差异.结论 绝经后女性的体成分与年龄、绝经年龄、绝经年限和腰椎、髋部BMD相关,其中,绝经年限对体成分的影响最大,体成分组分对BMD的影响存在部位差异.     

绝经后女性肌肉质量的影响因素研究

目的 探讨广州市绝经后女性肌肉质量的相关影响因素。方法 收集2019年6月至2020年12月广州市120名自愿参加本研究的绝经后女性的临床资料;其中符合纳入标准的有90例,年龄47～88岁,平均年龄(62.4±7.5)岁。所有受试者均记录其年龄、绝经年龄、绝经年限和身高、体重,计算BMI数值并进行骨密度测定、体成分分析检测肌肉质量。根据ASMI数值将受试者分为肌肉减少组及非肌肉减少组;分析两组年龄、绝经年龄、绝经年限和BMI数值、骨密度及肌肉质量的差异,比较两组患骨质疏松症的比率,利用Pearson相关性分析研究各因素与肌肉质量的相关程度,利用多元线性回归分析分析各指标与肌肉质量的相关性并得出回归方程。结果 肌肉减少组BMI和ASMI数值低于非肌肉减少组(P<0.05);肌肉减少组发生骨质疏松的比例大于非肌肉减少组(P>0.05); Pearson相关性分析提示绝经年龄(r=0.262,P=0.012)和BMI(r=0.771,P<0.001)与ASMI呈正相关;多元线性回归分析显示,影响绝经后女性ASMI值的因素主要有绝经年龄(P=0.037,B=0.034)和BM...     

脂肪因子Omentin-1、脂联素与中老年女性骨密度相关性研究

目的观察脂肪因子Omentin-1、脂联素与中老年女性骨密度之间的相关性。方法选取2017年3月至2018年4月在佛山市中医院就诊的338名女性,按照绝经状态分为围绝经期/绝经期组(n=194)和绝经后组(n=124)。将参研人员年龄、体质量指数(bone mass index,BMI)、腰围、吸烟状况、身体活动、脂联素、Omentin-1和激素进行多变量调整(ANCOVA),用于研究其脂肪因子和骨密度(bone mineral density,BMD)之间的潜在关系。结果与绝经后女性的腰椎BMD [(0. 69±0. 08)g/cm~2]相比,围绝经期女性的腰椎BMD[(0. 89±0. 09) g/cm~2]更高;在围绝经期/绝经期组女性中,脂联素和Omentin-1均与腰椎BMD无显著相关性(P0. 05);在绝经后组女性中,脂联素与腰椎BMD无相关性(P 0. 05);而在绝经后组女性中,Omentin-1与腰椎BMD呈显著负相关(P0. 05)。结论绝经后女性的Omentin-1与腰椎BMD呈负相关。     

胶东半岛成年人群骨密度与年龄、身高、体重、体重指数和体表面积关系的研究

目的研究胶东半岛成年人群骨密度(BMD)与年龄、身高、体重、体重指数(BMI)和体表面积(BS)之间的关系。方法采用双能X线骨密度仪(DEXA)对胶东半岛沿海地区多中心多阶段整群抽样调查3879名21～89岁居民进行骨密度测量,记录年龄,测量身高、体重,计算出BMI和BS,并进行统计学分析。不同年龄组分别按BMI大小分成3组:BMI≤20 kg/m2,(20～25)kg/m2,≥25kg/m2;BS大小分成3组:大体表面积组(LBSG),中体表面积组(IBSG),小体表面积组(SBSG)。结果男性和女性骨密度随年龄、身高、体重、BMI和BS的变化模式不同。腰椎和股骨BMD随体重、BMI和Bs增加而增高。不同年龄组骨密度均为:BMI≤20 kg/m2组IBSG>SBSG,差异有统计学意义。高龄、低体重和低体重指数者骨密度均较其他组低,差异有显著性。结论年龄、身高、体重、BMI和BS是影响骨密度的重要因素。     

Association between body mass index,body height,and the prevalence of spinal deformities

Background contextThe most common spinal deformities among adolescents are adolescent idiopathic scoliosis (AIS; 2%–3% prevalence) and Scheuermann kyphosis (SK; 1%–8% prevalence). Both are believed to have a genetic influence in their etiology. The association between body mass index (BMI) and body stature and their possible association to spinal deformities is uncertain.Study designA cross-sectional prevalence study.PurposeTo examine the prevalence of all adolescent spinal deformities according to the extent of their severity as well as their possible association to BMI and body height.Outcome measuresSubjects diagnosed as having spinal deformities were classified into one of three severity groups; “Mild,” “Intermediate,” or “Severe,” according to their curve scoliosis or kyphosis measurement with a standing X-ray.MethodsThe data for this study were derived from a medical database containing records of 17-year-old male and female patients before their recruitment into mandatory military service. Information on the disability codes associated with spinal deformities according to the Regulations of Medical Fitness Determination was retrieved. Logistic regression models were used to assess the association between the BMI and body height to various degrees of spinal deformities by severity.ResultsThe study cohort included 829,791 consecutive subjects, of whom 103,249 were diagnosed with spinal deformities (76% were mild in degree). The prevalence of spinal deformities was significantly greater among the underweight male and female patients (p<.001). Increased BMI had a protective effect for developing spinal deformities. The odds ratios for severe spinal deformities were greater compared with mild spinal deformities in the underweight groups. The risk for developing spinal deformities increased significantly with height for both genders (p<.001).ConclusionsAn association between height and the risk for spinal deformities by severity was found for all height groups. Below normal BMI is associated with severity of spinal deformities, whereas above-normal BMI apparently has a protective effect. Body height is also positively associated with the severity of spinal deformities.     

绝经后妇女骨密度、体重指数、体脂和雌激素分泌的关系

目的　调查分析绝经后妇女骨密度、体重指数、体脂和雌激素分泌之间的关系。方法　上海市区 5 0～ 70岁社区绝经后女性健康志愿者共 4 5 7例 ,进行身高体重、腰椎和股骨颈骨密度的测定、腰椎和髋部脂肪成分的检测 ,以及随机选取 118例志愿者进行血清雌激素的测定。所有资料输入电脑 ,应用SPSS软件进行统计分析。结果　非骨质疏松 (Non OP)组中体重指数与腰椎和股骨颈骨密度的相关系数分别为 0 . 5 3和 0 . 5 4 ,骨质疏松 (OP)组分别为 0 .33和 0 . 33;Non OP组中体重指数与腰椎和髋部体脂的相关系数分别为 0. 2 1和 0 . 0 92 ,OP组分别为 0 . 72和 0 .2 7;Non OP组的血清雌激素浓度与体脂呈弱相关 ,OP组血清雌激素浓度与体脂无关。Non- OP组中体重指数大于OP组 ,体脂低于OP组 ,但无统计学意义。经体重指数校正后 ,体脂 (即体脂 /体重指数 ,亦即体脂在体重中所占的比重 ) ,OP组体脂明显大于Non -OP组 (P <0 . 0 5 )。结论　体重是影响绝经后妇女骨密度的重要因素 ,体脂在体重中的比重增加会降低绝经后妇女的骨密度 ,这种体脂的增加与雌激素可能无关。绝经后妇女应在不增加体脂的前提下 ,适当增加体重来预防骨质疏松症的发生。     

体质指数和体脂百分比与类风湿关节炎继发骨质疏松的相关性研究

目的探讨体质指数(BMI)和体脂百分比(PBF)与类风湿关节炎(RA)继发骨质疏松(OP)间的相关性。方法采用生物电阻抗体成分测定法测量359例RA患者和158例年龄、性别相匹配的正常对照组体重(kg)、身高(m)和PBF,根据体重/(身高)2计算出BMI,并将BMI分为4组:消瘦BMI18.5,正常24BMI≥18.5,超重28BMI≥24,肥胖BMI≥28;PBF分为2组:肥胖为PBF男25%或女30%,否则为正常。采用双能X线骨密度吸收仪测定髋部(包括股骨颈Neck、Ward三角区、大转子GT、总髋部Hip)及腰椎1-4(L1-4)骨密度(BMD)。结果 RA患者BMI低于正常对照组(22.40±3.76 vs 23.66±3.24,t=3.813,P0.0001),其中消瘦患者百分比明显高于对照组(14.4%vs 5.8%,x~2=10.536,P=0.015);而PBF则高于对照组(32.45±10.38 vs 30.53±6.98,t=2.442,P=0.015)。RA患者OP发生率为37.9%(128/338),明显高于对照组的13.9%(22/158)(x~2=29.265,P0.0001)。RA患者不同BMI分组间各部位BMD均有显著不同,且都表现为消瘦组水平更低,超重或肥胖组水平更高(P0.0001～0.05);除Ward区的PBF正常组BMD高于肥胖组(t=2.224,P=0.027)外,其余各部位BMD均无明显差别(P0.05)。Hip区和L1-4区均表现为消瘦组OP发生率(27.8%、20.7%)明显高于肥胖组(3.7%、1.1%)(x~2=22.041,P=0.001;x~2=13.401,P=0.037)。不同PBF分组间骨量构成比的比较无差别(P0.05)。各部位BMD均与BMI成正直线相关(P0.0001～0.01);而Ward、GT、Hip区BMD与PBF成负直线相关(P=0.015～0.04)。多元Logistic回归分析结果显示:年龄(OR=1.114,95%CI:1.082～1.148,P0.0001)、性别(OR=5.802,95%CI:2.608～12.906,P0.0001)和病程(OR=1.050,95%CI:1.017～1.084,P=0.003)均为RA患者发生OP的危险因素,而BMI(OR=0.879,95%CI:0.815～0.946,P=0.001)为发生OP的保护因素。结论 BMI和PBF在RA中变化不同,且呈现出与BMD相反的相关性,BMI是RA患者发生OP的保护因素。     

Polymyositis, dermatomyositis and inclusion body myositis, nosological aspects

THREE GROUPS OF PRIMARY INFLAMMATORY MUSCLE DISEASES: The primary inflammatory muscle diseases comprise three main subsets: polymyositis (PM), dermatomyositis (DM) and inclusion body myositis (IBM). PM and DM are characterized by a proximal weakness that develops along weeks to months and by elevated creatine phosphokinase levels. Cutaneous involvement including both erythema and edema and infantile or adult onset are DM specific. PM and IBM only concern adults. Several PM/DM manifestations must be searched for because of their severity: swallowing disorders, various mechanisms of respiratory dysfunction (swallowing pneumopathies, interstitial lung disease, respiratory muscle deficiency) and cardiac involvement. DIAGNOSTIC ELEMENTS FOR PM AND DM: Two investigations, beside biopsy, are particularly useful: muscle MRI imaging showing inflammatory pattern and specific detection of antisynthetase autoantibodies (PM/DM with interstitial lung disease) and anti-Mi-1 and 2 in DM. PHYSIOPATHOLOGICAL DATA: PM and DM differ in their histological and physiopathological characteristics: perivascular B and CD4 lymphocyte infiltrates and complement deposits at the origin of humoral induced vascular disease in DM and perimysial CD8 lymphocytes inducing a cellular mediated cytotoxic injury in PM. Class I HLA antigen expression on the muscle fibers and production of cytokines play a crucial role in the pathogenesis of these two diseases. PM and DM may be associated with cancers, connective-tissue disease (overlap syndrome). Some PM are secondary to HIV, HTLV1 virus and toxoplasmosis infection. CHARACTERISTICS OF INCLUSION BODY MYOSITIS: IBM, the most frequent acquired myopathy after 50 years of age, is characterized by particular features: not only clinical (late onset, selective weakness, early distal involvement, slow course, unresponsiveness to corticosteroid and immunosuppressant agents); but also histological (rimmed vacuoles, filamentous inclusions) and pathogenic (cytotoxic and degenerative inflammatory process, similar to Alzheimer's disease, with beta-amyloid protein accumulation).     

Body mass index,body fat percentage,and the effect of body fat mass on SWL success

Objectives In the present study, we investigated the effects of the Body Mass Index (BMI), the Body Fat Percentage (BFP), and the Body Fat Mass (BFM) on success of SWL, prospectively. Patients and methods The BMI, BFP, BFM values of patients, who were treated by SWL due to upper urinary system stone disease (pelvis renalis, upper ureter, kidney lower and upper calices) between January and December 2005 in our hospital’s urolithiasis center, were measured. Patients with stones smaller than 5 mm or larger than 20 mm and patients who had a stone localized somewhere other than in the upper urinary system, were not included in the study. Patients evaluated to be clinically successful according to the SWL were put in group 1, and the other patients who were not successful were included in group 2. Results About 158 (97 male, 61 female) patients aged between 16 and 92 (mean 36.69 (±13.22) years), put on SWL therapy due to presence of upper urinary system stone disease, were included in the study. While the mean BMI was 23.97 ± 0.4 in group 1 and 25.98 ± 0.5 (P = 0.02) in group 2, BFP was 23.85 ± 0.8 in group 1 and 29.19 ± 1.1 (P = 0.001) in group 2, and BFM was determined to be 16.74 ± 0.7 and 21.19 ± 1.01 (P = 0.001) in group 2. Regarding all the parameters (BMI, BFP, BFM), the statistical analyses carried out between the groups showed significant differences. Conclusion BFP and BFM parameters are also important factors along with the BMI in providing a successful SWL treatment. All the parameters should be considered regarding the success of the treatment and the patients should be informed.     

Assessment of total body water and lean body mass from anthropometry, Watson formula, creatinine kinetics, and body electrical impedance compared with antipyrine kinetics in peritoneal dialysis patients

Background. Indirect methods such as anthropometry (A), Watson formula (W), creatinine kinetics (CK), and body electrical impedance (BEI) are increasingly applied to determine total body water (TBW) and lean body mass (LBM) in dialysis patients. These methods share the disadvantage that they have been validated for healthy men only. We studied which of these four commonly applied methods can best be used routinely in CAPD patients. Methods. TBW estimates obtained from A, W, CK, and BEI were compared with those obtained by a gold standard (antypirine distribution volume, ADV) in eight CAPD patients. In addition, several BEI equations to derive lean body mass (LBM) were compared with LBM estimated by ADV in order to determine which equation is the most valuable for the assessment of LBM by BEI in CAPD patients. Results. TBW as ADV was 41.4±6.6 (mean±SD) L. TBW estimated by W, A and CK underestimated ADV by a mean±SD of 2.3±13, 5±8.4 and 12.3±10.9% respectively. TBW as measured by BEI overestimated ADV by 2.5±8.8%. The correlation coefficients between ADV-TBW and TBW estimated by the indirect methods were r=0.88 (A), r=0.87 (BEI), r=0.82 (CK), and 0.68 (W). LBM estimated by ADV was 56.7±8.9 (mean±SD) kg; LBM by different BEI equations ranged from 49.9±7 to 58.1±10.7 kg. The correlation coefficient between LBM by ADV and LBM according to the various BEI equations ranged from 0.81 to 0.93. Conclusions. A and BEI: can be used to estimate TBW, but the considerable SD (or inaccuracy) makes individual predictions hazardous. Considering the correlation coefficients and difference between LBM by ADV and LBM according to different BEI equations, Deurenberg's formula can be advocated for use in the estimation of LBM by BEI.