食欲对维持性透析患者蛋白质能量消耗发生风险的影响研究

The influence of appetite on protein-energy wasting in maintenance dialysis patients

目的探究食欲对维持性透析患者蛋白质能量消耗(protein-energy wasting,PEW)发生风险的影响。方法通过方便抽样调查稳定维持性透析治疗患者。使用营养不良炎症量表和食欲可视化量表分别评估患者PEW和食欲状况。应用人体成分检测仪、人体测量及血液生化指标评估患者人体成分和营养状况。采用二元Logistic回归分析PEW和食欲之间的关系。结果研究共纳入101例维持性透析患者,其PEW发生率为31.7%。PEW组患者饱腹感评分高于非PEW组(Z=3.136,P=0.002);且PEW组存在胃肠道症状的患者比例高于非PEW组(Z=2.613,P=0.009)。存在胃肠道症状(OR=4.445,P=0.005)和高餐后饱腹感(OR=1.023,P=0.012)是透析患者发生PEW的危险因素。结论近三分之一维持性透析患者存在PEW。高餐后饱腹感和胃肠道症状是PEW发生的危险因素。

Objective To investigate the protein-energy wasting(PEW)status and its correlation with appetite in chronic kidney disease(CKD)patients treated with maintenance dialysis,so as to provide scientific basis for clinical nutrition intervention and management.Methods This study is a cross-sectional study,recruiting participants from three hospitals through a convenient sampling method.The malnutrition inflammation scale and appetite visualization scale were used to investigate the PEW and appetite status.Body composition monitoring,anthropometrics and biochemical examinations were performed to assess patients'nutrition and body composition.Multivariate logistic regression was used to explore the relationship between PEW and appetite.Results A total of 101 maintenance dialysis patients were recruited,and the incidence of PEW was 31.7%.In PEW group,the five dimensions of appetite,the mean score for desire to eat and the amount of food consumed were relatively lower,being 39.41±26.25 and 31.63±25.67.The satiety score in PEW group was significantly higher than that in non-PEW group(Z=3.136,P=0.002).In addition,the ratio of gastrointestinal symptoms was significantly higher in PEW group(75.0%)than in non-PEW group(43.5%).Multiple logistic regression analysis showed that gastrointestinal symptoms(OR=4.445,P=0.005)and postprandial satiety(OR=1.023,P=0.012)were the risk factors for PEW.Conclusion Nearly one third of maintenance dialysis patients have PEW.The higher postprandial satiety and higher ratio of gastrointestinal symptoms are the risk factors for PEW.