腹膜透析患者脂肪分布水平的因素分析及临床意义

Factor analysis of fat distribution in peritoneal dialysis and its clinical value

目的探究腹膜透析患者脂肪分布水平及其影响因素,为提高临床安全性提供科学性依据。方法选取2012年9月~2014年7月在绍兴第二医院肾内科住院且自愿参加本次研究的149例腹膜透析患者,采用体重指数（BMI）评价腹膜透析患者的肥胖程度,同时采用MC-190体成分测量仪检测总体脂肪率及最大内脏脂肪水平,对比患者脂肪分布情况及采用Pearson相关分析腹膜透析患者脂肪分布的影响因素。结果 149例腹膜透析患者平均BMI（24.37±4.02）kg/m2,肥胖率为52.35%;平均总体脂肪率为（32.19±10.54）%,肥胖率为63.76%;平均内脏脂肪水平为（10.27±4.42）,肥胖率为66.44%。男女间在总体体脂率、最大内脏脂肪水平上差异有统计学意义（P〈0.01）;不同年龄间在总体体脂率、最大内脏脂肪水平上差异有统计学意义（P〈0.01）,经LSD法,（≥60岁）组〉（50~60岁）组〉（≤60岁）组;糖尿病组在BMI、总体体脂率及最大内脏脂肪水平上显著高于非糖尿病组（P〈0.01）;不同透析年龄间BMI、总体体脂率及最大内脏脂肪水平上差异有统计学意义（P〈0.01）,经LSD法,（≥24月）组〉（12~24月）组〉（≤12月）组;年龄与BMI无相关性,与总体体脂率及最大内脏脂肪水平存在显著正相关（P〈0.01）,透析年龄与BMI、总体体脂率及最大内脏脂肪水平存在显著相关（P〈0.05）。结论腹膜透析患者肥胖程度较高,年龄及透析年龄是影响腹膜透析患者脂肪分布水平的关键因素。

Objective To explore the fat distribution of patients with peritoneal dialysis and analyse its influencing factors. Methods 149 cases patients with peritoneal dialysis from September 2012 to July 2014 in our hospital were selected. The obesity degree were assessed by body mass index（ BMI）,total body fat rate and the maximum visceral fat levels were detected by MC-190 instrument for body component analysis. The fat distribution and influencing factors were analysed by Pearson correlation method in patients with peritoneal dialysis. Results Among 149 patients,the average of BMI was（ 24. 37 ± 4. 02） kg/m2,obesity rate was 52. 35%; the average of total body fat rate was（ 32. 19 ± 10. 54） %,obesity rate was 63. 76%; the average of visceral fat levels was（ 10. 27 ± 4. 42） kg / m2,obesity rate was 66. 44%. There were significant differences in total body fat rate and maximum visceral fat levels between male and female patients（ P〈0. 01）; there were significant differences in total body fat rate and maximum visceral fat levels among different age groups（ P〈0. 01）,LSD results showed that above aged 60 group 〉age from 50 to 60 group 〉age 60 or below group; the BMI,total body fat rate and maximum visceral fat levels in diabetes mellitus group were significantly higher than those in non-diabetes mellitus group（ P〈0. 01）; there were significant differences in total body fat rate and maximum visceral fat levels among different period of dialysis（ P〈0. 01）,LSD results showed that above12 months 〉12 to 24 months 〉12 months or below. The age has no correlation with BMI,while has the correlations with total body fat rate and the maximum visceral fat levels（ P〈0. 01）; period of dialysis has the correlations with BMI,total body fat rate and the maximum visceral fat levels（ P〈0. 05）. Conclusion The patients with peritoneal dialysis has a higher obesity degree and age and period of dialysis is the key factors of fat distribution.