慢性病中的体重变化:与死亡率和功能相关联
Richard Singer1,2, Hsin-Chia Huang2,3
1Canberra Health Services Renal Unit Garran Australian Capital Territory Australia.
Obesity science & practice
|January 24, 2024
概括
患有中度至重度慢性病 (CKD) 的患者的体重变化很常见,并且与增加的死亡率和功能下降有关. 蓄意减肥是罕见的,并且可能会混关联.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内部医学 内部医学
- 临床研究 临床研究
背景情况:
- 体重过重是慢性病 (CKD) 进展的已知危险因素.
- 矛盾的是,CKD患者的体重减轻与死亡率的增加有关,这使得普遍的减肥建议具有争议性.
- 关于CKD人群体重变化模式的数据有限.
研究的目的:
- 描述中度至重度CKD患者的体重变化.
- 探索超重/肥胖CKD患者体重变化与死亡率或结点之间的关联.
主要方法:
- 随访的非透析患者估计球膜过率 (eGFR) <60mL/min/1.73m2和体重指数 (BMI) ≥25kg/m2长达5.5年.
- 定义的临床显著的体重变化为≥5%和脏终点为透析,移植或≥40%的EGFR下降.
- 使用考克斯回归来评估第一年体重变化与随后的死亡率或脏终点之间的关系.
主要成果:
- 研究了310名患者 (中位数75岁,中位数BMI为31kg/m2);68%患有第四期CKD.
- 在4.4年的时间里,128名患者死亡,140人体重发生显著变化 (42人体重减少≥5%,23人体重增加≥5%).
- 在第一年显著的体重减轻或增加与死亡风险和脏终点的增加有关,故意减肥的病例很少.
结论:
- 中度至重度的CKD患者经历了与基线功能无关的显著体重变化.
- 显著的体重变化与增加的死亡率和功能丧失有关.
- 观察到的关联很可能受到混因素的影响.
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