中华临床营养杂志
中華臨床營養雜誌
중화림상영양잡지
CHINESE JOURNAL OF CLINICAL NUTRITION
2014年
6期
343-347
,共5页
持续非卧床腹膜透析%能量摄入%能量消耗%体质量指数
持續非臥床腹膜透析%能量攝入%能量消耗%體質量指數
지속비와상복막투석%능량섭입%능량소모%체질량지수
Continuous ambulatory peritoneal dialysis%Energy intake%Energy consumption%Body mass index
目的 研究持续非卧床腹膜透析(CAPD)患者的能量摄入和消耗,探讨CAPD患者超重和肥胖的可能影响因素.方法 选择2011年5月至12月在北京大学第三医院门诊稳定透析的115例CAPD患者,根据体质量指数(BMI)分为正常组(18.5 kg/m2≤BMI< 24 kg/m2,n=61)和超重/肥胖组(BMI≥24 kg/m2,n =54).收集患者3d饮食记录,计算饮食热量、蛋白质、脂肪和碳水化合物摄入,测定24 h透析液中吸收的葡萄糖量,测定患者静息能量消耗(REE),收集3d活动记录计算总能量消耗(TEE),进行人体成分分析.结果 两组患者在年龄、身高、饮食热量摄入、饮食蛋白质和碳水化合物摄入、肌肉量、水负荷方面的差异无统计学意义.超重/肥胖组患者透析液中吸收的葡萄糖热量和饮食脂肪摄入量均显著高于正常组[(1 920.5 ±506.3) kJ/d比(1 673.6±535.6) kJ/d,x2=2.536,P=0.013; (62.5±19.8) g/d比(53.1 ±18.7) g/d,x2 =2.575,P=0.011].超重/肥胖组的REE显著高于正常组[(5066.8±1 029.3)kJ/d比(4 556.4±799.1)kJ/d,x2=2.979,P=0.004],但两组TEE差异无统计学意义[(7 819.9±728.0) kJ/d比(7 803.2±1 092.0) kJ/d,x2=0.770,P=0.939].Logistic回归分析显示,透析液吸收热量和饮食脂肪摄入量是超重/肥胖的危险因素(OR=1.003,95％ CI=1.000 ～1.007,P=0.029;OR=1.024,95％ CI=1.003 ～1.046,P=0.027).结论 与BMI正常的CAPD患者比较,超重和肥胖患者饮食脂肪摄入量和从透析液中吸收的葡萄糖多,但TEE差异无统计学意义,提示超重/肥胖的CAPD患者处于能量正平衡状态,应减少高浓度葡萄糖透析液使用,并鼓励体育锻炼.
目的 研究持續非臥床腹膜透析(CAPD)患者的能量攝入和消耗,探討CAPD患者超重和肥胖的可能影響因素.方法 選擇2011年5月至12月在北京大學第三醫院門診穩定透析的115例CAPD患者,根據體質量指數(BMI)分為正常組(18.5 kg/m2≤BMI< 24 kg/m2,n=61)和超重/肥胖組(BMI≥24 kg/m2,n =54).收集患者3d飲食記錄,計算飲食熱量、蛋白質、脂肪和碳水化閤物攝入,測定24 h透析液中吸收的葡萄糖量,測定患者靜息能量消耗(REE),收集3d活動記錄計算總能量消耗(TEE),進行人體成分分析.結果 兩組患者在年齡、身高、飲食熱量攝入、飲食蛋白質和碳水化閤物攝入、肌肉量、水負荷方麵的差異無統計學意義.超重/肥胖組患者透析液中吸收的葡萄糖熱量和飲食脂肪攝入量均顯著高于正常組[(1 920.5 ±506.3) kJ/d比(1 673.6±535.6) kJ/d,x2=2.536,P=0.013; (62.5±19.8) g/d比(53.1 ±18.7) g/d,x2 =2.575,P=0.011].超重/肥胖組的REE顯著高于正常組[(5066.8±1 029.3)kJ/d比(4 556.4±799.1)kJ/d,x2=2.979,P=0.004],但兩組TEE差異無統計學意義[(7 819.9±728.0) kJ/d比(7 803.2±1 092.0) kJ/d,x2=0.770,P=0.939].Logistic迴歸分析顯示,透析液吸收熱量和飲食脂肪攝入量是超重/肥胖的危險因素(OR=1.003,95％ CI=1.000 ～1.007,P=0.029;OR=1.024,95％ CI=1.003 ～1.046,P=0.027).結論 與BMI正常的CAPD患者比較,超重和肥胖患者飲食脂肪攝入量和從透析液中吸收的葡萄糖多,但TEE差異無統計學意義,提示超重/肥胖的CAPD患者處于能量正平衡狀態,應減少高濃度葡萄糖透析液使用,併鼓勵體育鍛煉.
목적 연구지속비와상복막투석(CAPD)환자적능량섭입화소모,탐토CAPD환자초중화비반적가능영향인소.방법 선택2011년5월지12월재북경대학제삼의원문진은정투석적115례CAPD환자,근거체질량지수(BMI)분위정상조(18.5 kg/m2≤BMI< 24 kg/m2,n=61)화초중/비반조(BMI≥24 kg/m2,n =54).수집환자3d음식기록,계산음식열량、단백질、지방화탄수화합물섭입,측정24 h투석액중흡수적포도당량,측정환자정식능량소모(REE),수집3d활동기록계산총능량소모(TEE),진행인체성분분석.결과 량조환자재년령、신고、음식열량섭입、음식단백질화탄수화합물섭입、기육량、수부하방면적차이무통계학의의.초중/비반조환자투석액중흡수적포도당열량화음식지방섭입량균현저고우정상조[(1 920.5 ±506.3) kJ/d비(1 673.6±535.6) kJ/d,x2=2.536,P=0.013; (62.5±19.8) g/d비(53.1 ±18.7) g/d,x2 =2.575,P=0.011].초중/비반조적REE현저고우정상조[(5066.8±1 029.3)kJ/d비(4 556.4±799.1)kJ/d,x2=2.979,P=0.004],단량조TEE차이무통계학의의[(7 819.9±728.0) kJ/d비(7 803.2±1 092.0) kJ/d,x2=0.770,P=0.939].Logistic회귀분석현시,투석액흡수열량화음식지방섭입량시초중/비반적위험인소(OR=1.003,95％ CI=1.000 ～1.007,P=0.029;OR=1.024,95％ CI=1.003 ～1.046,P=0.027).결론 여BMI정상적CAPD환자비교,초중화비반환자음식지방섭입량화종투석액중흡수적포도당다,단TEE차이무통계학의의,제시초중/비반적CAPD환자처우능량정평형상태,응감소고농도포도당투석액사용,병고려체육단련.
Objective To investigate the energy intakes and energy consumption in continuous ambulatory peritoneal dialysis (CAPD) patients,and to identify the possible influence factors for overweight and obesity of CAPD patients.Methods A total of 115 CAPD patients were enrolled from May to December 2011 in Peking University Third Hospital.Based on body mass index (BMI),they were divided into normal group (18.5 kg/m2 ≤ BMI < 24 kg/m2,n =61) and obese group (BMI ≥ 24 kg/m2,n =54).Three-day dietary intakes including dietary energy,protein,fat,and carbohydrates intakes were collected.Glucose absorption from dialysate was measured.Three-day activities were recorded for the calculation of resting energy expenditure (REE) and total energy expenditure (TEE).Body composition of the patients was analyzed.Results There were no significant differences in age,height,dietary energy intake,protein intake,carbohydrate intakes,lean tissue mass,and hydration status between the two groups.Glucose absorption from dialysate and dietary fat intake were significantly higher in the obese group than in the normal group [(1 920.5 ± 506.3) kJ/d vs.(1 673.6 ±535.6) kJ/d,x2 =2.536,P=0.013; (62.5 ±19.8) g/dvs.(53.1 ±18.7) g/d,x2=2.575,P =0.011].Although REE was higher in the obese group as compared with the normal group [(5 066.8 ±1 029.3) kJ/d vs.(4 556.4 ± 799.1) kJ/d,x2 =2.979,P =0.004],there was no significant difference in TEE between the two groups [(7 819.9 ±728.0) kJ/d vs.(7 803.2 ± 1 092.0) kJ/d,x2 =0.770,P =0.939].Logistic regression showed that glucose absorption from dialysate and dietary fat intakes were risk factors for obesity in the study population (OR =1.003,95％ CI =1.000-1.007,P =0.029 ; OR =1.024,95％ CI =1.003-1.046,P =0.027).Conclusions Obese CAPD patients may absorb more glucose from peritoneal dialysate and consume more fat than non-obese CAPD patients,but TEE is not significantly different.It indicates that obese CAPD patients are at positive energy balance.Less use of high glucose dialysate and more physical exercises are recommended for these patients.
