摘要
目的 评价不同人体测量指标对评估慢性肾脏病(CKD)患者体脂含量的预测价值。方法 采用生物电阻抗分析测量279例CKD非透析患者的体脂百分比及内脏脂肪面积;测量身高、体质量以计算体质量指数(BMI);测量腰围、臀围以计算腰臀比;测量皮褶厚度(肱三头肌皮褶厚度及肩胛下角皮褶厚度)。采用Pearson相关性分析探讨各项人体测量指标与体脂百分比及内脏脂肪面积的相关性。绘制受试者工作特征(ROC)曲线,并进行Delong检验,比较ROC曲线的曲线下面积(AUC)的差异。结果 Pearson相关性分析显示,BMI(r=0.419,P<0.001)、臀围(r=0.450,P<0.001)、肱三头肌皮褶厚度(r=0.229,P<0.001)、肩胛下角皮褶厚度(r=0.324,P<0.001)与体脂百分比具有显著相关性;BMI(r=0.658,P<0.001)、臀围(r=0.648,P<0.001)、肱三头肌皮褶厚度(r=0.194,P=0.001)、肩胛下角皮褶厚度(r=0.333,P<0.001)与内脏脂肪面积也存在显著相关性。ROC曲线分析显示,肱三头肌皮褶厚度诊断慢性肾脏病患者肥胖的AUC值最大(0.732),敏感度和特异度分别为62.1%、78.8%,诊断效果一般;BMI和臀围评估慢性肾脏病患者内脏型肥胖的AUC值分别为0.806、0.804,诊断效果较好,而腰臀比对整体肥胖和内脏型肥胖的诊断价值较差。结论 测量BMI及臀围对于慢性肾脏病患者内脏脂肪蓄积的诊断具有一定价值,但在评估慢性肾脏病患者整体肥胖时,需联合不同人体测量指标进行综合评估。另外,不同人体测量指标在不同类型肥胖中的诊断价值存在差异,需根据实际情况适当选择。
Objective To evaluate the predictive value of different anthropometric indices in as-sessing body fat content in patients with chronic kidney disease(CKD).Methods Bioelectrical im-pedance analysis was used to measure body fat percentage and visceral fat area in 279 non-dialysis CKD patients:Height and body mass were measured to calculate body mass index(BMI).Waist and hip circumferences were measured to calculate waist-to-hip ratio.Skinfold thickness(triceps skinfold thickness and subscapular skinfold thickness)was also measured.Pearson correlation analysis was employed to explore the correlations between anthropometric indices and body fat percentage as well as visceral fat area.Receiver operating characteristic(ROC)curves were plotted,and the DeLong test was conducted to compare the differences in the area under the curve(AUC)of the ROC curves.Results Pearson correlation analysis revealed significant correlations between body fat percentage and BMI(r=0.419,P<0.001),hip circumference(r=0.450,P<0.001),triceps skinfold thickness(r=0.229,P<0.001),and subscapular skinfold thickness(r=0.324,P<0.001).Significant correlations were also observed between visceral fat area and BMI(r=0.658,P<0.001),hip circumference(r=0.648,P<0.001),triceps skinfold thickness(r=0.194,P=0.001),and subscapular skinfold thickness(r=0.333,P<0.001).R0C curve analysis demonstrated that the triceps skinfold thickness had the largest AUC value(0.732)for diagnosing obesity in CKD patients,with a sensitivity of 62.1%and specificity of 78.8%,indicating a moderate diagnostic performance.BMI and hip circumference had AUC values of 0.806 and 0.804,respectively,for as-sessing visceral obesity in CKD patients,showing good diagnostic performance.In contrast,the waist-to-hip ratio exhibited poor diagnostic value for both overall obesity and visceral obesity.Conclusion Measuring BMI and hip circumference is valuable for diagnosing visceral fat accumula-tion in CKD patients.However,when assessing overall obesity in CKD patients,multiple anthropo-metric indices should be combined for comprehensive evaluation.Additionally,our results indicate that different anthropometric indices have varying diagnostic values for different types of obesity,ne-cessitating appropriate selection based on actual circumstances.
作者
姜洁
贾梦雪
毕光宇
徐道亮
刘文进
JIANG Jie;JIA Mengxue;BI Guangyu;XU Daoliang;LIU Wenjin(Medical College,Yangzhou University,Yangzhou,Jiangsu,225001;Department of Nephrology,Northern Jiangsu People′s Hospital Affiliated to Yangzhou University,Yangzhou,Jiangsu,225001;Dalian Medical University,Dalian,Liaoning,116000;Yangzhou Precision Kidney Disease Research Institute,Yangzhou,Jiangsu,225001)
出处
《实用临床医药杂志》
2025年第11期7-13,共7页
Journal of Clinical Medicine in Practice
基金
国家自然科学基金青年基金项目(82302133)
江苏省扬州市科技局社会发展项目(YZ2022094)
江苏省扬州市科技局市级重点实验室项目(YZ2022169)。
关键词
慢性肾脏病
体脂百分比
内脏脂肪面积
人体测量指标
生物电阻抗
皮褶厚度
整体肥胖
内脏型肥胖
chronic kidney disease
body fat percentage
visceral fat area
anthropometric indices
bioelectrical impedance
skinfold thickness
overall obesity
visceral obesity
