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Comparison of lean mass indices as predictors of mortality in incident peritoneal dialysis patients

BACKGROUND: Few studies have considered optimal adjusted lean mass indices for prediction of clinical outcomes in peritoneal dialysis (PD) patients. We aimed to evaluate clinical variables using various adjusted indices in PD patients. METHODS: Total 528 incident PD patients were included. Lean mass...

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Autores principales: Kang, Seok Hui, Kim, A. Young, Do, Jun Young
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297877/
https://www.ncbi.nlm.nih.gov/pubmed/34293044
http://dx.doi.org/10.1371/journal.pone.0254942
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author Kang, Seok Hui
Kim, A. Young
Do, Jun Young
author_facet Kang, Seok Hui
Kim, A. Young
Do, Jun Young
author_sort Kang, Seok Hui
collection PubMed
description BACKGROUND: Few studies have considered optimal adjusted lean mass indices for prediction of clinical outcomes in peritoneal dialysis (PD) patients. We aimed to evaluate clinical variables using various adjusted indices in PD patients. METHODS: Total 528 incident PD patients were included. Lean mass was measured using dual energy X-ray absorptiometry. Appendicular lean mass (ALM) was calculated using the sum for both upper and lower extremities. Each ALM index was calculated using ALM per body weight (ALM/BW), height squared (ALM/Ht(2)), or body mass index (ALM/BMI). Limb/trunk lean mass (LTLM) ratio was defined as the sum for both upper and lower extremities divided by trunk lean mass. RESULTS: A total of 528 patients were analyzed men: 286, women: 242. In area under the receiver operating characteristic curve analyses, LTLM alone was associated with 1 year mortality. In the LTLM ratio, the cut-off value for 1-year mortality was ≤ 0.829 in men and ≤ 0.717 in women, respectively. In both sexes, LTLM ratio alone showed statistical significance in all-cause mortality in both univariate and multivariate Cox-regression analyses. Compared with other indices, the LTLM ratio was independent of edema and fat in both sexes. Edema- and C-reactive protein-adjusted correlation analysis showed that LTLM ratio alone was associated with serum albumin in men. Although statistical significance was not obtained for women, the correlation coefficient was highest for the LTLM ratio compared with other indices. CONCLUSION: Among various indices using lean mass, LTLM ratio was independent of volume status and fat mass and was associated with mortality in incident PD patients.
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spelling pubmed-82978772021-07-31 Comparison of lean mass indices as predictors of mortality in incident peritoneal dialysis patients Kang, Seok Hui Kim, A. Young Do, Jun Young PLoS One Research Article BACKGROUND: Few studies have considered optimal adjusted lean mass indices for prediction of clinical outcomes in peritoneal dialysis (PD) patients. We aimed to evaluate clinical variables using various adjusted indices in PD patients. METHODS: Total 528 incident PD patients were included. Lean mass was measured using dual energy X-ray absorptiometry. Appendicular lean mass (ALM) was calculated using the sum for both upper and lower extremities. Each ALM index was calculated using ALM per body weight (ALM/BW), height squared (ALM/Ht(2)), or body mass index (ALM/BMI). Limb/trunk lean mass (LTLM) ratio was defined as the sum for both upper and lower extremities divided by trunk lean mass. RESULTS: A total of 528 patients were analyzed men: 286, women: 242. In area under the receiver operating characteristic curve analyses, LTLM alone was associated with 1 year mortality. In the LTLM ratio, the cut-off value for 1-year mortality was ≤ 0.829 in men and ≤ 0.717 in women, respectively. In both sexes, LTLM ratio alone showed statistical significance in all-cause mortality in both univariate and multivariate Cox-regression analyses. Compared with other indices, the LTLM ratio was independent of edema and fat in both sexes. Edema- and C-reactive protein-adjusted correlation analysis showed that LTLM ratio alone was associated with serum albumin in men. Although statistical significance was not obtained for women, the correlation coefficient was highest for the LTLM ratio compared with other indices. CONCLUSION: Among various indices using lean mass, LTLM ratio was independent of volume status and fat mass and was associated with mortality in incident PD patients. Public Library of Science 2021-07-22 /pmc/articles/PMC8297877/ /pubmed/34293044 http://dx.doi.org/10.1371/journal.pone.0254942 Text en © 2021 Kang et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Kang, Seok Hui
Kim, A. Young
Do, Jun Young
Comparison of lean mass indices as predictors of mortality in incident peritoneal dialysis patients
title Comparison of lean mass indices as predictors of mortality in incident peritoneal dialysis patients
title_full Comparison of lean mass indices as predictors of mortality in incident peritoneal dialysis patients
title_fullStr Comparison of lean mass indices as predictors of mortality in incident peritoneal dialysis patients
title_full_unstemmed Comparison of lean mass indices as predictors of mortality in incident peritoneal dialysis patients
title_short Comparison of lean mass indices as predictors of mortality in incident peritoneal dialysis patients
title_sort comparison of lean mass indices as predictors of mortality in incident peritoneal dialysis patients
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8297877/
https://www.ncbi.nlm.nih.gov/pubmed/34293044
http://dx.doi.org/10.1371/journal.pone.0254942
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