The association between anthropometric measurements and nutritional status in chronic hemodialysis patients

The association between anthropometric

measurements and nutritional status in

chronic hemodialysis patients

Chiu YC

1

_{, Lin WC}

1

_{, Yang SH}

1,2

1

_{School of Nutrition and Health Sciences, Taipei}

Medical University

2

_{Nutrition research center, Taipei Medical University}

Abstract



Objective: Our study was to evaluate the association between

anthropometric measurements and nutritional status in chronic hemodialysis

(CHD) patients.



Method: 107 hemodialysis patients were recruited from Taipei Medical

University Hospital and Wanfang Hospital in 2010. Which were 53 males

and 54 females. The mean of age was 63.4 years and the mean of body

mass index (BMI) was 23.1. We used the BMI to classify subjects into three

groups, includes underweight ( BMI <18.5 ), normal weight ( 18.5 < BMI <

23.9 ) and overweight & obese ( BMI ≧ 24) groups.



Result: Overweight & obese group had higher phosphate and calcium ×

phosphate than underweight group. Normal weight and overweight & obese

groups had higher GNRI score than underweight group

.

Higher BMI groups

includes normal weight and overweight & obese groups had more well-

nourished (GNRI score > 90) but lower calorie and protein intake.



Conclusion: Higher BMI may reflect well-nourished in CHD patients, but they

have lower dietary intake.

Introduction

Hemodialysis (HD) patients with elevated body mass index

(BMI) demonstrate better nutritional status compared to normal

BMI or overweight patients. Our study was to evaluate the

association between anthropometric measurements and

nutritional status in chronic hemodialysis (CHD) patients.

Results

Table 1. Clinical characteristics of hemodialysis patients divided by BMI groups. BMI (kg/m2)

Variables Total underweight normal weight overweight & obese p

Subjects (n) 107 9 58 40 BMI (kg/m2) 23.1 ± 3.9 17.1 ± 1.6 21.4 ± 1.5 26.8 ± 3.4 Age (years) 63.4 ± 14.7 68.4 ± 19.3 63.9 ± 14.9 61.6 ± 13.1 0.426 Hemoglobin (g/dL) 10.5 ± 1.3 10.6 ± 1.5 10.3 ± 1.4 10.8 ± 1.0 0.174 Total protein (g/dL) 6.8 ± 0.6 6.8 ± 0.5 6.7 ± 0.6 6.8 ± 0.6 0.744 Albumin (g/dL) 3.9 ± 0.4 3.9 ± 0.6 3.9 ± 0.4 4.0 ± 0.3 0.741 BUN (mg/dL) 71.3 ± 20.3 63.4 ± 15.7 70.6 ± 23.0 74.0 ± 16.5 0.345 Creatinine (mg/dL) 10.4 ± 3.0 8.9 ± 2.4 10.3 ± 3.2 10.9 ± 2.6 0.167 Cholesterol (mg/dL) 174 ± 44 157 ± 46 174 ± 46 178 ± 41 0.439 Triglyceride (mg/dL) 194 ± 136 156 ± 137 179 ± 132 226 ± 140 0.168 Potassium (mg/dL) 4.6 ± 0.8 4.6 ± 0.7 4.5 ± 0.7 4.6 ± 0.8 0.643 Calcium (mg/dL) 9.4 ± 0.9 9.1 ± 0.5 9.4 ± 0.9 9.4 ± 0.8 0.463 Phosphate (mg/dL) 5.1 ± 1.4 4.2 ± 0.9a 4.9 ± 1.5ab 5.6 ± 1.3b 0.013 Ca × P (mg2/dL2) 48.0 ± 13.8 38.1 ± 8.3a 48.4 ± 13.7ab 52.5 ± 13.4b 0.007 Kt/V 1.63 ± 0.29 1.66 ± 0.36 1.67 ± 0.27 1.57 ± 0.30 0.237 GNRI score 98.7 ± 6.9 89.8 ± 9.9a 98.7 ± 6.5b 100.7 ± 4.9b <.0001 Calorie (kcal/kg) 24.4 ± 7.9 28.4 ± 10.4 25.1 ± 8.3 22.3 ± 6.2 0.062 Protein (g/kg) 0.97 ± 0.35 1.09 ± 0.44 1.01 ± 0.38 0.88 ± 0.27 0.097 Values are expressed as mean ± SD. BUN = blood urea nitrogen; Ca × P = calcium phosphate

products; GNRI = geriatric nutritional risk index.

Values with different superscripts are significantly

different at p < 0.05 by t test.

Results

Table 2. Odds ratio of nutritional status parameter with optimal target according to BMI groups. Target underweight normal weight overweight &

obese p for trend

n 9 58 40 BMI, kg/m2 17.1 ± 1.63 21.41 ± 1.46 26.82 ± 3.41 Range 13.3 ~ 18.3 18.5 ~ 23.8 23.9 ~ 38.9 Albumin (g/dL) ≧ 4.0 4 (44.4) 29 (49.2) 17 (43.6) 0.746 1 (reference) 1.21 (0.29-4.95) 0.96 (0.22-4.16) GNRI score ≧ 90.0 5 (55.6) 54 (91.5) 38 (97.4) 0.001 1 (reference) 8.64 (1.74-42.9) 30.4 (2.81-328.9) Calorie (kcal/kg) ≧ 30.0 4 (44.4) 14 (23.7) 5 (12.8) 0.035 1 (reference) 0.39 (0.29-4.95) 0.18 (0.04-0.92) Protein (g/kg) ≧ 1.20 4 (44.4) 15 (25.4) 4 (10.3) 0.012 1 (reference) 0.43 (0.10-1.79) 0.14 (0.02-0.76)

Values are number, mean ± SD or odds ratio with 95% confidence interval. GNRI = geriatric nutritional risk index. Statistical significance analyzed by logistic regression at p < 0.05.

Result



Overweight & obese group had higher phosphate and calcium ×

phosphate than underweight group. Normal weight and overweight

& obese groups had higher GNRI score than underweight group

.



Higher BMI groups includes normal weight and overweight & obese

groups had more well-nourished (GNRI score > 90) but lower

calorie and protein intake. We suggested that overweight & obese

was told to decrease calorie and protein intake by dietitians.

Conclusion



Higher BMI may reflect well-nourished in CHD patients, but they

have lower dietary intake.