Study On The Body Composition Of Maintenance Hemodialysis Patients Based On Quantitative CT

Objective: To analyze the differences in body composition between maintenance hemodialysis patientsandhealthy subjects,and toexploretheapplication valueofquantitative CTtechnology.Methods: A total of 85 maintenance hemodialysis patients(dialysis group)in Yijishan Hospital from July 2015 to November 2021 and 62 gender and age matched healthy people(healthy control group)were retrospectively analyzed.The bone mineral density,abdominal fat and muscle content of the two groups were measured by quantitative CT technology,and the differences in body composition of hemodialysis patients with different gender,age and dialysis duration were analyzed.Results: Osteoporosis and osteopenia accounted for 16.50%(14 cases)and 29.40%(25 cases)in the dialysis group,while in the healthy control group,osteoporosis and osteopenia accounted for6.50%(4 cases)and 16.10%(10 cases),respectively.The difference between the two groups was statistically significant.The contents of intra-abdominal fat and subcutaneous fat in the dialysis group were [108.70(53.50,168.85)]cm2 and [77.10(29.35,131.70)]cm2,respectively,which were lower than those in the healthy control group [131.85(91.70,173.10)]cm 2,[112.40(84.10,143.25)]cm2,and L3-skeletal muscle area(L3-SMA)in the dialysis group < L3-SMA in the control group,(106.91± 30.35)cm2<(121.37±32.87)cm2,the bone density values in the dialysis group were lower than those in the healthy control group,(139.80±53.34)cm2 <(157.75±52.27)cm2,all of which were statistically different.Among dialysis patients of different sexes and ages,the bone density value of lumbar spine in male dialysis patients was(156.42±52.07)(mg/cm3),which was statistically significant compared with female(121.97±49.30)(mg/cm3).L3-SMA in female dialysis patients < L3-SMA in male patients,(92.44±30.73)cm2<(120.40±23.13)cm2,the difference was statistically significant,the subcutaneous fat content in female patients was higher than that in men,while the difference in intra-abdominal fat content between men and women was not statistically significant.BMD and L3-SMA of dialysis patients over 60 years old were lower than those of dialysis patients under 60 years old,and the difference was statistically significant.There was no difference in bone density and L3-SMA change in dialysis group and length of dialysistime.Conclusion:The incidence of osteoporosis in maintenance hemodialysis patients is higher than that in healthy people,and the bone mineral density,abdominal fat and muscle content are lower than those in healthy people.The BMD and muscle mass of female dialysis patients are lower than those of male dialysis patients,and the subcutaneous fat content is higher than that of male dialysis patients,Bonemineraldensityand L3-SMAarelowerin elderlydialysispatients.Objective: To analyze the relationship between lumbar mineral density(BMD)and body composition and other related indexes in maintenance hemodialysis(MHD)patients by quantitativecomputedtomography(QCT)technique.Methods: A total of 106 MHD patients in Yijishan Hospital from July 2014 to August 2022 were retrospectively analyzed.QCT was used to measure the BMD of L1 and L2,and the body composition information of L3 central level,including visceral adipose tissue(VAT),subcutaneous adipose tissue(SAT),total adipose tissue(TAT),L3-skeletal muscle area(L3-SMA),and L3-intramuscularfat(L3-IMAT).At thesametime,theage,gender,dialysis duration and blood biochemical indicators of the patients were recorded.Pearson correlation analysis was used to analyze the correlation between lumbar BMDand various indicators in MHD patients.According to the results of BMD measurement,106 MHD patients were divided into normal bone mass group(n=61)and abnormal bone mass group(n=45).The differences in body composition and various clinical indicators between the two groups were compared,and multivariate logistic regression was used to analyze the risk factors of abnormal bone mass in MHDpatients.Results:Among 106 MHDpatients,61 cases(57.55%)hadnormal bonemass,45 cases(42.45%)had abnormal bone mass,of which 28 cases(26.41%)had osteopenia and 17 cases(16.04%)had osteoporosis.The age,total cholesterol(TC),low-density lipoprotein cholesterol(LDL-C),phosphorus(P),VAT,SAT,TAT,L3-SMA and L3-IMAT in the abnormal bone mass group were higher than those in the normal bone mass group(P < 0.05).However,there were no significant differences ingender,dialysis age,triglyceride(TG),high-density lipoproteincholesterol(HDL-C),albumin(ALB)and calcium(Ca)levels between the two groups(P>0.05).Lumbar BMD in MHD patients was positively correlated with L3-SMA(r=0.264,P < 0.05),and negatively correlated with age,VAT,SAT,TAT,L3-IMAT and TC(P < 0.05).There was no correlation between BMD and other indexes in MHD patients(P>0.05).Multivariate logistic regression showed that high serum phosphorus,old age and high L3-IMAT were risk factors for abnormal bonemass in MHDpatients.Conclusion:Lumbar BMD is correlated with body composition,age and TC in MHD patients.High serum phosphorus,old age and high L3-IMAT are independent risk factors for abnormal bonemass in MHDpatients.