Page 85 - 南京医科大学自然版

第44卷第10期 南京医科大学学报（自然科学版）
2024年10月 Journal of Nanjing Medical University（Natural Sciences） ·1401 ·

·临床研究·

慢性肾脏病非透析患者瘦组织质量/脂肪组织质量比值与左心

室肥厚的关系

张承宁，马玉晨，段俗言，袁杨刚，毛慧娟，张 波 *

南京医科大学第一附属医院肾内科，江苏 南京 210029

［摘 要］ 目的：探讨瘦组织质量（lean tissue mass，LTM）/脂肪组织质量（adipose tissue mass，ATM）比值对慢性肾脏病（chronic
kidney disease，CKD）非透析患者左心室肥厚（left ventricular hypertrophy，LVH）的影响。方法：纳入CKD非透析患者417例，根
据左心室重量指数（left ventricular mass index，LVMI）分为左心室正常组（Non⁃LVH 组）240例、左心室肥厚组（LVH 组）177例。
收集基线资料及实验室指标等参数，同时收集超声心动图及生物电阻抗检测结果，比较两组之间的基线数据及LTM/ATM比值
等数据。采用多因素Logistic回归分析CKD非透析患者LVH的危险因素。绘制受试者工作特征（receiver operating characteristic，
ROC）曲线评价 LTM/ATM 对 LVH 的预测价值。结果：LVH 组高血压患病率、年龄、女性比例、收缩压显著高于 Non⁃LVH 组，
BMI、血红蛋白、血白蛋白、估算的肾小球滤过率（estimated Glomerular Filtration Rate，eGFR）显著低于Non⁃LVH组，差异均有统
计学意义。LVH组LTM、瘦组织指数、LTM/ATM比值低于Non⁃LVH组，两组之间容量负荷差异无统计学意义。多因素Logistic
回归分析显示年龄、BMI、收缩压、血红蛋白、LTM/ATM 比值+性别均为 CKD 非透析患者 LVH 的独立危险因素。LTM/ATM 比
值+性别联合血红蛋白预测LVH的ROC曲线下面积为0.769。结论：低LTM/ATM比值为CKD非透析患者LVH的危险因素，该
比值预测此类患者LVH的发生具有一定价值。
［关键词］ 慢性肾脏病；左心室肥厚；瘦组织质量/脂肪组织质量；生物电阻抗
［中图分类号］ R586.12 ［文献标志码］ A ［文章编号］ 1007⁃4368（2024）10⁃1401⁃07
doi：10.7655/NYDXBNSN240220

Relationship between lean tissue mass/adipose tissue mass ratio and left ventricular
hypertrophy in non⁃dialysis patients with chronic kidney disease

ZHANG Chengning，MA Yuchen，DUAN Suyan，YUAN Yanggang，MAO Huijuan，ZHANG Bo *
Department of Nephrology，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：To explore the effect of lean tissue mass（LTM）/adipose tissue mass（ATM）ratio on left ventricular
hypertrophy（LVH）in non⁃dialysis patients with chronic kidney disease（CKD）. Methods：417 non⁃dialysis patients with CKD were
included and divided into a normal left ventricular（Non⁃LVH）group with 240 patients and a left ventricular hypertrophy（LVH）group
with 177 patients according to the left ventricular mass index（LVMI）. Baseline data and laboratory indicators were collected，along
with echocardiography and bioelectrical impedance analysis results. Baseline data and LTM/ATM ratio were compared between the two
groups. Multivariate logistic regression analysis was used to determine the risk factors for LVH in non⁃dialysis CKD patients. The
receiver operator characteristic（ROC）curve was drawn to evaluate the predictive value of LTM/ATM ratio for LVH. Results：The
prevalence of hypertension，age，female ratio，and systolic blood pressure in the LVH group were significantly higher than those in the
Non⁃LVH group，while BMI，hemoglobin，albumin，and eGFR were significantly lower than those in the Non⁃LVH group，all with
statistical differences. The LTM，lean tissue index and LTM/ATM ratio in the LVH group were lower than those in the Non⁃LVH group，
and there was no difference in volume load between the two groups. Multivariate logistic regression analysis showed that age，BMI，

systolic blood pressure，hemoglobin，and LTM/ATM ratio ⁃ gender were all independent risk factors for LVH in non ⁃ dialysis CKD
patients. The area under the ROC curve of LTM/ATM ratio ⁃ gender combined with hemoglobin in predicting LVH was 0.769.

［基金项目］ 北京融和医学发展基金会（KYS2021⁃03⁃02⁃14）
∗
通信作者（Corresponding author），E⁃mail：zhangbo@jsph.org.cn