血液透析患者四肢骨骼肌质量的新预测方程：参考生物电阻抗分析
Novel prediction equations for appendicular skeletal muscle mass in hemodialysis patients: referenced against bioelectrical impedance analysis.
摘要(中文译文)
准确评估四肢骨骼肌质量（ASM）在涉及血液透析（HD）患者的临床实践和研究中至关重要。然而，由于透析相关的身体成分和水合状态改变，在一般人群中开发的ASM预测方程可能不适用于HD患者。本研究旨在评估现有基于人体测量学的ASM预测方程在HD患者中的表现，并开发针对该人群的透析特异性方程。在这项横断面研究中，共纳入111例接受维持性血液透析的患者。ASM采用多频生物电阻抗分析（BIA）在标准化透析后条件下测量。评估了三个既往发表的方程，即身高-体重（HW）模型、肢体长度-周长（LC）模型和身高-周长（HC）模型的表现。通过线性回归利用人体测量学变量开发新的透析特异性方程。采用Bland-Altman分析评估一致性，并通过交叉验证和Bootstrap重采样进行内部验证。现有方程与BIA测量的ASM一致性有限，表现出显著的系统性偏倚和较宽的一致性界限。开发了两个透析特异性方程：改进的HW模型（校正R = 0.785，RMSE = 2.712 kg）和HW联合HC（HH）模型（校正R = 0.807，RMSE = 2.628 kg）。与原始方程相比，两个模型均显示出明显改善的一致性，偏倚极小且一致性界限更窄。内部验证显示HH模型性能更为稳定，在内部验证和超滤分层敏感性分析中均保持一致性。源自一般人群的ASM预测方程在维持性血液透析患者中适用性有限。透析特异性人体测量学校准可改善与参考ASM的一致性，其中HH方程为该人群的肌肉质量评估提供了一种实用且可靠的工具。
Abstract
Accurate assessment of appendicular skeletal muscle mass (ASM) is essential in clinical practice and research involving patients undergoing hemodialysis (HD). However, ASM prediction equations developed in the general population may be inappropriate for HD patients because of dialysis-related alterations in body composition and hydration status. To evaluate the performance of existing anthropometric ASM prediction equations in HD patients and to develop dialysis-specific equations tailored to this population. In this cross-sectional study, 111 patients receiving maintenance hemodialysis were enrolled. ASM was measured using multi-frequency bioelectrical impedance analysis (BIA) under standardized post-dialysis conditions. The performance of three previously published equations, namely the height-weight (HW), limb-length-circumference (LC), and height-circumference (HC) models, was assessed. New dialysis-specific equations were developed using anthropometric variables through linear regression. Agreement was evaluated using Bland-Altman analysis, and internal validation was performed using cross-validation and bootstrap resampling. Existing equations demonstrated limited agreement with BIA-measured ASM, showing substantial systematic bias and wide limits of agreement. Two dialysis-specific equations were developed: an advanced HW model (adjusted R = 0.785, RMSE = 2.712 kg) and a HW plus HC (HH) model (adjusted R = 0.807, RMSE = 2.628 kg). Both models showed markedly improved agreement with minimal bias and narrower limits of agreement compared with the original equations. Internal validation revealed more stable performance of the HH model, which maintained consistent agreement across internal validation and ultrafiltration-stratified sensitivity analyses. ASM prediction equations derived from the general population have limited applicability in patients undergoing maintenance hemodialysis. Dialysis-specific anthropometric calibration improves agreement with reference ASM, with the HH equation providing a practical and reliable tool for muscle mass assessment in this population.
如何引用
AMA
Xinyu Wang, Lijuan Chen, Wenjing Yu, Dan Qiao, Li Li, Jian Wang, et al. Novel prediction equations for appendicular skeletal muscle mass in hemodialysis patients: referenced against bioelectrical impedance analysis.. Frontiers in nutrition. 2026; doi:10.3389/fnut.2026.1735182.
APA
Xinyu Wang, Lijuan Chen, Wenjing Yu, Dan Qiao, Li Li, Jian Wang, et al (2026). Novel prediction equations for appendicular skeletal muscle mass in hemodialysis patients: referenced against bioelectrical impedance analysis.. Frontiers in nutrition. https://doi.org/10.3389/fnut.2026.1735182
GB/T 7714
Xinyu Wang, Lijuan Chen, Wenjing Yu, Dan Qiao, Li Li, Jian Wang, et al. Novel prediction equations for appendicular skeletal muscle mass in hemodialysis patients: referenced against bioelectrical impedance analysis.[J]. Frontiers in nutrition, 2026 doi:10.3389/fnut.2026.1735182.
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