[Longitudinal study on the body mass index (BMI) of dialysis patients]. / Estudio longitudinal del Indice de masa corporal (IMC) en pacientes en diálisis.

Chronic renal failure is commonly related to hyponutrition, affecting approximately on third of patients with advanced renal failure. We carried out a longitudinal study to assess nutritional evolution of 73 patients on a regular hemodialysis program, assessing changes in the anthropometrical parameter body mass index (BMI) and its correspondence to biochemical nutritional parameters such as total protein (TP) levels and serum albumin (Alb). Every three months plasma TP and albumin levels were collected and BMI was calculated by the standard formula: post-dialysis weight in kg/height in m2. For classifying by BMI categories, overweight and low weight were defined according to the WHO Expert Committee. Studied patients had a mean age of 53 years, 43 were male and 30 were female patients. BMI in women was lower than that in men (p < 0.001), as well as TP (p < 0.001) and Alb (p < 0.001) levels. Mean BMI was 29.3 kg/m2. Three point two percent of the determinations showed low weight, 12.16% overweight, and 83.97% normal BMI. TP were normal in 90.76% and decreased in 9.24%. Alb was normal in 82.2% and low in 17.78%. After the follow-up time (21.6 months, minimum 18 months, maximum 53 months), the Kruskal-Wallis test did not show a statistically significant change for BMI but it did show a change for the biochemical parameters albumin and total proteins (p < 0.05): nutritional impairment in CRF patients is manifested on biochemical parameters (TP and Alb) with no reflection on anthropometrical data.

Estudio longitudinal del Índice de masa corporal (IMC) en pacientes en diálisis / Longitudinal study on the body mass index (bmi) of dialysis patients

La insuficiencia renal crónica está relacionada frecuentemente con la malnutrición, afectando aproximadamente a un tercio de los pacientes con enfermedad renal avanzada. Realizamos un estudio longitudinal de la evolución nutricional de 73 pacientes en programa de hemodiálisis periódica, valorando las modificaciones del parámetro antropométrico de índice de masa corporal (IMC) y su correspondencia con parámetros nutricionales bioquímicos como son proteínas totales (PT) y albúmina sérica (Alb). Trimestralmente se recogieron los niveles plasmáticos de PT y Alb, y se evaluó su IMC calculado por la fórmula Standard: peso postdiálisis en Kg / altura m2. Para la clasificación en grupos según el IMC, sobrepeso y bajo peso fueron definidos según los valores del Comité de Expertos de la OMS. Los pacientes estudiados presentan una edad media de 53 años, 43 eran varones y 30 mujeres. El IMC de las mujeres fue inferior al de los varones (p<0,001), así como los niveles de PT (p<0,001) y Alb (p<0,001). El IMC medio es de 29,3 Kg/m2. El 3,2% de las determinaciones mostraban bajo peso, 12,16% sobrepeso y el 83,97 % un IMC normal. Las PT eran normales en el 90,76% y disminuidas en el 9,24%, la Alb normal en el 82,2% y baja en el 17,78%. Tras el tiempo de seguimiento (21,6 meses, con mínimo de 18 meses y máximo de 53) el Test de Kruskal-Wallis no mostró variación estadísticamente significativa en IMC y sí en los parámetros bioquímicos albúmina y proteínas totales (p<0,05): el deterioro nutricional de los pacientes con IRC en programa de diálisis se manifiesta en los parámetros bioquímicos (PT y Alb) sin que se refleje en los datos antropométricos (AU)

Chronic renal failure is commonly related to hyponutrition, affecting approximately on third of patients with advanced renal failure. We carried out a longitudinal study to assess nutritional evolution of 73 patients on a regular hemodialysis program, assessing changes in the anthropometrical parameter body mass index (BMI) and its correspondence to biochemical nutritional parameters such as total protein (TP) levels and serum albumin (Alb). Every three months plasma TP and albumin levels were collected and BMI was calculated by the standard formula: post-dialysis weight in kg/height in m2. For classifying by BMI categories, overweight and low weight were defined according to the WHO Expert Committee. Studied patients had a mean age of 53 years,43 were male and 30 were female patients. BMI in women was lower than that in men (p < 0.001), as well as TP (p < 0.001) and Alb (p < 0.001) levels. Mean BMI was 29.3 kg/m2. Three point two percent of the determinations showed low weight, 12.16% overweight, and 83.97% normal BMI. TP were normal in 90.76% and decreased in 9.24%. Alb was normal in 82.2% and low in 17.78%. After the follow-up time (21.6 months, minimum 18 months, maximum 53 months), the Kruskal-Wallis test did not show a statistically significant change for BMI but it did show a change for the biochemical parameters albumin and total proteins (p < 0.05): nutritional impairment in CRF patients is manifested on biochemical parameters (TP and Alb) with no reflection on anthropometrical data (AU)

Serum and urine selenium concentrations as indicators of body status in patients with diabetes mellitus.

Serum and urine selenium levels were determined in patients with diabetes by hydride generation atomic absorption spectrometry. Mean serum selenium concentrations measured in patients with diabetes mellitus (64.9 +/- 22.8 micrograms/l) were significantly lower than those determined in the control group (74.9 +/- 27.3 micrograms/l) (P < 0.05). Mean serum selenium concentrations were not significantly different between the two groups of diabetic patients considered (P > 0.05). Mean urine selenium concentration in diabetic patients (18.8 +/- 10.7 micrograms/l) were not significantly different from those measured in the control group (20.2 +/- 10.1 micrograms/l) (P < 0.05). No significant differences in serum and urine selenium levels were found if related to sex of patients (P > 0.05). Application of linear regression analysis to serum and urine selenium levels and patients' age showed a non-statistically significant correlation (P > 0.05). Given the marked overlap between the two ranges of the populations, the predictive values of serum selenium in diabetic patients are low.

Serum zinc and copper concentrations and Cu/Zn ratios in patients with hepatopathies or diabetes.

The serum zinc and copper levels, as well as Zn/Cu ratios, were determined in 30 patients (18 with diabetes and 12 with hepatopathies) and compared to healthy-age matched controls by atomic absorption spectrometry. Serum Zn (0.946 +/- 0.302 mg/l) and Cu (0.952 +/- 0.355 mg/l) concentrations were not significantly different in patients with hepatopathies as compared to controls (p > 0.05). Serum Zn concentrations (0.778 +/- 0.164 mg/l) were significantly lower in diabetic patients than those determined in controls (p < 0.01). In contrast, Cu levels (0.987 +/- 0.305 mg/l) were not significantly different (p > 0.05) than in controls. Serum Cu/Zn ratios were not significantly different in patients with diabetes or hepatopathies than those measured in healthy controls (p > 0.05). In patients, no statistically significant differences were observed in the Zn, Cu and Cu/Zn with respect to sex (p > 0.05) or age (p > 0.05).

Serum copper and zinc concentrations in serum from patients with cancer and cardiovascular disease.

A single cross-sectional study for serum copper and zinc levels was evaluated in 20 patients with cancer (respiratory, digestive, haematological, gynaecological) and 21 patients with cardiopathy (acute myocardial infarction and ischemic cardiomyopathy). A control group of 84 healthy subjects was selected. The mean serum zinc levels in patients with gynaecological cancer and ischemic cardiomyopathy were significantly lower than the control group (P < 0.05). However, the mean serum copper level was not statistically different among patients with cancer (P < 0.05) and cardiomyopathy (P > 0.05) than the control group. Male patients did not have statistically different values for serum Cu (P > 0.05) and Zn (P < 0.05) than those found in female patients. Patients' age did not have any statistical influence (P > 0.05) on serum Cu and Zn levels.

Determination of copper levels in serum of healthy subjects by atomic absorption spectrometry.

Copper levels in serum samples of 84 healthy subjects living in southeastern Spain were determined using the flame atomic absorption spectrometry technique. Mineralization of samples was carried out with an HNO3/HClO4 (4:1) mixture in a thermostated mineralization block. The accuracy of the method was tested by using a standard reference material. A mean recovery percentage of 104.70% was obtained. The relative standard deviation (R.S.D.) as a measurement of the precision of the method was lower than 5% in the concentration range considered. Mean copper concentrations were 1.092 +/- 0.365 mg/l (with the range 0.304-2.000 mg/l) and 1.113 +/- 0.253 mg/l (corresponding to an interval of 0.648-1.760 mg/l) for women and men, respectively. There are no significant differences between the copper levels in serum according to either sex or geography zone (P > 0.05). For example, there were no differences of copper levels in serum of subjects from coastal and mountainous zones. Estimated daily dietary intakes on copper in women and men were 1.38 and 2.10 mg Cu/day respectively.