Ohkawa Sakae, Odamaki Mari, Ikegaya Naoki, Hibi Ikuo, Miyaji Kunihiko, Kumagai Hiromichi
Department of Clinical Nutrition, School of Food and Nutritional Sciences, University of Shizuoka, 52-1 Yada, Shizuoka, 422-8526 Japan.
Nephrol Dial Transplant. 2005 May;20(5):945-51. doi: 10.1093/ndt/gfh643. Epub 2005 Mar 15.
In the general population, aging induces changes in body composition, such as sarcopenia or a relative increase in visceral fat, but it remains unclear if similar changes occur in elderly haemodialysis (HD) patients.
Age-related changes in muscle and fat mass and fat distribution in the thigh and abdomen were cross-sectionally investigated in Japanese HD patients. The thigh muscle area (TMA), thigh intermuscular fat area (IMFA), thigh subcutaneous fat area (TSFA), abdominal muscle area (AMA), abdominal visceral fat area (AVFA) and abdominal subcutaneous fat area (ASFA) were measured by computed tomography in 134 non-diabetic patients between 21 and 82 years on HD. AMA, AVFA and ASFA were also measured in 70 age-matched controls.
Muscle mass, fat mass and fat distribution differed significantly with age in both HD patients and controls, without significant differences in BMI. In both male and female HD patients, TMA and AMA showed significant negative correlations with age. All measures of subcutaneous fat-including TSFA, ASFA and the triceps skinfold thickness, were inversely associated with age in the female patients. In contrast, both IMFA and AVFA showed significant positive correlations with age in both male and female patients. The increase in the AVFA/ASFA ratio with age suggests progression of visceral fat accumulation in the elderly HD patients. Controls showed similar relationships between age and muscle mass and visceral fat accumulation.
We found an association between age and decrease in muscle mass as well as increase in visceral and intermuscular fat in non-diabetic HD patients. Such changes may be associated with the metabolic abnormalities and increased mortality in elderly HD patients.
在普通人群中，衰老会引起身体成分的变化，如肌肉减少症或内脏脂肪相对增加，但老年血液透析（HD）患者是否会发生类似变化仍不清楚。
对日本HD患者的肌肉和脂肪量以及大腿和腹部的脂肪分布与年龄相关的变化进行了横断面研究。通过计算机断层扫描测量了134例年龄在21至82岁之间的非糖尿病HD患者的大腿肌肉面积（TMA）、大腿肌间脂肪面积（IMFA）、大腿皮下脂肪面积（TSFA）、腹部肌肉面积（AMA）、腹部内脏脂肪面积（AVFA）和腹部皮下脂肪面积（ASFA）。还对70名年龄匹配的对照组进行了AMA、AVFA和ASFA的测量。
HD患者和对照组的肌肉量、脂肪量和脂肪分布随年龄有显著差异，体重指数无显著差异。在男性和女性HD患者中，TMA和AMA均与年龄呈显著负相关。在女性患者中，所有皮下脂肪测量指标，包括TSFA、ASFA和肱三头肌皮褶厚度，均与年龄呈负相关。相比之下，男性和女性患者的IMFA和AVFA均与年龄呈显著正相关。AVFA/ASFA比值随年龄增加表明老年HD患者内脏脂肪积累进展。对照组在年龄与肌肉量和内脏脂肪积累之间显示出类似的关系。
我们发现非糖尿病HD患者的年龄与肌肉量减少以及内脏和肌间脂肪增加之间存在关联。这些变化可能与老年HD患者的代谢异常和死亡率增加有关。
