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活性维生素 D 给药对血液透析患者肌肉质量的影响。

The effect of active vitamin D administration on muscle mass in hemodialysis patients.

机构信息

Second Department of Internal Medicine, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.

出版信息

Clin Drug Investig. 2013 Nov;33(11):837-46. doi: 10.1007/s40261-013-0132-7.

Abstract

BACKGROUND

Muscle wasting is common and insidious in end-stage renal disease (ESRD). Loss of muscle quantity and quality reduces quality of life and increases mortality in ESRD patients. Additionally, secondary hyperparathyroidism (SHPT) causes muscle atrophy. Meanwhile, vitamin D, which is used for SHPT treatment, plays an essential role in muscle growth.

OBJECTIVES

We prospectively investigated the effect of active vitamin D administration on muscle mass.

METHODS

We measured muscle mass based on bioelectrical impedance analysis in 68 hemodialysis patients. Patients were divided into a control group (without active vitamin D administration) and a VitD group (with active vitamin D administration). We compared muscle mass at the beginning of treatment and 1 year later. We also investigated health-related quality of life (HR-QOL) using the Medical Outcome Study Short Form-36 (SF-36).

RESULTS

The VitD group experienced a significant increase in the amount of change in total muscle mass and muscle mass percentage in men (p = 0.025) but not in women (p = 0.945). By multivariable logistic regression analysis, active vitamin D administration was independently associated with increased muscle mass percentage in men only. In the SF-36, the physical functioning (PF) scores were significantly decreased at the end of the study in the patients without active vitamin D treatment, especially in women.

CONCLUSION

Our results suggested that active vitamin D treatment was associated with increased muscle mass in men, and it might have a favorable effect on maintaining PF in HR-QOL in hemodialysis patients.

摘要

背景

肌肉减少症在终末期肾病(ESRD)中很常见且隐匿。肌肉数量和质量的损失降低了 ESRD 患者的生活质量并增加了死亡率。此外,继发性甲状旁腺功能亢进症(SHPT)会导致肌肉萎缩。同时,用于治疗 SHPT 的维生素 D 在肌肉生长中起着重要作用。

目的

我们前瞻性研究了活性维生素 D 给药对肌肉质量的影响。

方法

我们通过生物电阻抗分析测量了 68 名血液透析患者的肌肉质量。患者分为对照组(未给予活性维生素 D 治疗)和 VitD 组(给予活性维生素 D 治疗)。我们比较了治疗开始时和 1 年后的肌肉质量。我们还使用医疗结局研究 36 项简短形式(SF-36)调查了健康相关生活质量(HR-QOL)。

结果

VitD 组男性的总肌肉量和肌肉量百分比的变化量显著增加(p = 0.025),但女性无显著变化(p = 0.945)。通过多变量逻辑回归分析,只有男性活性维生素 D 给药与肌肉量百分比增加独立相关。在 SF-36 中,在没有活性维生素 D 治疗的患者中,尤其是女性,在研究结束时身体机能(PF)评分显著下降。

结论

我们的结果表明,活性维生素 D 治疗与男性肌肉质量增加相关,并且可能对维持血液透析患者 HR-QOL 中的 PF 具有有利影响。

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