Tufan Asli, Tufan Fatih, Akpinar Timur Selcuk, Ilhan Birkan, Bahat Gulistan, Karan Mehmet Akif
a Department of Internal Medicine , Division of Geriatrics, Marmara University Hospital , Istanbul , Turkey.
b Department of Internal Medicine , Istanbul Faculty of Medicine, Division of Geriatrics, Istanbul University , Istanbul , Turkey , and.
Aging Male. 2017 Jun;20(2):110-114. doi: 10.1080/13685538.2016.1225032. Epub 2016 Sep 20.
We aimed to evaluate the association of a decreased glomerular-filtration-rate (GFR <60 ml/min/1.73 m), estimated using Modification of Diet in Renal Disease (MDRD), creatinine- and cystatin C-based (CKDEPI-CR and CKDEPI-CC) Chronic Kidney Disease Epidemiology Collaboration equations with handgrip strength (HGS).
Community-dwelling males aged ≥60 years admitted to outpatient clinic were included. We used MDRD, CKDEPI-CR, and CKDEPI-CC formulas for GFR estimation and corrected these for body surface area. Muscle strength was assessed by HGS.
209 men (mean age 67.8 ± 6.4) were enrolled. Sixty-two patients (29.7%) had sarcopenic HGS. Subjects with sarcopenic HGS were older, had higher rate of a GFR < 60 ml/min/1.73 m, had lower mid-upper arm circumference; tended to have lower creatine kinase, albumin, CKDEPI-CC-GFR levels; and higher BUN/creatinine ratio and cystatin C. Multivariate logistic regression analysis revealed a CKDEPI-CC lower than 60 ml/min/1.73 m as the only independent factor underlying sarcopenic HGS. Higher age tended to have an independent association. Only higher age was independently associated with low HGS when other estimations were used (p = 0.013 and p = 0.021 when MDRD and CKDEPI-CR were used, respectively).
There is a strong association of a GFR level of <60 ml/min/1.73 m with sarcopenic HGS, when CKDEPI-CC formula is used.
我们旨在评估使用肾脏疾病饮食改良（MDRD）、基于肌酐和胱抑素C（CKDEPI-CR和CKDEPI-CC）的慢性肾脏病流行病学协作方程估算的肾小球滤过率降低（GFR <60 ml/min/1.73 m²）与握力（HGS）之间的关联。
纳入门诊就诊的年龄≥60岁的社区男性居民。我们使用MDRD、CKDEPI-CR和CKDEPI-CC公式估算GFR，并对体表面积进行校正。通过握力评估肌肉力量。
共纳入209名男性（平均年龄67.8 ± 6.4岁）。62例患者（29.7%）存在肌肉减少性握力。肌肉减少性握力的受试者年龄更大，GFR <60 ml/min/1.73 m²的比例更高，上臂中部周长更低；肌酸激酶、白蛋白、CKDEPI-CC-GFR水平往往更低；血尿素氮/肌酐比值和胱抑素C更高。多因素逻辑回归分析显示，CKDEPI-CC低于60 ml/min/1.73 m²是肌肉减少性握力的唯一独立因素。年龄较大往往具有独立关联。使用其他估算方法时，只有年龄较大与低握力独立相关（使用MDRD和CKDEPI-CR时，p分别为0.013和0.021）。
当使用CKDEPI-CC公式时，GFR水平<60 ml/min/1.73 m²与肌肉减少性握力之间存在密切关联。
