Hsiao Shih-Ming, Tsai Yi-Chun, Chen Hui-Mei, Lin Ming-Yen, Chiu Yi-Wen, Chen Tzu-Hui, Wang Shu-Li, Hsiao Pei-Ni, Kung Lan-Fang, Hwang Shang-Jyh, Huang Mei-Feng, Yeh Yi-Chun, Chen Cheng-Sheng, Kuo Mei-Chuan
Department of Nursing, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
Division of General Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan.
PLoS One. 2016 Oct 31;11(10):e0165400. doi: 10.1371/journal.pone.0165400. eCollection 2016.
Impairment of physical function and abnormal body composition are the major presentations in patients with chronic kidney disease (CKD). The aim of this study is to investigate the relationship between body composition and physical function in CKD patients.
This cross-sectional study enrolled 172 of CKD stages 1-5 from February 2013 to September 2013. Handgrip strength (upper extremity muscle endurance), 30-second chair-stand test (lower extremity muscle endurance) and 2-minute step test (cardiorespiratory endurance) were used as indices of physical function. Body composition, including fluid status (extracellular water/total body water, ECW/TBW), lean tissue index (LTI), and fat tissue index (FTI), was measured using a bioimpedance spectroscopy method.
All patients with high ECW/TBW had lower handgrip strength and 30-second chair-stand than those with low ECW/TBW (P<0.001 and P = 0.002). CKD patients with high FTI had lower handgrip strength and 30-second chair-stand than those with low FTI (P<0.001 and P = 0.002). These patients with low LTI had lower handgrip strength than those with high LTI (P = 0.04). In multivariate analysis, high ECW/TBW was positively associated with decreased handgrip strength (β = -41.17, P = 0.03) in CKD patients. High FTI was significantly correlated with decreased times of 30-second chair-stand (β = -0.13, P = 0.01). There was no significant relationship between body composition and 2-minute step test.
Our results show a significant association of impaired upper and lower extremity muscle endurance with high fluid status and fat tissue. Evaluation of body composition may assist in indentifying physical dysfunction earlier in CKD patients.
身体功能受损和身体成分异常是慢性肾脏病（CKD）患者的主要表现。本研究旨在探讨CKD患者身体成分与身体功能之间的关系。
这项横断面研究在2013年2月至2013年9月期间纳入了172例1 - 5期CKD患者。握力（上肢肌肉耐力）、30秒椅子站立试验（下肢肌肉耐力）和2分钟台阶试验（心肺耐力）被用作身体功能指标。使用生物电阻抗光谱法测量身体成分，包括液体状态（细胞外液/总体液，ECW/TBW）、瘦组织指数（LTI）和脂肪组织指数（FTI）。
所有ECW/TBW高的患者握力和30秒椅子站立能力均低于ECW/TBW低的患者（P<0.001和P = 0.002）。FTI高的CKD患者握力和30秒椅子站立能力低于FTI低的患者（P<0.001和P = 0.002）。这些LTI低的患者握力低于LTI高的患者（P = 0.04）。在多变量分析中，高ECW/TBW与CKD患者握力下降呈正相关（β = -41.17，P = 0.03）。高FTI与30秒椅子站立次数减少显著相关（β = -0.13，P = 0.01）。身体成分与2分钟台阶试验之间无显著关系。
我们的结果表明，上肢和下肢肌肉耐力受损与高液体状态和脂肪组织显著相关。评估身体成分可能有助于更早地识别CKD患者的身体功能障碍。
