Yanishi M, Kimura Y, Tsukaguchi H, Koito Y, Taniguchi H, Mishima T, Fukushima Y, Sugi M, Kinoshita H, Matsuda T
Department of Urology and Andrology, Kansai Medical University, Osaka, Japan.
Health Science Center, Kansai Medical University, Osaka, Japan.
Transplant Proc. 2017 Mar;49(2):288-292. doi: 10.1016/j.transproceed.2016.12.015.
Sarcopenia is characterized by an involuntary loss of skeletal muscle mass, strength, and function. Previous studies suggest that it is generally associated with aging and chronic kidney diseases. The focus of this study was on the association between sarcopenia and pre-sarcopenia in kidney transplant recipients.
Fifty-one patients who underwent kidney transplantation at Kansai Medical University Hospital were enrolled, and their sarcopenia status was evaluated between April and July 2016. Sarcopenia was defined according to the criteria for the Asia Working Group for Sarcopenia. Skeletal muscle mass index was measured by using dual-energy radiograph absorptiometry; the cutoff points were <7.0 kg/m for male subjects and <5.4 kg/m for female subjects. For hand grip strength, values <26 kg (male subjects) and <17 kg (female subjects) was judged as sarcopenia. In both sexes, the cutoff point for walking speed was <0.8 m/s.
Fifty-one recipients (36 men and 15 women) who met the inclusion criteria were enrolled in the study. The mean age of the recipients was 46.2 ± 12.8 years, and the mean duration of dialysis was 2.72 ± 3.61 years. Overall, 6 recipients (11.8%) had sarcopenia, and 25 recipients (49.0%) had pre-sarcopenia; 20 (39.2%) did not have sarcopenia. There were significant differences in age, duration of dialysis, body mass index, and triglyceride levels between the subgroups of recipients with and without sarcopenia. Multivariate regression analysis showed that age and duration of dialysis were independent variables for sarcopenic status.
Our observations indicate that age and duration of dialysis before transplantation were independent determinants of sarcopenia and pre-sarcopenia in these kidney transplant recipients.
肌肉减少症的特征是骨骼肌质量、力量和功能的非自愿性丧失。先前的研究表明，它通常与衰老和慢性肾脏疾病有关。本研究的重点是肾移植受者中肌肉减少症与肌肉减少症前期之间的关联。
纳入了51例在关西医科大学医院接受肾移植的患者，并于2016年4月至7月对他们的肌肉减少症状况进行了评估。肌肉减少症根据亚洲肌肉减少症工作组的标准进行定义。使用双能X线吸收法测量骨骼肌质量指数；男性受试者的截断点为<7.0kg/m²，女性受试者为<5.4kg/m²。对于握力，男性受试者<26kg、女性受试者<17kg的值被判定为肌肉减少症。在两性中，步行速度的截断点为<0.8m/s。
51名符合纳入标准的受者（36名男性和15名女性）被纳入研究。受者的平均年龄为46.2±12.8岁，平均透析时间为2.72±3.61年。总体而言，6名受者（11.8%）患有肌肉减少症，25名受者（49.0%）患有肌肉减少症前期；20名（39.2%）没有肌肉减少症。有肌肉减少症和没有肌肉减少症的受者亚组在年龄、透析时间、体重指数和甘油三酯水平方面存在显著差异。多变量回归分析表明，年龄和透析时间是肌肉减少症状态的独立变量。
我们的观察结果表明，移植前的年龄和透析时间是这些肾移植受者中肌肉减少症和肌肉减少症前期的独立决定因素。
