Division of Nephrology, Department of Internal Medicine, Yeungnam University Hospital, Daegu, Korea.
Eur J Clin Nutr. 2017 Dec;71(12):1405-1410. doi: 10.1038/ejcn.2017.104. Epub 2017 Jun 28.
BACKGROUND/OBJECTIVES: There are few studies of the association between low appendicular muscle mass (LAM) and clinical outcomes in peritoneal dialysis (PD) patients. We aimed to determine the clinical association between LAM and clinical outcomes in PD patients.
SUBJECT/METHODS: We reviewed all PD patients who underwent PD between January 2001 and April 2014. Each patient's appendicular lean mass was estimated using dual-energy X-ray absorptiometry. The appendicular muscle mass index (AMI) was calculated using total appendicular lean mass (kg) over body mass index (kg/m). The cut-off AMI value for LAM was <0.789 for men and <0.512 for women.
The number of patients in the Non-LAM and LAM groups was 328 and 303, respectively. The median follow-up durations in the Non-LAM and LAM groups were 47 and 49 months, respectively. The numbers of deaths in the Non-LAM and LAM groups were 96 (29.3%) and 160 (52.8%), respectively. In a comparison with the Non-LAM group, the hazard ratio in the LAM group was 1.74 (95% confidence interval (CI), 1.35-2.24) in univariate and 1.71 (95% CI, 1.28-2.26) in multivariate Cox regression analysis. In addition, the hazard ratio for a 0.1 increase in baseline AMI was 0.89 (95% CI, 0.84-0.95) in univariate analysis and 0.84 (95% CI, 0.76-0.91) in multivariate analysis. Analyses using the 1-year AMI showed trends similar to those for the initial AMI.
Our study showed the association of LAM with mortality in the incident PD patients.
背景/目的：关于低四肢肌肉量（LAM）与腹膜透析（PD）患者临床结局之间的关联，研究甚少。我们旨在确定 LAM 与 PD 患者临床结局之间的临床关联。
我们回顾了 2001 年 1 月至 2014 年 4 月期间接受 PD 的所有 PD 患者。每位患者的四肢瘦体重使用双能 X 射线吸收法进行估计。四肢肌肉量指数（AMI）通过四肢瘦体重（kg）除以体重指数（kg/m）计算。男性 LAM 的截断 AMI 值<0.789，女性<0.512。
非 LAM 组和 LAM 组的患者人数分别为 328 人和 303 人。非 LAM 组和 LAM 组的中位随访时间分别为 47 个月和 49 个月。非 LAM 组和 LAM 组的死亡人数分别为 96 人（29.3%）和 160 人（52.8%）。与非 LAM 组相比，LAM 组在单变量和多变量 Cox 回归分析中的风险比分别为 1.74（95%置信区间（CI），1.35-2.24）和 1.71（95%CI，1.28-2.26）。此外，在单变量分析中，基线 AMI 每增加 0.1，风险比为 0.89（95%CI，0.84-0.95），在多变量分析中，风险比为 0.84（95%CI，0.76-0.91）。使用 1 年 AMI 的分析显示出与初始 AMI 相似的趋势。
我们的研究表明，LAM 与新发 PD 患者的死亡率相关。
