Division of Nephrology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea.
Department of Internal Medicine, Incheon St. Mary's Hospital.
Int J Med Sci. 2017 Sep 3;14(11):1054-1064. doi: 10.7150/ijms.20286. eCollection 2017.
This study assessed gender-specific associations between low muscle mass (LMM) and albuminuria. Data from the Korea National Health and Nutrition Examination Survey 2011 were employed. The study consisted of 1,087 subjects (≥50 years old). Skeletal muscle index (SMI) was defined as the weight-adjusted appendicular skeletal muscle mass. Mild LMM and severe LMM were defined as SMI that were 1-2 and >2 standard deviations below the sex-specific mean appendicular skeletal muscle mass of young adults, respectively. Increased albuminuria was defined as albumin-to-creatinine ratio ≥30mg/g Men with mild and severe LMM were significantly more likely to have increased albuminuria (15.2% and 45.45%, respectively) than men with normal SMI (9.86%, <0.0001), but not women. Severe LMM associated independently with increased albuminuria in men (OR=7.661, 95% CI=2.72-21.579) but not women. Severe LMM was an independent predictor of increased albuminuria in hypertensive males (OR=11.449, 95% CI=3.037-43.156), non-diabetic males (OR=8.782, 95% CI=3.046-25.322), and males without metabolic syndrome (MetS) (OR=8.183, 95% CI=1.539-43.156). This was not observed in males without hypertension, males with diabetes or MetS, and all female subgroups. Severe LMM associated with increased albuminuria in men, especially those with hypertension and without diabetes or MetS.
本研究评估了低肌肉量(LMM)与白蛋白尿之间的性别特异性关联。数据来自 2011 年韩国国家健康和营养检查调查。研究包括 1087 名(≥50 岁)受试者。骨骼肌指数(SMI)定义为体重校正的四肢骨骼肌量。轻度 LMM 和重度 LMM 分别定义为 SMI 低于年轻成年人性别特异性平均四肢骨骼肌量 1-2 个和>2 个标准差。白蛋白尿增加定义为白蛋白与肌酐比值≥30mg/g。 男性中,轻度和重度 LMM 患者发生白蛋白尿增加的可能性显著高于 SMI 正常的男性(分别为 15.2%和 45.45%,<0.0001),但女性则不然。重度 LMM 与男性白蛋白尿增加独立相关(OR=7.661,95%CI=2.72-21.579),但与女性无关。重度 LMM 是高血压男性(OR=11.449,95%CI=3.037-43.156)、非糖尿病男性(OR=8.782,95%CI=3.046-25.322)和无代谢综合征(MetS)男性(OR=8.183,95%CI=1.539-43.156)白蛋白尿增加的独立预测因子。在无高血压的男性、无糖尿病或 MetS 的男性以及所有女性亚组中均未观察到这种情况。重度 LMM 与男性白蛋白尿增加相关,尤其是高血压且无糖尿病或 MetS 的男性。