Demircioglu Demet Tekdos
Physical Medicine and Rehabilitation Department, Istanbul University, Istanbul, Turkey.
Clinics (Sao Paulo). 2018;73:e116. doi: 10.6061/clinics/2018/e116. Epub 2018 Feb 15.
The aim of this study was to investigate the frequency of frailty and the association of vitamin D levels and the frailty phenotype among non-geriatric dialysis patients.
Seventy-four stable, chronic hemodialysis patients from the hemodialysis unit of the hospital were enrolled in the study. The patients' medical histories and laboratory findings were obtained from the medical records of the dialysis unit. Serum parathyroid hormone and 25-hydroxy vitamin D levels were determined using chemiluminometric immunoassays. Frailty was defined by Fried et al. as a phenotype; shrinking, weakness, self-reported exhaustion, decreased activity and slowed walking speed were evaluated.
Forty-one (55%) of the patients were males. The patients were divided into 3 groups according to frailty scores: 39 (53%) patients were frail, 6 (8%) patients were intermediately frail, and 28 (39%) patients were normal. Significant differences were found for 25-hydroxy vitamin D and hemoglobin levels among the groups; however, no differences were observed in body mass index, comorbidities, sex, marital status, education, disease and dialysis durations, or parathyroid hormone, creatinine, serum calcium, phosphorus, and potassium levels.
Weakness and slowness are serious outcomes of both vitamin D deficiency and frailty, and vitamin D deficiency has been associated with increased risks of decreased physical activity, falls, fractures and death in postmenopausal women and older men. Although studies on frailty have focused on older adults, growing evidence indicates that the frailty phenotype is becoming a factor associated with poor health outcomes in non-geriatric populations with chronic disease.
本研究旨在调查非老年透析患者中衰弱的发生率以及维生素D水平与衰弱表型之间的关联。
本研究纳入了来自医院血液透析科的74例病情稳定的慢性血液透析患者。患者的病史和实验室检查结果来自透析科的病历记录。采用化学发光免疫分析法测定血清甲状旁腺激素和25-羟维生素D水平。衰弱由弗里德等人定义为一种表型;评估了体型缩小、虚弱、自我报告的疲惫、活动减少和步行速度减慢情况。
41名(55%)患者为男性。根据衰弱评分将患者分为3组:39名(53%)患者衰弱,6名(8%)患者中度衰弱,28名(39%)患者正常。各组间25-羟维生素D和血红蛋白水平存在显著差异;然而,在体重指数、合并症、性别、婚姻状况、教育程度、疾病和透析时长,或甲状旁腺激素、肌酐、血清钙、磷和钾水平方面未观察到差异。
虚弱和行动迟缓是维生素D缺乏和衰弱的严重后果,维生素D缺乏与绝经后女性和老年男性身体活动减少、跌倒、骨折及死亡风险增加有关。尽管关于衰弱的研究主要集中在老年人,但越来越多的证据表明,衰弱表型正成为患有慢性疾病的非老年人群健康状况不佳的一个相关因素。