Tabibi Hadi, As'habi Atefeh, Najafi Iraj, Hedayati Mehdi
Department of Clinical Nutrition & Dietetics, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Department of Nutrition, Semnan University of Medical Sciences, Semnan, Iran.
Kidney Res Clin Pract. 2018 Dec;37(4):404-413. doi: 10.23876/j.krcp.18.0064. Epub 2018 Dec 31.
Dynapenic obesity and sarcopenic obesity increase cardiovascular disease (CVD) and mortality in nonuremic patients. The present study was designed to determine the prevalence of dynapenic obesity and sarcopenic obesity and their associations with CVD risk factors in peritoneal dialysis (PD) patients.
All eligible PD patients in Tehran peritoneal dialysis centers were included in this cross-sectional study. Skeletal muscle mass and fat mass were assessed using bioelectrical impedance analysis. Muscle strength and physical performance were determined using hand grip strength and a 4-meter walk gait speed test, respectively. In addition, a 5-mL blood sample was obtained from each patient.
The prevalence of dynapenic obesity and sarcopenic obesity were 11.4% and 3.8% in PD patients, respectively. Serum high-sensitive C-reactive protein (hs-CRP), soluble intercellular adhesion molecule type 1, triglyceride, total cholesterol, and low-density lipoprotein cholesterol were significantly higher in PD patients with dynapenic obesity than in dynapenic nonobese and nondynapenic nonobese patients. Similarly, serum concentrations of CVD risk factors in PD patients with sarcopenic obesity were higher than in nonsarcopenic nonobese patients, but these differences were statistically significant only for serum hs-CRP and triglyceride. In addition, muscle strength and skeletal muscle mass percentage were negatively associated with markers of inflammation and dyslipidemia, whereas body fat percentage was positively associated with these CVD risk factors.
This study indicates that although the prevalence of dynapenic obesity and sarcopenic obesity are relatively low in PD patients, these disorders may be associated with CVD risk factors.
肌肉减少性肥胖和肌少症性肥胖会增加非尿毒症患者患心血管疾病(CVD)的风险及死亡率。本研究旨在确定腹膜透析(PD)患者中肌肉减少性肥胖和肌少症性肥胖的患病率及其与CVD危险因素的关联。
本横断面研究纳入了德黑兰腹膜透析中心所有符合条件的PD患者。使用生物电阻抗分析评估骨骼肌质量和脂肪质量。分别使用握力和4米步行速度测试来确定肌肉力量和身体表现。此外,从每位患者采集5毫升血样。
PD患者中肌肉减少性肥胖和肌少症性肥胖的患病率分别为11.4%和3.8%。肌肉减少性肥胖的PD患者血清高敏C反应蛋白(hs-CRP)、可溶性细胞间黏附分子1、甘油三酯、总胆固醇和低密度脂蛋白胆固醇显著高于肌肉减少性非肥胖和非肌肉减少性非肥胖患者。同样,肌少症性肥胖的PD患者血清CVD危险因素浓度高于非肌少症性非肥胖患者,但这些差异仅在血清hs-CRP和甘油三酯方面具有统计学意义。此外,肌肉力量和骨骼肌质量百分比与炎症和血脂异常标志物呈负相关,而体脂百分比与这些CVD危险因素呈正相关。
本研究表明,尽管PD患者中肌肉减少性肥胖和肌少症性肥胖的患病率相对较低,但这些疾病可能与CVD危险因素有关。