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骨骼肌减少症及其各组分在成年肾移植受者中的流行情况及其与身体脂肪含量的关系。

Sarcopenia and its components in adult renal transplant recipients: prevalence and association with body adiposity.

机构信息

Post Graduation Program in Medical Science, Rio de Janeiro State University, Rio de Janeiro, Brazil.

Department of Applied Nutrition, Nutrition Institute, Rio de Janeiro State University, Rio de Janeiro, Brazil.

出版信息

Br J Nutr. 2019 Dec 28;122(12):1386-1397. doi: 10.1017/S0007114519002459.

Abstract

Sarcopenia is a progressive and generalised skeletal muscle disorder associated with adverse outcomes. Ageing causes primary sarcopenia, while secondary causes include chronic kidney disease (CKD), long-term use of glucocorticoids and obesity. The aim of the present study was to evaluate the prevalence of sarcopenia using guidelines recommended by the European Working Group on Sarcopenia in Older People (EWGSOP, 2010; EWGSOP2, 2018) and the Foundation of the National Institutes of Health (FNIH) and analyse the relationship between sarcopenia and body adiposity in adult renal transplant recipients (RTR). This was a cross-sectional study of adult RTR (BMI ≥ 18·5 kg/m2). Body composition was evaluated by dual-energy X-ray absorptiometry (DXA) and anthropometry. Glomerular filtration rate was estimated (eGFR) by CKD-Epidemiology Collaboration equation. The prevalence of sarcopenia in adult RTR (n 185; 57 % men, 50 (se 0·82) years and eGFR 55·80 (se 1·52) ml/min) was 7 % (FNIH), 11 % (EWGSOP2) and 17 % (EWGSOP). Low muscle mass, muscle function and physical performance affected, respectively, up to 28, 46 and 10 % of the participants. According to EWGSOP and EWGSOP2, body adiposity evaluated by anthropometry and DXA (percentage trunk fat) was lower in participants with sarcopenia. Conversely, according to the FNIH criteria, RTR with sarcopenia presented higher waist:height ratio. The present study suggests that adult RTR sarcopenia prevalence varies according to the diagnostic criteria; low muscle mass, low muscle function and low physical performance are common conditions; the association of body adiposity and sarcopenia depends on the criteria used to define this syndrome; and the FNIH criteria detected higher adiposity in individuals with sarcopenia.

摘要

肌肉减少症是一种与不良后果相关的进行性和全身性骨骼肌疾病。衰老导致原发性肌肉减少症,而继发性病因包括慢性肾脏病(CKD)、长期使用糖皮质激素和肥胖。本研究旨在使用欧洲老年人肌肉减少症工作组(EWGSOP,2010 年;EWGSOP2,2018 年)和美国国立卫生研究院基金会(FNIH)推荐的指南评估肌肉减少症的患病率,并分析肌肉减少症与成人肾移植受者(RTR)体脂肪之间的关系。这是一项对成年 RTR(BMI≥18.5kg/m2)的横断面研究。采用双能 X 射线吸收法(DXA)和人体测量法评估身体成分。通过 CKD 流行病学合作方程估算肾小球滤过率(eGFR)。185 名成年 RTR(57%为男性,50 岁(se 0.82),eGFR 55.80(se 1.52)ml/min)的肌肉减少症患病率为 7%(FNIH)、11%(EWGSOP2)和 17%(EWGSOP)。肌肉质量低、肌肉功能和身体表现分别影响到 28%、46%和 10%的参与者。根据 EWGSOP 和 EWGSOP2,通过人体测量法和 DXA(躯干脂肪百分比)评估的体脂肪在肌肉减少症患者中较低。相反,根据 FNIH 标准,患有肌肉减少症的 RTR 患者的腰围与身高比更高。本研究表明,成人 RTR 肌肉减少症的患病率因诊断标准而异;肌肉质量低、肌肉功能低和身体表现低是常见的情况;体脂肪与肌肉减少症的相关性取决于定义该综合征的标准;FNIH 标准检测到肌肉减少症患者的体脂率更高。

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