Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Naples, Italy.
Department of Clinical Medicine and Surgery, Physiology Nutrition Unit, Federico II University of Naples, Naples, Italy.
Nutrition. 2020 Oct;78:110815. doi: 10.1016/j.nut.2020.110815. Epub 2020 Mar 19.
Using the new European Working Group on Sarcopenia in Older People (EWGSOP2) criteria, we identified sarcopenic and dynapenic patients in a cohort of predialysis patients with chronic kidney disease (CKD), and evaluated their clinical and laboratory characteristics.
The study population consisted of 85 (55 men) clinically stable predialysis CKD patients (92.9% in stages 3-5), with a median age of 65.0 (52.5-72.0) y. We classified as sarcopenic the patients with handgrip strength (HGS) and muscle mass both lower than the respective EWGSOP2 cutoff values and as dynapenic those in whom only HGS was less than these reference values. HGS was measured with a hand dynamometer, whereas muscle mass was measured by bioimpedance analysis. Renal function was evaluated as Modification of Diet in Renal Disease estimated glomerular filtration rate.
The prevalence of sarcopenia and dynapenia was, respectively, 7.1% and 17.6%. As reported in previous studies, serum albumin and hemoglobin were lower in sarcopenic patients than in patients with preserved muscle mass and strength. However, unlike in these studies, sarcopenia prevalence did not increase with CKD stage, and estimated glomerular filtration rate was similar between groups. Moreover, no difference was identified in any of the aforementioned parameters between dynapenic patients and patients with preserved muscle mass and strength.
The EWGSOP2 criteria identified sarcopenia in CKD with a prevalence similar to previous diagnostic criteria. In addition, they found that dynapenia was highly prevalent. Nevertheless, the EWGSOP2 criteria could be better adapted to CKD patients to improve their ability to detect high-risk sarcopenic and dynapenic patients.
使用新的欧洲老年人肌少症工作组（EWGSOP2）标准，我们在一组接受透析的慢性肾脏病（CKD）患者中确定了肌少症和动力肌少症患者，并评估了他们的临床和实验室特征。
研究人群由 85 名（55 名男性）临床稳定的透析前 CKD 患者（92.9%为 3-5 期）组成，中位年龄为 65.0（52.5-72.0）岁。我们将握力（HGS）和肌肉量均低于 EWGSOP2 截值的患者分类为肌少症患者，将仅 HGS 低于这些参考值的患者分类为动力肌少症患者。HGS 使用手持测力计测量，而肌肉量则使用生物阻抗分析测量。肾功能评估采用改良肾脏病饮食研究估计肾小球滤过率。
肌少症和动力肌少症的患病率分别为 7.1%和 17.6%。与之前的研究报道一致，血清白蛋白和血红蛋白在肌少症患者中低于肌肉量和力量正常的患者。然而，与这些研究不同的是，肌少症的患病率并未随着 CKD 分期的增加而增加，各组之间的估计肾小球滤过率也相似。此外，在上述任何参数方面，动力肌少症患者与肌肉量和力量正常的患者之间均无差异。
EWGSOP2 标准在 CKD 患者中识别出肌少症的患病率与之前的诊断标准相似。此外，他们发现动力肌少症的患病率很高。然而，EWGSOP2 标准可能需要更好地适应 CKD 患者，以提高其识别高危肌少症和动力肌少症患者的能力。
