Department of Nephrology, Kanazawa Medical University School of Medicine, 1-1 Daigaku, Uchinada, Ishikawa, 920-0293, Japan.
Sci Rep. 2020 Jul 1;10(1):10723. doi: 10.1038/s41598-020-67711-1.
Although it has been reported that chronic kidney disease exacerbates sarcopenia progression, the mechanisms of the process remain unclear. Fifty-one patients who underwent renal transplantation at our hospital since 1998 (31 males and 20 females; aged 29-52 years at the time of transplantation) were retrospectively examined for the relationships among the psoas muscle index (PMI), intramuscular adipose tissue content (IMAC), serum adiponectin fractions (high-/low-molecular-weight) and new-onset diabetes after transplantation (NODAT). Before transplantation, age at kidney transplantation negatively correlated with PMI and positively correlated with IMAC (rS = - 0.427, p < 0.01; rS = 0.464, p < 0.01, respectively). Both at 1 and 5 years after transplantation, PMI was higher than before transplantation (p < 0.01). IMAC transiently decreased to - 0.39 at 1 year after kidney transplantation but subsequently increased to - 0.36 at 5 years after kidney transplantation. Multivariate analyses revealed that the mean increase in high-molecular weight adiponectin concentrations was an exacerbating factor for the mean change in PMI (p = 0.003). Moreover, the mean increases in IMAC were exacerbating factors for NODAT. In conclusion, the increase in the PMI is associated with high-molecular weight adiponectin levels after renal transplantation.
虽然有研究报道慢性肾脏病会加重肌肉减少症的进展,但具体机制尚不清楚。本研究回顾性分析了 1998 年以来在我院接受肾移植的 51 例患者(男 31 例,女 20 例;移植时年龄 29-52 岁)的腰大肌指数(PMI)、肌肉内脂肪含量(IMAC)、血清脂联素分数(高分子量/低分子量)与移植后新发糖尿病(NODAT)之间的关系。移植前,年龄与 PMI 呈负相关,与 IMAC 呈正相关(rS=-0.427,p<0.01;rS=0.464,p<0.01)。移植后 1 年和 5 年时,PMI 均高于移植前(p<0.01)。IMAC 在移植后 1 年时短暂下降至-0.39,但随后在移植后 5 年时增加至-0.36。多变量分析显示,高分子量脂联素浓度的平均升高是 PMI 平均变化的加重因素(p=0.003)。此外,IMAC 的平均增加是 NODAT 的加重因素。综上所述,肾移植后 PMI 的增加与高分子量脂联素水平有关。