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终末期肾病的老年社区居住糖尿病患者 dynapenic 腹型肥胖与炎症特征之间的关联。

Association between dynapenic abdominal obesity and inflammatory profile in diabetic older community-dwelling patients with end-stage renal disease.

机构信息

Graduate Program of Physical Education, Catholic University of Brasilia, Brasília, Distrito Federal, Brazil.

Graduate Program of Physical Education, Catholic University of Brasilia, Brasília, Distrito Federal, Brazil.

出版信息

Exp Gerontol. 2021 Apr;146:111243. doi: 10.1016/j.exger.2021.111243. Epub 2021 Jan 15.

Abstract

BACKGROUND

Obesity and poor strength impose higher risk factor for end-stage renal disease (ESRD) patients. It is expected that the combination of both conditions might be critically associated with the inflammatory profile in this population, especially in community-dwelling elderly. So, diagnosis of dynapenic obesity and inflammation is an important tool in the management of chronic kidney disease patients at imminent risk of hospitalization.

PURPOSE

To investigate the association between dynapenic abdominal obesity and inflammatory markers in community-swelling elderly with ESRD.

METHODS

Two hundred and forty-seven community-dwelling older patients (66.74 ± 3.20 years; n = 150, 60.73%, males) undergoing maintenance phase hemodialysis volunteered for this study. The study sample was categorized into four groups according to handgrip strength and waist circumference as follows: control, dynapenia (low strength alone), abdominal obesity (high waist circumference alone), and dynapenic obesity (D/AO) (the combination of low strength and high waist circumference). Blood samples were collected for tumor necrosis factor alpha (TNF-α), interleukin (IL)- 6 and IL- 10. Results were considered significant at P < 0.05.

RESULTS

Proportions for control, abdominal obesity, dynapenic, and D/AO were 38.5%, 15.8%, 25.9%, and 19.8%, respectively. Higher concentrations of TNF-α were found in the D/AO group (P < 0.0001). This group also displayed lower levels of IL-10 (P < 0.0001). Further, the D/AO traits were strongly associated with TNF-α and IL-10 (P < 0.0001).

CONCLUSION

The closely relation between D/AO and inflammatory profile provides evidence that the pooled information of low muscle strength and abdominal obesity may be clinically relevant for the management of ESRD patients.

摘要

背景

肥胖和力量不足会使终末期肾病(ESRD)患者面临更高的风险因素。预计这两种情况的结合可能与该人群的炎症特征密切相关,尤其是在社区居住的老年人中。因此,诊断dynapenic 肥胖和炎症是管理有住院风险的慢性肾病患者的重要工具。

目的

研究社区肿胀老年 ESRD 患者 dynapenic 腹型肥胖与炎症标志物之间的关系。

方法

本研究招募了 247 名接受维持性血液透析的社区居住老年患者(66.74±3.20 岁;n=150,60.73%,男性)。根据握力和腰围将研究样本分为四组:对照组、dynapenia(仅低力量)、腹型肥胖(仅高腰围)和 dynapenic 肥胖(D/AO)(低力量和高腰围的结合)。采集血液样本检测肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6 和 IL-10。结果以 P<0.05 为差异有统计学意义。

结果

对照组、腹型肥胖组、dynapenia 组和 D/AO 组的比例分别为 38.5%、15.8%、25.9%和 19.8%。D/AO 组 TNF-α浓度较高(P<0.0001)。该组还显示出较低的 IL-10 水平(P<0.0001)。此外,D/AO 特征与 TNF-α和 IL-10 密切相关(P<0.0001)。

结论

D/AO 与炎症特征之间的密切关系提供了证据,表明低肌肉力量和腹型肥胖的综合信息可能与 ESRD 患者的管理密切相关。

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