Do Jun Young, Kim A Young, Kang Seok Hui
Division of Nephrology, Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, South Korea.
Front Med (Lausanne). 2021 Jul 14;8:653807. doi: 10.3389/fmed.2021.653807. eCollection 2021.
Maintenance of a peritoneal membrane is essential for maintaining long-term peritoneal dialysis (PD). Peritoneal protein loss (PPL) is basically the loss of an essential nutrient, which may lead to malnutrition. We aimed to evaluate the association between PPL and sarcopenia in PD patients. We conducted a cross-sectional study from September 2017 to November 2020 on all PD patients ( = 199). Finally, the patients were divided into tertiles based on the PPL level as follows: low, middle, and high. PPL (mg/day), appendicular lean mass (ALM) using dual-energy X-ray absorptiometry, and handgrip strength (HGS) were evaluated. Sarcopenia was defined using cut-off values from the Asian Working Group for Sarcopenia. The median PPL (interquartile range, interval) in the low, middle, and high tertiles were 4,229 (904, 1,706-5,111), 6,160 (760, 5,118-7,119), and 8,543 (2,284, 7,145-24,406) mg/day, respectively. HGS in the low, middle, and high tertiles was 23.4 ± 9.2, 23.8 ± 8.9, and 23.6 ± 8.3 kg, respectively ( = 0.967). The ALM index in the low, middle, and high tertiles was 6.0 ± 1.3, 6.0 ± 1.2, and 6.5 ± 1.1 kg/m, respectively ( = 0.061). Multivariate analyses did not reveal significant differences in HGS and ALM index in among tertiles. The proportions of patients with sarcopenia in the low, middle, and high tertiles was 24 (36.4%), 19 (28.4%), and 21 (31.8%), respectively ( = 0.612). The present study showed that PPL is not independently associated with muscle mass, strength, and sarcopenia in PD patients.
维持腹膜功能对于长期进行腹膜透析(PD)至关重要。腹膜蛋白丢失(PPL)本质上是一种必需营养素的流失,这可能导致营养不良。我们旨在评估PD患者中PPL与肌肉减少症之间的关联。我们于2017年9月至2020年11月对所有PD患者(n = 199)进行了一项横断面研究。最后,根据PPL水平将患者分为三分位数,如下:低、中、高。评估了PPL(毫克/天)、使用双能X线吸收法测量的四肢瘦体重(ALM)和握力(HGS)。根据亚洲肌肉减少症工作组的临界值定义肌肉减少症。低、中、高三分位数组的PPL中位数(四分位间距,区间)分别为4229(904,1706 - 5111)、6160(760,5118 - 7119)和8543(2284,7145 - 24406)毫克/天。低、中、高三分位数组的HGS分别为23.4±9.2、23.8±8.9和23.6±8.3千克(P = 0.967)。低、中、高三分位数组的ALM指数分别为6.0±1.3、6.0±1.2和6.5±1.1千克/米²(P = 0.061)。多变量分析未显示三分位数组之间HGS和ALM指数存在显著差异。低、中、高三分位数组中肌肉减少症患者的比例分别为24(36.4%)、19(28.4%)和21(31.8%)(P = 0.612)。本研究表明,PPL与PD患者的肌肉质量、力量和肌肉减少症无独立关联。