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慢性肝病日本患者肾功能高估的频率和特征及其与肌肉减少症的关系。

Frequency and Characteristics of Overestimated Renal Function in Japanese Patients with Chronic Liver Disease and Its Relation to Sarcopenia.

机构信息

Department of Gastroenterology and Hepatology, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan.

Laboratory of Molecular and Cellular Medicine, Faculty of Pharmaceutical Sciences, Hokkaido University, Sapporo 060-8638, Japan.

出版信息

Nutrients. 2021 Jul 14;13(7):2415. doi: 10.3390/nu13072415.

DOI:10.3390/nu13072415
PMID:34371925
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8308887/
Abstract

Renal dysfunction and sarcopenia are important prognostic factors in patients with chronic liver disease (CLD). Muscle atrophy can cause the overestimation of renal function based on serum creatinine. However, the frequency of overestimated renal function in Japanese patients with CLD and its relationship with sarcopenia are unclear. In present study, we evaluated the frequency of overestimated renal function, defined as a >20% higher eGFR using creatinine than using cystatin C, in 307 patients with CLD as well as its relationship with indicators of sarcopenia. In total, 24.8% of patients had overestimated renal function. In a multivariate regression analysis, liver cirrhosis ( = 0.004) and psoas muscle mass index ( = 0.049) were significantly associated with overestimated renal function. Loss of skeletal muscle mass was significantly more frequent in both male and female patients with overestimated renal function than without. In males, the loss of muscle strength and rate of sarcopenia, defined as loss of muscle mass and strength, were significantly higher in patients with than without overestimated renal function. The high frequency of overestimated renal function in Japanese patients suggests that indicators of renal function should be carefully considered; furthermore, monitoring and interventions for both renal function and sarcopenia are needed in patients with CLD.

摘要

肾功能不全和肌肉减少症是慢性肝病 (CLD) 患者的重要预后因素。肌肉萎缩会导致基于血清肌酐的肾功能估计过高。然而,日本 CLD 患者肾功能估计过高的频率及其与肌肉减少症的关系尚不清楚。在本研究中,我们评估了 307 例 CLD 患者中使用肌酐而非胱抑素 C 估计的 eGFR 高出 >20%的肾功能估计过高的频率及其与肌肉减少症指标的关系。共有 24.8%的患者存在肾功能估计过高。在多变量回归分析中,肝硬化 (=0.004) 和腰大肌肌肉质量指数 (=0.049) 与肾功能估计过高显著相关。与无肾功能估计过高的患者相比,无论男女,肾功能估计过高的患者骨骼肌质量丢失更为频繁。在男性中,与无肾功能估计过高的患者相比,有肾功能估计过高的患者肌肉力量和肌肉减少症的丧失(即肌肉质量和力量的丧失)的发生率显著更高。日本患者肾功能估计过高的高频率表明,应仔细考虑肾功能指标;此外,CLD 患者需要对肾功能和肌肉减少症进行监测和干预。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f6f/8308887/2064b8058d1e/nutrients-13-02415-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f6f/8308887/255987ceafe6/nutrients-13-02415-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f6f/8308887/aa1c72204d9e/nutrients-13-02415-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f6f/8308887/b28fe727160d/nutrients-13-02415-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f6f/8308887/232f8e656417/nutrients-13-02415-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f6f/8308887/2064b8058d1e/nutrients-13-02415-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f6f/8308887/255987ceafe6/nutrients-13-02415-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f6f/8308887/aa1c72204d9e/nutrients-13-02415-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f6f/8308887/b28fe727160d/nutrients-13-02415-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6f6f/8308887/232f8e656417/nutrients-13-02415-g004.jpg
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