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澳大利亚维持性透析患者肌少症的患病率及相关因素:一项单中心、横断面研究。

Prevalence and Factors Associated with Sarcopenia in Patients on Maintenance Dialysis in Australia-A Single Centre, Cross-Sectional Study.

机构信息

Department of Renal Medicine, Nepean Hospital, Kingswood, NSW 2747, Australia.

Nepean Clinical School, The University of Sydney, Sydney, NSW 2006, Australia.

出版信息

Nutrients. 2021 Sep 20;13(9):3284. doi: 10.3390/nu13093284.

Abstract

Sarcopenia is associated with significant morbidity and mortality in patients with chronic kidney disease. The prevalence of sarcopenia in the dialysis population varies from 4% to 63%. However, the prevalence and risk factors of sarcopenia in the Australian dialysis population remain uncertain. To study the prevalence of sarcopenia in patients on maintenance dialysis by using the European Working Group on Sarcopenia in Older People (EWGSOP) diagnostic criteria of sarcopenia and to identify associated risk factors. We evaluated adult patients on maintenance haemodialysis and peritoneal dialysis in this single-centre cross-sectional study in Australia. Patient's clinical (age, gender, dialysis modality and diabetic status) and laboratory parameters (serum albumin, calcium, phosphate, 25-hydroxy-vitamin D and parathyroid hormone levels) were investigated. We employed bioimpedance spectroscopy, hand grip dynamometer and the timed up and go test (TUG) to evaluate muscle mass, strength and function, respectively. We evaluated 39 dialysis patients with a median age of 69 years old. The prevalence of sarcopenia was 18%. Sarcopenia was associated with low serum albumin ( = 0.02) and low serum phosphate level ( = 0.04). Increasing age and female sex were potential risk factors for sarcopenia ( = 0.05 and 0.08, respectively). Low lean muscle mass, reduced hand grip strength and prolonged TUG were present in 23.1%, 41% and 40.5%, respectively, of the cohort. The hand grip test had good correlation with lean muscle evaluation and the TUG. Sarcopenia was prevalent in 18% of maintenance haemodialysis patients from an Australian single-centre cohort, with low serum albumin and phosphate as significant risk factors.

摘要

肌肉减少症与慢性肾脏病患者的发病率和死亡率显著相关。透析人群中肌肉减少症的患病率从 4%到 63%不等。然而,澳大利亚透析人群中肌肉减少症的患病率和危险因素仍不确定。 本研究旨在使用欧洲老年人肌肉减少症工作组(EWGSOP)的肌肉减少症诊断标准,通过维持性透析患者来研究肌肉减少症的患病率,并确定相关的危险因素。 在这项澳大利亚单中心横断面研究中,我们评估了接受维持性血液透析和腹膜透析的成年患者。患者的临床(年龄、性别、透析方式和糖尿病状况)和实验室参数(血清白蛋白、钙、磷、25-羟维生素 D 和甲状旁腺激素水平)均进行了调查。我们分别采用生物电阻抗光谱法、握力计和计时起立行走测试(TUG)来评估肌肉量、力量和功能。 我们评估了 39 名透析患者,中位年龄为 69 岁。肌肉减少症的患病率为 18%。肌肉减少症与低血清白蛋白( = 0.02)和低血清磷水平( = 0.04)相关。年龄增长和女性是肌肉减少症的潜在危险因素(分别为 = 0.05 和 0.08)。在该队列中,分别有 23.1%、41%和 40.5%的患者存在低瘦肌肉量、握力降低和 TUG 延长。握力测试与瘦肌肉评估和 TUG 具有良好的相关性。 在澳大利亚单中心队列中,维持性血液透析患者中肌肉减少症的患病率为 18%,低血清白蛋白和磷是显著的危险因素。

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