de Oliveira Matos Beatriz, da Costa Rosa Clara Suemi, Ribeiro Heitor Siqueira, Marcos Natasha Maggi, Losilla Milene Peron Rodrigues, Monteiro Henrique Luiz, Gimenes Camila
Centro Universitário do Sagrado Coração (UNISAGRADO), Pró-reitoria de Pesquisa e Pós-graduação, Bauru, SP, Brazil.
Universidade Estadual Paulista (UNESP), Faculdade de Ciências, Bauru, SP, Brazil.
Int Urol Nephrol. 2022 Jul;54(7):1751-1759. doi: 10.1007/s11255-021-03060-w. Epub 2021 Nov 23.
To investigate the prevalence of obesity phenotypes and their association with physical activity levels among diabetic hemodialysis patients.
This is a cross-sectional study with 84 diabetic hemodialysis patients (63.5 ± 9.4 years, 54.8% of men). Obesity was diagnosed as high body fat (≥ 40% for male and ≥ 30% for female). Sarcopenic obesity was considered if low skeletal muscle mass (< 20.0 kg for males and < 15.0 kg for females) and obesity were combined. Dynapenic obesity was defined in the presence of low handgrip strength (< 27 kg for males and < 16 kg for females) and obesity. Muscle failure obesity was confirmed in the concomitant presence of obesity, sarcopenia, and dynapenia. Physical activity level was assessed by the Baecke questionnaire and patients were classified as low physical activity according to the first tertile for each of and total domains.
Fifty-four patients (64%) presented obesity. From these, 5 (6%), 19 (23%) and 8 (10%) were classified as sarcopenic obese, dynapenic obese, and muscle failure obese, respectively, and 22 (26%) were only obese. Patients with sarcopenic obesity and muscle failure obesity had lower leisure and locomotion physical activity scores than non-obese, whereas the total domain score did not differ across the groups. Muscle failure obesity was independently associated with low leisure physical activity (OR 10.8, 95% CI 1.3-88.1). Only sarcopenic obesity was independently associated with the locomotion and total physical activity domains (OR 15.4, 95% CI 1.4-90.2 and OR 17.0, 95% CI 1.5-95.4, respectively).
Our study found a lower prevalence of sarcopenic obesity compared to dynapenic obesity and muscle failure obesity among diabetic hemodialysis patients. Moreover, sarcopenic obesity and muscle failure obesity, but not dynapenic obesity, were associated with low physical activity levels.
调查糖尿病血液透析患者肥胖表型的患病率及其与身体活动水平的关联。
这是一项横断面研究，纳入了84例糖尿病血液透析患者（年龄63.5±9.4岁，男性占54.8%）。肥胖被诊断为高体脂（男性≥40%，女性≥30%）。如果合并低骨骼肌量（男性<20.0kg，女性<15.0kg）和肥胖，则考虑诊断为肌少症肥胖。如果存在低握力（男性<27kg，女性<16kg）和肥胖，则定义为动力缺乏性肥胖。肥胖、肌少症和动力缺乏同时存在时，确诊为肌肉功能衰竭性肥胖。通过贝克问卷评估身体活动水平，根据每个领域和总领域的第一个三分位数，将患者分类为低身体活动。
54例患者（64%）存在肥胖。其中，分别有5例（6%）、19例（23%）和8例（10%）被分类为肌少症肥胖、动力缺乏性肥胖和肌肉功能衰竭性肥胖，22例（26%）仅为肥胖。肌少症肥胖和肌肉功能衰竭性肥胖患者的休闲和运动身体活动得分低于非肥胖患者，而各组的总领域得分无差异。肌肉功能衰竭性肥胖与低休闲身体活动独立相关（比值比10.8，95%置信区间1.3 - 88.1）。仅肌少症肥胖与运动和总身体活动领域独立相关（分别为比值比15.4，95%置信区间1.4 - 90.2和比值比17.0，95%置信区间1.5 - 95.4）。
我们的研究发现，在糖尿病血液透析患者中，肌少症肥胖的患病率低于动力缺乏性肥胖和肌肉功能衰竭性肥胖。此外，肌少症肥胖和肌肉功能衰竭性肥胖与低身体活动水平相关，而动力缺乏性肥胖则不然。
