Nishibe Toshiya, Dardik Alan, Kusakabe Tomomi, Fukuda Shoji, Nishibe Masayasu, Koizumi Jun
Department of Cardiovascular Surgery, Tokyo Medical University, 6-7-1 Nishi-Shinjuku, Shinjuku-ku, Tokyo, 160-0023, Japan.
Department of Surgery, Yale University School of Medicine, New Haven, CT, USA.
Surg Today. 2022 Nov;52(11):1576-1581. doi: 10.1007/s00595-022-02500-z. Epub 2022 Apr 25.
The influence of lower limb ischemia on the loss of skeletal muscle mass, which is a prerequisite for sarcopenia, remains poorly studied in patients with peripheral artery disease (PAD). We determined whether or not lower limb ischemia correlates with a loss of skeletal muscle mass in patients with PAD.
The data of 101 patients (202 legs) with PAD were retrospectively analyzed. Body composition was measured using a bioelectrical impedance analysis. Based on the Asian Working Group for Sarcopenia, low muscle mass (LMM) was defined as skeletal muscle mass index (SMI) < 7.00 kg/m (male) and < 5.70 kg/m (female). Both univariable and multivariable analyses of the risk factors for LMM were performed.
There were significant differences in age, ankle-brachial pressure index (ABI) per patient, and the geriatric nutritional risk index (GNRI), between patients with and without LMM. Multivariable logistic regression analysis showed age (odds ratio [OR], 1.09; p = 0.009), GNRI (OR, 0.93; p = 0.003), and ABI per patient (OR, 0.02; p = 0.027) as independent risk factors for LMM.
These data show a detrimental effect of lower limb ischemia on skeletal muscle mass loss, suggesting that PAD may affect the development of secondary sarcopenia.
下肢缺血对骨骼肌质量丧失的影响在周围动脉疾病(PAD)患者中研究较少,而骨骼肌质量丧失是肌肉减少症的一个先决条件。我们确定了下肢缺血是否与PAD患者的骨骼肌质量丧失相关。
对101例(202条腿)PAD患者的数据进行回顾性分析。使用生物电阻抗分析测量身体成分。根据亚洲肌肉减少症工作组的标准,低肌肉量(LMM)定义为骨骼肌质量指数(SMI)<7.00kg/m²(男性)和<5.70kg/m²(女性)。对LMM的危险因素进行了单变量和多变量分析。
有LMM和无LMM的患者在年龄、每位患者的踝臂压力指数(ABI)以及老年营养风险指数(GNRI)方面存在显著差异。多变量逻辑回归分析显示年龄(优势比[OR],1.09;p=0.009)、GNRI(OR,0.93;p=0.003)和每位患者的ABI(OR,0.02;p=0.027)是LMM的独立危险因素。
这些数据表明下肢缺血对骨骼肌质量丧失有不利影响,提示PAD可能影响继发性肌肉减少症的发生发展。