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外周动脉疾病患者下肢缺血与骨骼肌质量丧失的关联

Association of lower limb ischemia with loss of skeletal muscle mass in patients with peripheral artery disease.

作者信息

Nishibe Toshiya, Dardik Alan, Kusakabe Tomomi, Fukuda Shoji, Nishibe Masayasu, Koizumi Jun

机构信息

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.

出版信息

Surg Today. 2022 Nov;52(11):1576-1581. doi: 10.1007/s00595-022-02500-z. Epub 2022 Apr 25.

Abstract

PURPOSE

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.

METHODS

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.

RESULTS

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.

CONCLUSION

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.

摘要

目的

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。

方法

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。

结果

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。

结论

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。

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