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慢性肾脏病中的肌肉减少症:不同定义下的患病率及与肥胖的关系。

Sarcopenia in chronic kidney disease: prevalence by different definitions and relationship with adiposity.

机构信息

Post-graduate Program in Health Sciences, Ribeirão Preto Faculty of Medicine, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto City, São Paulo 14049-190, Brazil.

Nutrition and Metabolism Undergraduate Course, Ribeirão Preto Faculty of Medicine, University of São Paulo, Bandeirantes Avenue, 3900, Ribeirão Preto City, São Paulo 14049-190, Brazil.

出版信息

Appl Physiol Nutr Metab. 2022 Sep 1;47(9):915-925. doi: 10.1139/apnm-2021-0521. Epub 2022 Jun 3.

Abstract

This was a cross-sectional study with chronic kidney disease (CKD) patients under non-dialysis-dependent (NDD), hemodialysis (HD), and kidney transplant (KTx) treatment aimed to evaluate the prevalence of sarcopenia using the European Working Group on Sarcopenia in Older People (EWGSOP2) and the Foundation for the National Institutes of Health (FNIH) guidelines, and to analyze the relationship between sarcopenia and its components and body adiposity. Body composition was assessed by dual-energy X-ray absorptiometry and anthropometry. Bioelectrical impedance provided data on the phase angle and body water. The prevalence of sarcopenia in the total sample ( = 243; 53% men, 48 ± 10 years) was 7% according to the FNIH and 5% according to the EWGSOP2 criteria, and was low in each CKD group independently of the criteria applied (maximum 11% prevalence). Low muscle mass was present in 39% (FNIH) and 36% (EWGSOP2) and dynapenia in 10% of the patients. Patients who were sarcopenic according to the EWGSOP2 criteria presented low body adiposity. Conversely, patients who were sarcopenic according to the FNIH criteria presented high adiposity. This study suggests that in CKD (i) sarcopenia and low muscle mass prevalence varies according to the diagnostic criteria; (ii) sarcopenia and low muscle mass are common conditions; (iii) the association with body adiposity depends on the criteria used to define low muscle mass; and (iv) the FNIH criteria detected higher adiposity in individuals with sarcopenia. Prevalence of sarcopenia and low muscle mass in CKD varied according to the diagnostic criteria. Association of excess adiposity with sarcopenia and low muscle mass depends on muscle mass index applied. FNIH criteria detected higher adiposity in individuals with sarcopenia and low muscle mass.

摘要

这是一项横断面研究,纳入了非透析依赖型(NDD)、血液透析(HD)和肾移植(KTx)治疗的慢性肾脏病(CKD)患者,旨在使用欧洲老年人肌肉减少症工作组(EWGSOP2)和美国国立卫生研究院基金会(FNIH)指南评估肌少症的患病率,并分析肌少症及其成分与身体肥胖之间的关系。身体成分通过双能 X 射线吸收法和人体测量法进行评估。生物电阻抗提供相位角和身体水分的数据。根据 FNIH 标准,总样本(=243;53%为男性,48±10 岁)的肌少症患病率为 7%,根据 EWGSOP2 标准为 5%,且每个 CKD 组的患病率均较低,而与所应用的标准无关(患病率最高为 11%)。根据 FNIH 标准,39%的患者存在低肌肉量,10%的患者存在肌力下降。根据 EWGSOP2 标准被诊断为肌少症的患者体脂率较低。相反,根据 FNIH 标准被诊断为肌少症的患者体脂率较高。本研究表明,在 CKD 中:(i)肌少症和低肌肉量的患病率因诊断标准而异;(ii)肌少症和低肌肉量是常见的病症;(iii)与身体肥胖的关联取决于用于定义低肌肉量的标准;(iv)FNIH 标准在肌少症患者中检测到更高的肥胖程度。CKD 患者肌少症和低肌肉量的患病率因诊断标准而异。与肌少症和低肌肉量相关的体脂过多取决于应用的肌肉质量指数。FNIH 标准在肌少症和低肌肉量患者中检测到更高的肥胖程度。

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