影响维持性血液透析患者肌肉量减少的危险因素。
Risk Factors Affecting Muscle Mass Decline in Maintenance Hemodialysis Patients.
机构信息
Division of Nephrology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China.
出版信息
Biomed Res Int. 2022 Dec 20;2022:2925216. doi: 10.1155/2022/2925216. eCollection 2022.
OBJECTIVE
There is a high prevalence of sarcopenia in maintenance hemodialysis (MHD) patients, which is known to be associated with increased mortality. This study is aimed at analyzing the risk factors affecting muscle mass decline in MHD patients.
METHODS
This retrospective study included MHD patients who underwent two body composition assessments in October 2013 and November 2017. Depending on whether there was muscle loss or not, the patients were divided into a normal muscle mass (NMM) group and a muscle mass decline (MMD) group. According to the muscle mass decline rate, patients in the MMD group were further classified into a low-rate group and a high-rate group. Biochemical variables, serum vitamin concentrations, anthropometric data, SGA, muscle mass, handgrip, and daily steps were assessed. Risk factors for muscle mass decline were screened by multivariate logistic analysis and linear regression analysis.
RESULTS
Of the 72 MHD patients included in this study, 33 were male and 39 were female with a mean age of 56.80 ± 10.86 years and a mean dialysis duration of 7.50 ± 5.20 years. Age ( = .014) and serum 25(OH)D ( = .040) were found to be associated with a higher risk of muscle mass decline after adjusting for gender, dialysis vintage, albumin, and hs-CRP ( = .040). Further analysis found that dialysis vintage ( = 0.285, = .030), 25(OH)D ( = -0.351, = .007), and log NT-proBNP ( = 0.312, = .020) were risk factors associated with the muscle mass decline rate in MHD patients.
CONCLUSION
Age and serum 25(OH)D were associated with a higher risk of muscle mass decline, while 25(OH)D, dialysis vintage, and NT-proBNP were associated with the muscle mass decline rate in MHD patients.
目的
维持性血液透析（MHD）患者中肌少症的患病率很高，已知其与死亡率增加有关。本研究旨在分析影响 MHD 患者肌肉质量下降的危险因素。
方法
这是一项回顾性研究，纳入了 2013 年 10 月和 2017 年 11 月接受两次身体成分评估的 MHD 患者。根据是否存在肌肉损失，患者被分为正常肌肉量（NMM）组和肌肉量下降（MMD）组。根据肌肉量下降率，MMD 组患者进一步分为低速率组和高速率组。评估生化变量、血清维生素浓度、人体测量数据、SGA、肌肉量、握力和每日步数。通过多变量逻辑分析和线性回归分析筛选肌肉量下降的危险因素。
结果
本研究纳入的 72 名 MHD 患者中，男性 33 名，女性 39 名，平均年龄为 56.80 ± 10.86 岁，透析时间平均为 7.50 ± 5.20 年。调整性别、透析年限、白蛋白和 hs-CRP 后，年龄（ =.014）和血清 25（OH）D（ =.040）与肌肉量下降风险较高相关（ =.040）。进一步分析发现，透析年限（ = 0.285， =.030）、25（OH）D（ = -0.351， =.007）和 log NT-proBNP（ = 0.312， =.020）是与 MHD 患者肌肉量下降率相关的危险因素。
结论
年龄和血清 25（OH）D 与肌肉量下降风险较高相关，而 25（OH）D、透析年限和 NT-proBNP 与 MHD 患者肌肉量下降率相关。
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