Department of Pediatrics, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.
Medicine (Baltimore). 2023 Dec 15;102(50):e36613. doi: 10.1097/MD.0000000000036613.
Chronic kidney disease (CKD), a pervasive public health concern, can lead to complications like sarcopenia and reduced bone mineral density (BMD). However, it is still unclear exactly how muscle mass correlates with BMD in youngsters and adolescents with CKD. We aimed to investigate the association between appendicular skeletal muscle index (ASMI) and BMD among children and adolescents with CKD. In our research, we utilized data from the National Health and Nutrition Examination Survey (NHANES) collected between 2011 and 2014 to investigate the association of ASMI with BMD among this population. The association linking ASMI with total BMD was examined through multivariate linear regression models. Furthermore, fitted smoothing curves were employed, as well as generalized additive models. Our analysis finally included 503 CKD participants aged between 8 and 19 years. We found a significant association linking ASMI with total BMD among children and adolescents with CKD. The connection persisted even after accounting for covariates. Upon subgroup analysis, there was a statistically significant association of ASMI with total BMD for both males and females, as well as for Mexican-American and non-Hispanic White populations. However, no significant association was observed in other Hispanic, non-Hispanic Black, or populations of other races. We discovered a positive correlation linking the ASMI and the total BMD in children and teenagers with CKD. In CKD patients, maintaining skeletal muscle mass may be crucial for managing and preventing renal osteodystrophy.
慢性肾脏病（CKD）是一个普遍存在的公共卫生问题，可导致肌肉减少症和骨密度降低等并发症。然而，在患有 CKD 的儿童和青少年中，肌肉质量与 BMD 的相关性究竟如何，目前还不是很清楚。我们旨在研究 CKD 患儿四肢骨骼肌指数（ASMI）与 BMD 的相关性。在我们的研究中，我们利用了 2011 年至 2014 年期间进行的国家健康和营养检查调查（NHANES）的数据，调查了 ASMI 与该人群中 BMD 的相关性。通过多元线性回归模型研究了 ASMI 与总 BMD 的关联。此外，还使用了拟合平滑曲线和广义加性模型。我们的分析最终包括了 503 名年龄在 8 至 19 岁之间的 CKD 参与者。我们发现，在患有 CKD 的儿童和青少年中，ASMI 与总 BMD 之间存在显著关联。即使考虑了协变量，这种关联仍然存在。在亚组分析中，ASMI 与总 BMD 之间存在统计学上显著的关联，无论是男性还是女性，墨西哥裔美国人和非西班牙裔白人都是如此。然而，在其他西班牙裔、非西班牙裔黑人或其他种族群体中，没有观察到这种关联。我们发现患有 CKD 的儿童和青少年的 ASMI 与总 BMD 之间存在正相关。在 CKD 患者中，维持骨骼肌质量对于管理和预防肾性骨营养不良可能至关重要。
