Álvarez Mauricio, Negrón Rosario, Neira-Maldonado Carolina, Ponce-Fuentes Felipe, Cuyul-Vásquez Iván
Nephrology, Unidad de Diálisis, Hospital Dr Mauricio Heyermann Torres, Angol, CHL.
Physical Therapy, Universidad Mayor, School of Kinesiology, Faculty of Medicine and Health Sciences, Temuco, CHL.
Cureus. 2024 Nov 25;16(11):e74432. doi: 10.7759/cureus.74432. eCollection 2024 Nov.
Contradictory data are available on the possible association between sarcopenia and other clinical disorders in patients with chronic kidney disease (CKD) undergoing hemodialysis.
To determine the association between sarcopenia and markers associated with systemic inflammation, fasting glycemia, and quality of life in older people with CKD undergoing hemodialysis.
This was an analytical cross-sectional study. People over 60 years with stage 5 CKD undergoing hemodialysis were invited to participate. Sarcopenia was assessed using the criteria of the European Working Group on Sarcopenia in Older People. Clinical variables such as body mass index, comorbidities, malnutrition inflammation, quality of life, fasting glycemia, glycosylated hemoglobin, hematocrit, uremia, creatinine, sodium, calcium, potassium, albumin, ferritin, C reactive protein were measured.
Twenty-three patients with CKD were included. The prevalence of sarcopenia was 56.5%. Sarcopenic participants showed higher fasting glycemia, glycosylated hemoglobin, and malnutrition inflammation, as well as expected lower physical performance compared to nonsarcopenic participants. Correlations that ranged from moderate to strong were observed between sarcopenia and clinical characteristics such as fasting glycemia (r=0.48; P<0.05), glycosylated hemoglobin (r=0.44; P<0.05), malnutrition inflammation (r=0.46; P<0.05), skeletal muscle mass (r=-0.70; <0.01), and balance capacity (r=-0.66; <0.01). Regression analyses showed that fasting glycemia increased the risk of sarcopenia by 1.82 times (OR=1.82; =0.04).
In a sample of older people with CKD who underwent hemodialysis, sarcopenia was correlated with fasting glycemia, glycosylated hemoglobin, and malnutrition inflammation. However, only fasting glycemia was found to be a significant predictor of sarcopenia. More studies are needed to determine the influence of glycemic control on sarcopenia in older people with CKD.
关于接受血液透析的慢性肾脏病（CKD）患者中肌肉减少症与其他临床疾病之间可能存在的关联，现有相互矛盾的数据。
确定接受血液透析的老年CKD患者中肌肉减少症与全身炎症、空腹血糖及生活质量相关标志物之间的关联。
这是一项分析性横断面研究。邀请60岁以上的5期CKD血液透析患者参与。采用欧洲老年人肌肉减少症工作组的标准评估肌肉减少症。测量临床变量，如体重指数、合并症、营养不良炎症、生活质量、空腹血糖、糖化血红蛋白、血细胞比容、尿毒症、肌酐、钠、钙、钾、白蛋白、铁蛋白、C反应蛋白。
纳入23例CKD患者。肌肉减少症的患病率为56.5%。与非肌肉减少症参与者相比，肌肉减少症参与者表现出更高的空腹血糖、糖化血红蛋白和营养不良炎症，以及预期更低的身体机能。在肌肉减少症与空腹血糖（r = 0.48；P < 0.05）、糖化血红蛋白（r = 0.44；P < 0.05）、营养不良炎症（r = 0.46；P < 0.05）、骨骼肌质量（r = -0.70；<0.01）和平衡能力（r = -0.66；<0.01）等临床特征之间观察到中度至高度的相关性。回归分析表明，空腹血糖使肌肉减少症风险增加1.82倍（OR = 1.82；= 0.04）。
在接受血液透析的老年CKD患者样本中，肌肉减少症与空腹血糖、糖化血红蛋白和营养不良炎症相关。然而，仅空腹血糖被发现是肌肉减少症的显著预测因素。需要更多研究来确定血糖控制对老年CKD患者肌肉减少症的影响。
