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SARC-F和SARC-CALF在筛查人类免疫缺陷病毒感染者肌肉减少症风险中的一致性分析及相关因素

Agreement analysis and associated factors of SARC-F and SARC-CALF in screening of risk sarcopenia in people living with human immunodeficiency virus.

作者信息

Vieira Lara Cristina, Ximenez Jaine Alves, Spexoto Maria Claudia Bernardes

机构信息

Nutrition Course, Faculty of Health Sciences, Federal University of Grande Dourados (UFGD), Dourados, Mato Grosso do Sul, Brazil.

Posgraduate Program in Food, Nutrition and Health, Faculty of Health Sciences, Federal University of Grande Dourados (UFGD), Dourados, Mato Grosso do Sul, Brazil.

出版信息

Clinics (Sao Paulo). 2025 Jan 2;80:100565. doi: 10.1016/j.clinsp.2024.100565. eCollection 2025.

Abstract

INTRODUCTION

People Living with Human Immunodeficiency Virus (PLHIV) appear to be at a higher risk of developing sarcopenia. Various factors seem to influence the risk of sarcopenia, and its prevalence may differ depending on the screening tool used. This study aimed to (i) Screen the risk of sarcopenia in PLHIV using the SARC-F and SARCCalf and identify associated factors; (ii) Analyze the agreement between the instruments in PLHIV.

METHODS

Cross-sectional study including PLHIV taking antiretroviral therapy. The authors assessed sarcopenia risk using the SARC-F and SARCCalf tools with ≥4 and ≥11 cutoff points, respectively, and a wide spectrum of variables was analyzed.

RESULTS

Participated 76 patients (44.9 ± 12.7 years). Sarcopenia risk, according to the SARC-F, was 27.6 % and was associated with socioeconomic status (p = 0.004), smoking (p = 0.001), disease status (p < 0.001), opportunistic infections (p = 0.001), CD4 T-cell count (p < 0.001), Handgrip Strength (HGS) (p < 0.001), and Gait Speed (GS) (p = 0,001). Using the SARCCalf, sarcopenia risk was 36.8 % and was associated with work activity (p = 0.029), socioeconomic status (p = 0.004), smoking (p = 0.009), disease status (p < 0.001), opportunistic infections (p = 0.015), CD4 T-cell count (p = 0.002), HGS (p = 0.001), Appendicular Skeletal Muscle Mass Index (ASMMI) (p = 0.009), and GS (p < 0.001). The agreement between tools was moderate (k = 0.49).

CONCLUSION

Sarcopenia risk, as determined by both tools, was higher in low-income PLHIV with opportunistic infections, CD4 T-cell count ≤ 200 cells/mm, low HGS, and low GS, and lower in asymptomatic and non-smoking individuals. The authors recommend investigating these factors in hospital and outpatient settings. The SARCCalf proved to be more appropriate for screening sarcopenia risk in PLHIV.

摘要

引言

人类免疫缺陷病毒感染者(PLHIV)患肌肉减少症的风险似乎更高。多种因素似乎会影响肌肉减少症的风险,其患病率可能因所使用的筛查工具而异。本研究旨在:(i)使用SARC - F和SARCCalf筛查PLHIV的肌肉减少症风险并确定相关因素;(ii)分析PLHIV中这些工具之间的一致性。

方法

横断面研究纳入接受抗逆转录病毒治疗的PLHIV。作者分别使用截断点≥4和≥11的SARC - F和SARCCalf工具评估肌肉减少症风险,并分析了广泛的变量。

结果

76名患者参与研究(年龄44.9±12.7岁)。根据SARC - F,肌肉减少症风险为27.6%,与社会经济状况(p = 0.004)、吸烟(p = 0.001)、疾病状态(p < 0.001)、机会性感染(p = 0.001)、CD4 T细胞计数(p < 0.001)、握力(HGS)(p < 0.001)和步速(GS)(p = 0.001)相关。使用SARCCalf,肌肉减少症风险为36.8%,与工作活动(p = 0.029)、社会经济状况(p = 0.004)、吸烟(p = 0.009)、疾病状态(p < 0.001)、机会性感染(p = 0.015)、CD4 T细胞计数(p = 0.002)、HGS(p = 0.001)、四肢骨骼肌质量指数(ASMMI)(p = 0.009)和GS(p < 0.001)相关。工具之间的一致性为中等(k = 0.49)。

结论

两种工具确定的肌肉减少症风险在患有机会性感染、CD4 T细胞计数≤200个细胞/mm³、HGS低和GS低的低收入PLHIV中较高,在无症状和不吸烟个体中较低。作者建议在医院和门诊环境中研究这些因素。事实证明,SARCCalf更适合筛查PLHIV的肌肉减少症风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2a71/11754822/6b60f59f2c1d/gr1.jpg

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