Oliveira Dílmerson, de Souza Viviane Angelina, Souza Guilherme Cardenaz, Suassuna Lucas Fernandes, Bastos Marcus Gomes, Reboredo Maycon Moura, da Silva Fernandes Natália Maria
Department of Clinical Medicine, School of Medicine, Federal University of Juiz de Fora, Juiz de Fora, Brazil.
Department of physiology, School of Physical Education, FAMINAS, Muriaé, Brazil.
PLoS One. 2025 Mar 18;20(3):e0318773. doi: 10.1371/journal.pone.0318773. eCollection 2025.
Sarcopenic obesity (SO) is a poorly defined physiological condition that is associated with increased morbimortality in the general population. The prevalence of SO has increased, making it an important public health issue; however, its effects when associated with other chronic conditions are still unclear. Therefore, it is necessary to comprehend the potential outcomes in chronic kidney disease (CKD) patients.
To assess the associations of predialysis CKD patients with SO and its components with death and disease progression to renal replacement therapy (RRT).
Prospective six-year cohort with 100 patients with predialysis CKD (stages one through five). Participants were older than 18 years and signed an informed consent form. The data were collected in an outpatient clinic specializing in predialysis care, and demographic, clinical, laboratory and inflammatory variable data were collected. A descriptive analysis was performed, and the SO and non-SO groups were compared with Student's t test, Mann‒Whitney U test and Cox regression, taking into consideration all relevant confounding variables. Body composition variables utilized to diagnose SO were separately analyzed along with the outcomes.
Sixteen percent of our sample were diagnosed with SO, but this was not associated with death or RRT, while lower BMI values were negatively associated with these outcomes. However, in an isolated analysis, handgrip strength was correlated with both RRT (p = 0.029) and death (p = 0.003). We recommend that health professionals pay greater attention to muscle strength, striving for earlier assessment, in an effort to better counsel patients and implement actions to increase or preserve strength through nonpharmacological treatment, such as resistance training.
肌少性肥胖（SO）是一种定义尚不明确的生理状况，与普通人群中死亡率和发病率的增加相关。SO的患病率呈上升趋势，使其成为一个重要的公共卫生问题；然而，其与其他慢性疾病相关时的影响仍不明确。因此，有必要了解慢性肾脏病（CKD）患者的潜在结局。
评估透析前CKD患者的SO及其组成成分与死亡和疾病进展至肾脏替代治疗（RRT）之间的关联。
对100例透析前CKD患者（一至五期）进行为期六年的前瞻性队列研究。参与者年龄超过18岁并签署了知情同意书。数据在一家专门提供透析前护理的门诊收集，收集了人口统计学、临床、实验室和炎症变量数据。进行了描述性分析，并采用学生t检验、曼-惠特尼U检验和Cox回归对SO组和非SO组进行比较，同时考虑所有相关混杂变量。用于诊断SO的身体成分变量与结局分别进行分析。
我们样本中有16%被诊断为SO，但这与死亡或RRT无关，而较低的BMI值与这些结局呈负相关。然而，在单独分析中，握力与RRT（p = 0.029）和死亡（p = 0.003）均相关。我们建议卫生专业人员更加关注肌肉力量，争取早期评估，以便更好地为患者提供咨询，并通过非药物治疗（如阻力训练）采取行动增加或保持力量。
