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欧洲老年人肌肉减少症工作组(EWGSOP)1和EWGSOP 2标准对维持性血液透析患者肌肉减少症诊断的可靠性及其与临床参数的关联

Reliability Between Sarcopenia Diagnosis by EWGSOP 1 and EWGSOP 2 Criteria and Association With Clinical Parameters in Maintenance Hemodialysis Patients.

作者信息

Guimarães Laura Tavares, Silva Maryanne Zilli Canedo da, Reis Nayrana do Carmo Soares, Caramori Jacqueline Costa Teixeira, Vogt Barbara Perez

机构信息

Medicine Faculty, Federal University of Uberlandia (UFU), Uberlandia, Brazil.

Department of Internal Medicine, Botucatu Medical School, UNESP Sao Paulo State University, Botucatu, Brazil.

出版信息

J Ren Nutr. 2025 Mar 17. doi: 10.1053/j.jrn.2025.03.005.

Abstract

OBJECTIVES

To analyze the reliability between the sarcopenia criteria proposed by the European Working Group on Sarcopenia in Older People (EWGSOP) 1 and 2 and to verify the association of clinical parameters with sarcopenia diagnosis in patients on maintenance hemodialysis.

METHODS

Cross-sectional analysis including adult patients on maintenance hemodialysis. The assessment of lean mass was performed by dual-energy X-ray absorptiometry, and the appendicular lean mass index was calculated. The assessment of muscle strength was performed using a handgrip dynamometer. The cutoff values considered for sarcopenia diagnosis were proposed by the EWGSOP 1 and EWGSOP 2 criteria.

RESULTS

124 patients were included. The frequency of sarcopenia diagnosis was higher according to EWGSOP 1 (25.8%) than according to EWGSOP 2 (12.9%). The frequency of sarcopenia diagnoses diminished in both sexes. The reliability between the two criteria was moderate (κ = 0.597; P < .001), and 87.1% of patients were classified equally by both criteria. In EWGSOP 1, the presence of diabetes and serum iron was significantly higher in the group with sarcopenia, and in EWGSOP 2 there was no such difference.

CONCLUSION

The frequency of sarcopenia diagnosis in patients on hemodialysis was higher by EWGSOP 1 compared to EWGSOP 2, and the reliability between the criteria was moderate. Sarcopenia diagnosed by EWGSOP 1 was associated with diabetes and serum iron, which are factors that may be associated with sarcopenia pathogenesis. EWGSOP 2 was not associated with the clinical parameters assessed.

摘要

目的

分析老年人肌少症欧洲工作组(EWGSOP)1和2提出的肌少症标准之间的可靠性,并验证维持性血液透析患者临床参数与肌少症诊断的相关性。

方法

对维持性血液透析的成年患者进行横断面分析。采用双能X线吸收法评估瘦体重,并计算四肢瘦体重指数。使用握力计评估肌肉力量。肌少症诊断的临界值由EWGSOP 1和EWGSOP 2标准提出。

结果

纳入124例患者。根据EWGSOP 1诊断的肌少症频率(25.8%)高于EWGSOP 2(12.9%)。两性中肌少症诊断的频率均降低。两个标准之间的可靠性为中等(κ = 0.597;P <.001),87.1%的患者在两个标准下分类相同。在EWGSOP 1中,肌少症组糖尿病和血清铁的存在显著更高,而在EWGSOP 2中则无此差异。

结论

与EWGSOP 2相比,EWGSOP 1诊断的血液透析患者肌少症频率更高,且标准之间的可靠性为中等。EWGSOP 1诊断的肌少症与糖尿病和血清铁相关,这些是可能与肌少症发病机制相关的因素。EWGSOP 2与所评估的临床参数无关。

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