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肌肉量替代标志物肌肉减少症指数与新发慢性肾脏病的关联

Association of sarcopenia index, a surrogate marker of muscle mass, and incident chronic kidney disease.

作者信息

Zhang Fan, Chu Aojiao, Bai Yan, Huang Liuyan, Zhong Yifei, Li Yi

机构信息

Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.

Department of Nephrology, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai, China.

出版信息

Clin Nutr ESPEN. 2025 Jun;67:184-191. doi: 10.1016/j.clnesp.2025.03.019. Epub 2025 Mar 18.

Abstract

BACKGROUND

Sarcopenia, characterized by loss of muscle mass and strength, has been linked to various health outcomes, including chronic kidney disease (CKD). This study aims to investigate the association of sarcopenia index, based on serum creatinine and cystatin C levels, with incident CKD in middle-aged and older adults.

METHODS

This study extracted data from a nation cohort, including age ≥45 years adults without CKD at baseline. Sarcopenia index was calculated based on serum creatinine and cystatin C levels, and incident CKD was assessed through follow-up surveys. Cox proportional hazards regression models were used to analyze the association between sarcopenia index and incident CKD, adjusting for potential confounders, with hazard ratio (HR) with 95 % confidence interval (95 % CI) reported.

RESULTS

A total of 8618 participants were included in the analysis. The median age was 61.0 years, and 44.7 % were male. During a mean follow-up period of 5.0 years, 514 cases of incident CKD were identified. After adjusting for covariates, compared with participants in the lowest tertile, the corresponding CKD HRs (95 % CIs) for participants in the medium and highest tertile were 0.701 (95 % CI: 0.558-0.880, P = 0.002), 0.784 (95 % CI: 0.618-0.994; P = 0.045). Restricted cubic spline curves revealed that incident rate decreased with increase in sarcopenia index.

CONCLUSION

This study provides national longitudinal evidence on the association of higher sarcopenia index with lower incident CKD. Our findings suggest that sarcopenia index may be a useful biomarker for predicting the risk of CKD in this population.

摘要

背景

肌肉减少症以肌肉质量和力量的丧失为特征,与包括慢性肾脏病(CKD)在内的多种健康结局相关。本研究旨在探讨基于血清肌酐和胱抑素C水平的肌肉减少症指数与中老年人群新发CKD之间的关联。

方法

本研究从一个全国性队列中提取数据,包括基线时年龄≥45岁且无CKD的成年人。根据血清肌酐和胱抑素C水平计算肌肉减少症指数,并通过随访调查评估新发CKD。采用Cox比例风险回归模型分析肌肉减少症指数与新发CKD之间的关联,并对潜在混杂因素进行调整,报告风险比(HR)及95%置信区间(95%CI)。

结果

共有8618名参与者纳入分析。中位年龄为61.0岁,男性占44.7%。在平均5.0年的随访期内,共识别出514例新发CKD病例。调整协变量后,与最低三分位数组的参与者相比,中间和最高三分位数组参与者对应的CKD HR(95%CI)分别为0.701(95%CI:0.558 - 0.880,P = 0.002)、0.784(95%CI:0.618 - 0.994;P = 0.045)。受限立方样条曲线显示,新发率随肌肉减少症指数的增加而降低。

结论

本研究提供了关于较高肌肉减少症指数与较低新发CKD关联的全国性纵向证据。我们的研究结果表明,肌肉减少症指数可能是预测该人群CKD风险的有用生物标志物。

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