衰弱对老年男性慢性肾脏病患者发生肌少症的影响

Effect of frailty on sarcopenia in elderly male chronic kidney disease patients

目的探讨衰弱对老年男性慢性肾病(CKD)患者发生肌少症的影响。方法选择2018年10月1日~2019年1月30日解放军总医院第二医学中心门诊就诊的老年男性CKD患者105例,根据肌少症诊断分为正常组72例和肌少症组33例。多因素回归分析衰弱与老年CKD患者发生肌少症的相关性。结果105例患者中,衰弱期31例,患病率29.5%。肌少症组年龄、衰弱比例明显高于正常组,体质量指数、肌肉质量、脂肪量、TC和估算的肾小球滤过率(e GFR)水平明显低于正常组,差异有统计学意义(P<0.05,P<0.01)。logistic回归分析显示,衰弱是老年男性CKD患者发生肌少症的危险因素(OR=3.575,95%CI:1.030~12.410,P=0.045),年龄与肌少症呈正相关(OR=1.160,95%CI:1.001~1.343,P=0.048),体质量指数和eGFR与肌少症呈负相关(OR=0.469,95%CI:0.273~0.803,P=0.006;OR=0.962,95%CI:0.928~0.997,P=0.033)。肌少症组步速减慢、握力下降、疲惫感、低体力活动比例明显高于正常组,差异有统计学意义(P<0.01)。结论老年男性CKD患者肌少症的发生主要与年龄、体质量指数及衰弱有关。

Objective To study the effect of frailty on sarcopenia in elderly male chronic kidney disease(CKD)patients.Methods One hundred and five elderly male CKD patients admitted to our hospital from 2018-10-01 to 2019-01-30 were divided into control group(n=72)and sarcopenia group(n=33).The association between frailty and sarcopenia in male CKD patients was analyzed by multivariate logistic regression analysis.Results of the 105 CKD patients included in this study,31(29.5%)were diagnosed with frailty.The age was significantly older,the incidence of frailty,BMI,muscle mass,fat mass,serum TC level,and eGFR were significantly lower in sarcopenia group than in control group(P<0.05,P<0.01).Logistic regression analysis showed that frailly was a risk factor for sarcopenia in elderly male CKD patients(OR=3.575,95%Cl:1.030-12.410,P-0.045)and age was positively related with sarcopenia while BMI and eGFR were negatively related with sarcopenia in elderly male CKD patients(OR=1.160,95%CI:1.001-1.343,P=0.048;OR=0.469,95%CI:0.273-0.803,P=0.006;OR=0.962,95%CI:0.928-0.997,P=0.033).The ratio of decreased walking speed,grip strength,fatigue sensation and physical activity was significantly higher in sarcopenia group than in control group(P<0.01).Conclusion Sarcopenia is associated with age,BMI and frailty in elderly male CKD patients.