肾功能对老年男性慢性肾脏病患者肌少症的影响

Effect of renal function on sarcopenia in elderly male patients with chronic kidney disease

目的探讨肾功能对老年男性慢性肾脏病(CKD)患者发生肌少症的影响。方法纳入105例于2018年10月1日至2019年1月30日在解放军总医院就诊的年龄≥65岁的男性CKD患者。根据肌少症诊断标准分为肌少症组33例,非肌少症组72例。使用两种公式估算肾小球滤过率。通过多因素logistic回归分析估算的肾小球滤过率(eGFR)与老年CKD患者发生肌少症的相关性。结果共纳入105例老年男性CKD患者,年龄74(68,77)岁,肌少症发生率为31.4%(33/105)。多因素logistic回归分析结果显示,基于血肌酐和胱抑素C的eGFR(eGFRscr-cys)<45 ml·min^-1·(1.73 m^2)-1(OR=4.17,95%CI:1.08~16.02,P=0.038)和基于胱抑素C的eGFR(eGFRcys)<45 ml·min^-1·(1.73 m^2)-1(OR=3.99,95%CI:1.08~14.75,P=0.038)均与肌少症的发生呈正相关。根据受试者工作特征曲线下面积(AUC),eGFRscr-cys(AUC=0.67)比eGFRcys(AUC=0.64)更适合预测老年CKD患者肌少症的发生。结论老年男性CKD患者肌少症的发生与肾功能减退有关,CKD进展至3b期时,肌少症的发生率随着肾功能的下降而增加。

Objective To evaluate the effect of renal function on sarcopenia in elderly male patients with chronic kidney disease(CKD).Methods A total of 105 male CKD patients aged≥65 years who were admitted to the Chinese PLA General Hospital between October 1,2018 and January 30,2019 were included in this study.Using two different equations to estimate glomerular filtration rate(GFR),respectively.According to the sarcopenia criteria,the participants were categorized as the non-sarcopenia group(n=72)and the sarcopenia group(n=33),respectively.The association of estimated GFR(eGFR)and the sarcopenia in the male CKD patients was analyzed using the model of multivariate logistic regression.Results Among the 105 patients,the median age was 74(68,77)years old.The prevalence of sarcopenia was 31.4%(33/105).According to the multivariate logistic regression analysis,eGFR based on serum creatinine and Cys-C(eGFRscr-cys)lower than 45 ml·min^-1·(1.73 m^2)-1(OR=4.17,95%CI:1.08-16.02,P=0.038)and eGFR based on Cys-C(eGFRcys)lower than 45 ml·min^-1·(1.73 m^2)-1(OR=3.99,95%CI:1.08-14.75,P=0.038)were independent risk factors for underlying sarcopenic,respectively.The area under the receiver operating characteristics curve(AUC)revealed that eGFRscr-cys(AUC=0.67)was more suitable than eGFRcys(AUC=0.64)to predict the sarcopenia in elderly male patients with CKD.Conclusion The increased incidence of sarcopenia in elderly men with CKD is accompanied with deterioration of renal function.