91例肾脏病患者骨骼肌含量及其影响因素研究

Study on skeletal muscle content and its influencing factors in 91 patients with kidney disease

目的探讨肾脏病患者骨骼肌含量及其影响因素。方法采用横断面研究收集完整信息的肾脏病患者91例并进行体成分检测,非条件Logistic回归分析肾脏病骨骼肌的影响因素。结果91例患者骨骼肌含量为(25.68±6.07)kg,低骨骼肌组32例(35.2%)。非低骨骼肌组和低骨骼肌组年龄、慢性肾衰竭(chronic renal failure,CRF)、尿素氮(blood urea nitrogen,BUN)、白蛋白(albumin,ALB)、尿蛋白、身高差异有统计学意义(P<0.05),2组性别、吸烟、饮酒、高血压、糖尿病、肾小球滤过率、肌酐、前白蛋白、三酰甘油和血红蛋白差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,CRF和ALB是肾脏病患者骨骼肌含量的危险因素,尿蛋白和身高为肾脏病患者骨骼肌含量的保护因素(P<0.05)。结论骨骼肌减少在肾脏疾病中普遍存在,是评估患者营养状况的良好指标,应在肾脏疾病各阶段中重视合理营养治疗对骨骼肌的重要影响。

Objective To explore the skeletal muscle content and its influencing factors in patients with kidney disease. Methods A cross-sectional study was performed to collect complete information of 91 patients with kidney disease for body composition testing. Unconditional Logistic regression analysis was performed to analyze the influencing factors of skeletal muscle in patients with kidney disease. Results Skeletal muscle content of 91 patients was(25.68 ± 6.07) kg, including 32 persons(35.2%) in the low skeletal muscle group. There were significant differences in age, creatine(Cr), blood urea nitrogen(BUN), albumin(ALB), urine protein and height between the non-low skeletal muscle group and the low skeletal muscle group(P<0.05). There was no significant difference in gender, smoking, drinking, hypertension, diabetes, estimated glomerular filtration rate(eGFR), Cr, prealbumin(PA), triglyceride(TG) and hemoglobin(Hb)(P>0.05). Multivariate Logistic regression analysis showed that Cr and ALB were independent risk factors for the low skeletal muscle content, while proteinuria and height were protective factors in patients with kidney disease. Conclusion Skeletal sarcopenia is common in kidney disease and a good indicator to assess the nutritional status of patients. The important effect of reasonable nutritional therapy on skeletal muscle should warrant attention in all stages of kidney disease.