老年女性腹膜透析患者并发肌少症的骨代谢特征及危险因素分析

目的分析老年女性腹膜透析(PD)患者并发肌少症的骨代谢特征及其危险因素。方法选取2015年1月至2021年12月本院就诊的72例老年女性PD患者,根据是否并发肌少症分为肌少症组和非肌少症组,收集临床资料,分析老年女性PD患者并发肌少症的骨代谢特征及其危险因素。结果72例老年女性PD患者中并发肌少症23例,发生率约为31.9%;与非肌少症组比较,肌少症组的透析龄、合并糖尿病比例、骨特异性碱性磷酸酶、骨钙素、I型前胶原氨基末端肽、抗酒石酸酸性磷酸酶(TRACP)和Ⅰ型胶原交联C-末端肽(CTX-1)等水平均明显升高,而体质量指数、腰椎骨密度(BMD)、25羟基维生素D3等水平均显著降低(P<0.05);多元Logistic回归分析显示:透析龄、糖尿病、TRACP和CTX-1是老年女性PD患者并发肌少症的独立危险因素;Peason相关分析显示,老年女性PD患者并发肌少症与透析龄、糖尿病、TRACP和CTX-1呈正相关关系。结论老年女性PD患者并发肌少症与透析龄、糖尿病、TRACP和CTX-1等危险因素密切相关。因此,建议针对具有以上危险因素的老年女性PD患者及时进行肌少症评估,以期早期防治肌少症。

Objective To analyze the characteristics and risk factors of bone metabolism in elderly female patients with peritoneal dialysis(PD)complicated with sarcopenia.Methods A total of 72 elderly female PD patients treated in our hospital from January 2015 to December 2021 were selected as the research objects.According to whether they were complicated with sarcopenia,they were divided into the sarcopenia group and the non-sarcopenia group.The clinical data of the two groups were collected,and the characteristics of bone metabolism and risk factors of elderly female PD patients complicated with sarcopenia were analyzed.Results Among 72 elderly female PD patients,23 cases were complicated with sarcopenia,the incidence rate was about 31.9%.Compared with the non-sarcopenia group,the dialysis age,the proportion of diabetes mellitus,the levels of BALP,OC,PINP,TRACP and CTX-1 were significantly increased,while the levels of BMI,lumbar BMD and 25-(OH)D3 were significantly decreased in the sarcopenia group(all P<0.05).Multiple Logistic regression analysis showed that dialysis age,diabetes mellitus,TRACP and CTX-1 were independent risk factors for sarcopenia in elderly female PD patients.The Pearson correlation analysis showed that sarcopenia was positively correlated with dialysis age,diabetes mellitus,TRACP and CTX-1 in elderly female PD patients.Conclusion Sarcopenia in elderly female PD patients is closely related to risk factors such as dialysis age,diabetes mellitus,TRACP and CTX-1.Therefore,it is suggested that sarcopenia evaluation should be performed in time for elderly female PD patients with the above risk factors in order to prevent and treat sarcopenia early.