维持性血液透析的2型糖尿病肾病患者并发肌少症的相关因素分析

Analysis of related factors of sarcopenia in type 2 diabetic nephropathy patients on maintenance hemodialysis

目的:分析维持性血液透析(maintenance hemodialysis,MHD)的2型糖尿病肾病患者并发肌少症的相关因素,以减少肌少症的发生率。方法:回顾性收集2021年9月至2023年4月在新乡医学院附属人民医院血液净化中心行MHD合并肌少症的237例患者的临床资料。将患者分为2型糖尿病肾病组(100例)和非糖尿病肾病组(137例),比较2组患者的临床资料及生物电阻抗法(bioelectrical impedance analysis,BIA)结果。以多因素Logistic回归模型分析影响MHD糖尿病肾病患者并发肌少症的相关因素。结果:2组间性别、空腹血糖、血清肌酐、白蛋白、前白蛋白、25⁃羟维生素D、体质量指数(body mass index,BMI)、体脂肪量(fat mass,FM)、上臂围(arm circumference,AC)、内脏脂肪面积(visceral fat area,VFA)、50 kHz相位角差异均有统计学意义(均P<0.05)。多因素Logistic回归分析结果显示,性别、空腹血糖、白蛋白、BMI为MHD糖尿病肾病患者并发肌少症的影响因素(OR=0.372、1.350、0.925、1.451,均P<0.05)。结论:MHD的糖尿病肾病患者中男性、低白蛋白血症、高血糖和高BMI者更易并发肌少症。

Objective To analyze related factors of sarcopenia in type 2 diabetic nephropathy patients on maintenance hemodialysis(MHD),in order to reduce the incidence of sarcopenia.Methods The clinical data of 237 patients with MHD complicated with sarcopenia were collected from the Blood Purification Center of the Affiliated People’s Hospital of Xinxiang Medical College from September 2021 to April 2023 retrospectively and analyzed.The patients were divided into type 2 diabetic nephropathy group(100 cases)and non⁃diabetic nephropathy group(137 cases),and the clinical data and the result of bioelectrical impedance analysis(BIA)were compared between the two groups.Multivariate Logistic regression model was used to analyze the related factors affecting sarcopenia in MHD patients with diabetic nephropathy.Results There were significant differences in gender,fasting blood glucose,serum creatinine,albumin,prealbumin,25⁃hydroxyvitamin D,body mass index(BMI),fat mass(FM),arm circumference(AC),visceral fat area(VFA)and 50 kHz phase angle between the two groups(all P<0.05).Multivariate Logistic regression analysis showed that gender,fasting blood glucose,albumin and BMI were independent influencing factors of sarcopenia in MHD diabetic nephropathy patients(odds ratio=0.372,1.350,0.925,1.451,all P<0.05).Conclusions Male,hypoalbuminemia,hyperglycemia and high BMI patients with MHD are more likely to have sarcopenia among diabetic nephropathy patients with MHD.