衰弱对老年男性慢性肾脏病患者发生肌少症的影响

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。

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

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.