Simplified discriminant parameters for sarcopenia among patients undergoing haemodialysis.
Simplified discriminant parameters for sarcopenia among patients undergoing haemodialysis.
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DOI：
10.1002/jcsm.13078
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发表时间：
2022-12
期刊：
影响因子：
--
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中科院分区：
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终末期肾病（ESRD）患者发生肌肉减少症的风险增加，这可能导致各种不良健康后果。尽管肌肉减少症的诊断对于临床管理至关重要，但在常规临床实践中，对于接受血液透析的人群来说，这是不可行的，因为它耗时且资源有限。ESRD患者的血清肌酐水平作为肌肉减少症的筛选参数已受到关注，因为血清肌酐是骨骼肌代谢的常规测量副产物。本研究旨在评价肌酐衍生指数对血液透析患者肌肉减少症的区分能力。我们根据亚洲肌肉减少症工作组（AWGS）2标准，在3家透析机构招募的356例临床稳定的ESRD门诊患者中诊断为肌肉减少症。除了AWGS推荐的小腿围、SARC‐F评分以及两者的组合（即SARC‐CalF评分）外，我们还采用了改良的肌酐指数作为肌肉减少症的简化判别参数。采用受试者操作特征分析和Logistic回归分析评价改良肌酐指数对肌少症的鉴别能力。在研究参与者中，142人（39.9%）被诊断为肌肉减少症。男性和女性受试者中改良肌酐指数对肌肉减少症的曲线下面积分别为0.77（95%置信区间[CI]：0.71至0.83）和0.77（95% CI：0.69至0.85）。所有简化的判别参数显着相关的肌肉减少症，即使在调整患者的特征和中心。在简化判别参数的1-标准差变化的肌肉减少症的比值比比较中，改良肌酐指数的比值比为1.92（95%CI：1.15 ~ 3.19），低于小腿围（比值比：6.58，95% CI：3.32至13.0），与SARC‐F（比值比：1.57，95% CI：1.14至2.16）和SARC‐CalF评分（比值比：2.36，95% CI：1.60至3.47）相似。本研究显示，在接受血液透析的患者中，肌酐衍生指数与肌肉减少症之间存在强相关性。改良肌酐指数在对肌肉减少症的区分度方面等于或上级优于SARC‐F和SARC‐CalF评分。然而，小腿围区分肌肉减少症的能力非常高，需要进一步研究以确定其是否可用于检测肌肉质量和功能随时间的退化。
Patients with end‐stage renal disease (ESRD) are at an increased risk of developing sarcopenia, which can lead to various adverse health outcomes. Although the diagnosis of sarcopenia is essential for clinical management, it is not feasible in routine clinical practice for populations undergoing haemodialysis because it is time‐consuming and resources are limited. Serum creatinine levels in patients with ESRD have been gaining attention as a screening parameter for sarcopenia because serum creatinine is a routinely measured byproduct of skeletal muscle metabolism. This study aimed to evaluate the discriminative ability of the creatinine‐derived index for sarcopenia in patients undergoing haemodialysis. We diagnosed sarcopenia according to the Asian Working Group for Sarcopenia (AWGS) 2 criteria in 356 clinically stable outpatients with ESRD enrolled from three dialysis facilities. We adopted the modified creatinine index as a simplified discriminant parameter for sarcopenia in addition to the calf circumference, SARC‐F score, and combination of both (i.e. SARC‐CalF score), which are recommended by the AWGS. Receiver operating characteristic analysis and logistic regression analysis were conducted to evaluate the discriminative ability of the modified creatinine index for sarcopenia. Of the study participants, 142 (39.9%) were diagnosed with sarcopenia. The areas under the curve of the modified creatinine index against sarcopenia in the male and female participants were 0.77 (95% confidence interval [CI]: 0.71 to 0.83) and 0.77 (95% CI: 0.69 to 0.85), respectively. All simplified discriminant parameters were significantly associated with sarcopenia, even after adjusting for patient characteristics and centre. In the comparison of the odds ratios for sarcopenia for 1‐standard deviation change in the simplified discriminant parameters, the odds ratio of the modified creatinine index was 1.92 (95% CI: 1.15 to 3.19), which was lower than that of the calf circumference (odds ratio: 6.58, 95% CI: 3.32 to 13.0) and similar to that of the SARC‐F (odds ratio: 1.57, 95% CI: 1.14 to 2.16) and SARC‐CalF scores (odds ratio: 2.36, 95% CI: 1.60 to 3.47). This study revealed a strong association between the creatinine‐derived index and sarcopenia in patients undergoing haemodialysis. The modified creatinine index was equal or superior to those of SARC‐F and SARC‐CalF score in discriminability for sarcopenia. However, the ability of the calf circumference to discriminate sarcopenia is extremely high, and further study is needed to determine whether it can be used to detect deterioration of muscle mass and function over time.
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DOI：
10.3390/diagnostics10110890
发表时间：
2020-10-31
期刊：
Diagnostics (Basel, Switzerland)
影响因子：
--
作者：
Lin YL;Hou JS;Lai YH;Wang CH;Kuo CH;Liou HH;Hsu BG
通讯作者：
Hsu BG
影响因子：
5.9
作者：
Hendriks, Floris K.;Smeets, Joey S. J.;van Loon, Luc J. C.
通讯作者：
van Loon, Luc J. C.
影响因子：
3.7
作者：
Canaud B;Granger Vallée A;Molinari N;Chenine L;Leray-Moragues H;Rodriguez A;Chalabi L;Morena M;Cristol JP
通讯作者：
Cristol JP
影响因子：
6.3
作者：
Kim, Jwa-Kyung;Choi, Sun Ryoung;Song, Young Rim
通讯作者：
Song, Young Rim
影响因子：
2
作者：
Plytzanopoulou, Petrini;Politis, Panagiotis;Papasotiriou, Marios
通讯作者：
Papasotiriou, Marios