Creatinine clearance, walking speed, and muscle atrophy: a cohort study.
Creatinine clearance, walking speed, and muscle atrophy: a cohort study.
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DOI：
10.1053/j.ajkd.2014.10.016
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发表时间：
2015-05
期刊：
影响因子：
--
通讯作者：
Kestenbaum B
中科院分区：
文献类型：
--
作者：
Roshanravan B;Patel KV;Robinson-Cohen C;de Boer IH;O'Hare AM;Ferrucci L;Himmelfarb J;Kestenbaum B
慢性肾脏病（CKD）与营养不良和炎症有关。这些过程可能会导致骨骼肌损失和身体机能下降。肾功能与肌肉成分和身体表现的纵向测量之间的关联尚不清楚。前瞻性队列研究。我们对参加 Invecchiare in Chianti (InCHIANTI) 研究的 826 名社区居住老年人进行了评估，这些老年人没有基线中风或日常生活活动障碍。基于 24 小时尿液收集的基线肌酐清除率 (Clcr)。使用等长测力法通过 7 米常用步态速度、400 米快速步态速度和膝关节伸展力量测量身体表现的横截面和纵向轨迹。通过定量 CT 评估小腿肌肉成分。参与者的平均年龄为 74 ± 7 (SD) 岁，其中 183 人的 Clcr < 60ml/min/1.73m2。调整后，Clcr 每减少 10ml/min/1.73m2，7 米步行速度就会减慢 0.01（95% CI，0.004–0.017）m/s，400 米步行速度会减慢 0.008（95% CI，0.002–0.014）m/s。 Clcr 每减少 10 ml/min/1.73m2，肌肉面积减少 28mm2 (95% CI, 0.8–55)，肌肉密度减少 0.15mg/cm3 (95% CI, 0.04–0.26)。调整后，较低的 Clcr 与随访过程中较慢的平均 7 米 (P=0.005) 和 400 米 (P=0.02) 步行以及膝关节伸展力量 (P=0.001) 相关。在平均 7.1 ±2.5 年的随访中，基线 Clcr 每降低 10 ml/min/1.73m2 与膝关节力量每年下降 0.024（95% CI，0.01–0.037）kg 相关。 Clcr 的单一基线测量和随访之间的 3 年间隔可能会导致非差异性错误分类和估计值衰减。结论：在老年人中，较低的 Clcr 与肌肉萎缩、步行速度降低以及下肢力量随时间的推移更快下降有关。
Chronic kidney disease (CKD) is associated with malnutrition and inflammation. These processes may lead to loss of skeletal muscle and reduced physical performance. Associations of kidney function with muscle composition and longitudinal measures of physical performance are unknown. Prospective cohort study. We evaluated 826 community-dwelling older adults enrolled in the Invecchiare in Chianti (InCHIANTI) Study free of baseline stroke or activities of daily living disability. Baseline creatinine clearance (Clcr) based on a 24-hour urine collection. Cross-sectional and longitudinal trajectories of physical performance measured by 7-meter usual gait speed, 400-meter fast gait speed, and knee extension strength using isometric dynamometry. Calf muscle composition assessed by quantitative CT. Mean age of participants was 74 ± 7 (SD) years with 183 having Clcr < 60ml/min/1.73m2. After adjustment each 10ml/min/1.73m2 decrement in Clcr was associated with 0.01 (95% CI, 0.004–0.017) m/s slower 7-meter usual walking speed and 0.008 (95% CI, 0.002–0.014) m/s slower 400-meter walking speed. Each 10 ml/min/1.73m2 decrement in Clcr was associated with 28mm2 (95% CI, 0.8–55) lower muscle area and 0.15mg/cm3 (95% CI, 0.04–0.26) lower muscle density. After adjustment, lower Clcr was associated with slower mean 7-meter (P=0.005) and 400-meter (P=0.02) walk and knee extension strength (P=0.001) over the course of follow-up. Over a mean follow-up of 7.1 ±2.5 years, each 10 ml/min/1.73m2 lower baseline Clcr was associated with 0.024 (95% CI, 0.01–0.037) kg/year greater decline in knee strength. Single baseline measurement of Clcr and 3-year interval between follow-up visits may lead to non-differential misclassification and attenuation of estimates. Conclusions: Among older adults, lower Clcr is associated with muscle atrophy, reduced walking speed and more rapid declines in lower extremity strength over time.
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DOI：
10.1056/nejmoa1114248
发表时间：
2012-07-05
期刊：
The New England journal of medicine
影响因子：
--
作者：
Inker LA;Schmid CH;Tighiouart H;Eckfeldt JH;Feldman HI;Greene T;Kusek JW;Manzi J;Van Lente F;Zhang YL;Coresh J;Levey AS;CKD-EPI Investigators
通讯作者：
CKD-EPI Investigators
DOI：
10.2215/cjn.02870313
发表时间：
2013-12-06
影响因子：
9.8
作者：
Dalrymple, Lorien S.;Katz, Ronit;Shlipak, Michael G.
通讯作者：
Shlipak, Michael G.
影响因子：
4.2
作者：
Reese, Peter P.;Cappola, Anne R.;Leonard, Mary B.
通讯作者：
Leonard, Mary B.
影响因子：
13.2
作者：
Plantinga, Laura C.;Johansen, Kirsten;Powe, Neil R.
通讯作者：
Powe, Neil R.
DOI：
10.1111/j.1532-5415.2000.tb03873.x
发表时间：
2000-12-01
影响因子：
6.3
作者：
Ferrucci, L;Bandinelli, S;Guralnik, JM
通讯作者：
Guralnik, JM