Non-invasive testing for sarcopenia predicts future cardiovascular events in patients with chronic kidney disease
Non-invasive testing for sarcopenia predicts future cardiovascular events in patients with chronic kidney disease
复制标题
DOI：
10.1016/j.ijcard.2018.03.064
复制
发表时间：
2018-10-01
影响因子：
3.5
通讯作者：
Tsujita, Kenichi
中科院分区：
文献类型：
--
作者：
Hanatani, Shinsuke;Izumiya, Yasuhiro;Tsujita, Kenichi
背景：在慢性肾脏病（CKD）患者中，经常观察到肌肉减少症，并与不良结局相关。一个简单的筛选测试肌肉减少症使用年龄，握力，小腿围最近开发。然而，这种肌肉减少症评分在CKD患者的临床效用仍不清楚。方法和结果：我们计算了265例CKD患者的肌肉减少症评分，并随访患者的心血管事件。本研究的终点是心血管住院和总死亡率的复合终点。我们使用一个简单的评分系统将所有参与者分为高（n=166）和低（n=99）肌肉减少症评分组。高肌肉减少症评分组患者的血浆B型利钠肽（BNP）水平显著高于低肌肉减少症评分组（中位数：103.1，四分位数间距：46.3-310.0 vs. 46.7，18.0-91.8 pg/mL; p < 0.0001）。Kaplan-Meier曲线显示，即使在使用倾向评分匹配校正潜在混杂因素后，高肌肉减少症评分组的心血管事件风险也显著更高（对数秩检验：p < 0.0001）。多变量考克斯风险分析将高肌肉减少症评分（风险比：3.04，95%置信区间：1.45-6.38，p=0.003）确定为主要终点的独立预测因子。此外，高肌肉减少症评分和高BNP水平的组合确定了具有显著更高的未来事件概率的患者（p < 0.0001）。结论：本研究表明，这种简单的肌肉减少症筛查评分可能是估计CKD患者未来不良事件风险的有用工具。(C)2018爱思唯尔B. V.保留所有权利。
Background: Sarcopenia is frequently observed and associated with poor outcomes in patients with chronic kidney disease (CKD). A simple screening test for sarcopenia using age, grip strength, and calf circumference was recently developed. However, the clinical utility of this sarcopenia score in patients with CKD remains unclear.Methods and results: We calculated the sarcopenia score of 265 patients with CKD and followed the patients for cardiovascular events. The endpoint of this study was the composite of cardiovascular hospitalization and total mortality. We divided all participants into high (n=166) and low(n=99) sarcopenia score groups using a simple scoring system. Patients in the high sarcopenia score group showed significantly higher plasma B-type natriuretic peptide (BNP) levels than those in the low sarcopenia score group (median: 103.1, interquartile range: 46.3-310.0 vs. 46.7, 18.0-91.8 pg/mL; p < 0.0001). The Kaplan-Meier curve revealed that the risk of cardiovascular events was significantly greater in the high sarcopenia score group (log-rank test: p < 0.0001), even after potential confounding factors were corrected using propensity score matching. Multivariate Cox hazard analysis identified a high sarcopenia score (hazard ratio: 3.04, 95% confidence interval: 1.45-6.38, p=0.003) as an independent predictor of the primary endpoints. Furthermore, the combination of a high sarcopenia score and high BNP level identified patients with a significantly higher probability of future events (p < 0.0001).Conclusions: This study demonstrates that this simple screening score for sarcopenia could be a useful tool for estimating the future adverse event risk in patients with CKD. (C) 2018 Elsevier B.V. All rights reserved.