Differences in the prevalence of sarcopenia in peritoneal dialysis patients using hand grip strength and appendicular lean mass: depends upon guideline definitions
Differences in the prevalence of sarcopenia in peritoneal dialysis patients using hand grip strength and appendicular lean mass: depends upon guideline definitions
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DOI：
10.1038/s41430-018-0238-3
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发表时间：
2018-07-01
影响因子：
4.7
通讯作者：
Davenport, Andrew
中科院分区：
文献类型：
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作者：
Abro, Asmat;Delicata, Lara-Anne;Davenport, Andrew
背景：腹膜透析(PD)患者伴有骨肉减少，死亡风险增加。人们一致认为，骨质疏松症应该结合肌肉功能和质量的评估。方法应用美国国立卫生研究院肉质营养不良项目基金会(FNIH)、欧洲老年人肉质营养不良工作组(EWGSOP)和亚洲肉质营养不良工作组(AWGs)对155例PD患者进行了握力(HGS)和节段性生物阻抗测定(ALM)，并测定了骨质疏松症的患病率。结果我们研究了155例PD患者，其中95名男性(61.3%)，平均年龄63.0±14.9岁，37.4%的糖尿病患者，治疗9个月(3~20个月)，HGS 22.5(15.5~30.2)kg，体重73.6±16.6 kg，体脂百分比31.4+/-4.2，ALM指数7.52+/-1.40 kg/m(2)。与FNIH标准相比，EWGSOP被定义为肌肉无力的患者更多(X-2=6.8p=0.009)，而与FNIH体重指数调整相比，符合EWGSOP肌肉萎缩标准的患者更少(X-2=7.7p=0.006)。然而，当结合这两个标准时，不同推荐定义之间的骨质疏松症发生率没有差异(11-15.5%)。结论我们报告的骨质疏松症的患病率比血液透析患者的研究要低得多。尽管可能存在患者选择偏差的因素，但PD患者在血液透析过程中不会受到水合和电解质变化的影响，这可能会影响HGS和肌肉质量的测量。使用HGS和节段性生物阻抗，我们发现使用EWGSOP、FNIH、AWGS定义的石棺减少的患病率相似。
Background Peritoneal dialysis (PD) patients with sarcopenia have increased risk of mortality. There is consensus that sarcopenia should combine assessments of muscle function and mass. We wished to determine the effect of using different operational definitions in PD patients.Methods Hand grip strength (HGS) and segmental bioimpedance derived appendicular lean mass (ALM) were measured and the prevalence of sarcopenia determined using the Foundation for the National Institutes of Health Sarcopenia Project (FNIH), European Working Group on Sarcopenia Older Persons (EWGSOP), and Asian Working Group on Sarcopenia (AWGS) definitions.Results We studied 155 PD patients, 95 men (61.3%), mean age 63.0 +/- 14.9 years, 37.4% diabetic, treated by PD 9 (3-20) months with a HGS of 22.5 (15.5-30.2) kg, weight 73.6 +/- 16.6 kg, % body fat 31.4 +/- 4.2, and ALM index 7.52 +/- 1.40 kg/m(2). More patients were defined with muscle weakness using the EWGSOP compared to the FNIH criteria (X-2 = 6.8, p = 0.009), whereas fewer patients met the EWGSOP criteria for muscle wasting compared to FNIH body mass index adjustment (X-2 = 7.7, p = 0.006). However, when combining both criteria, there was no difference in the prevalence of sarcopenia between the different recommended definitions (11-15.5%).Conclusion We report a much lower prevalence of sarcopenia compared to studies in haemodialysis patients. Although there may be an element of patient selection bias, PD patients are not subject to changes in hydration and electrolytes with haemodialysis, which can affect HGS and muscle mass measurements. Using HGS and segmental bioimpedance we found similar prevalence of sarcopenia using EWGSOP, FNIH, AWGS definitions.