肾移植受者小腿围与肌肉减少症的关系研究  

Association between Calf Circumference and Sarcopenia in Kidney Transplant Recipients

作　　者：黄鹤 邹志卓 李琴[3] 刘东[3] 王宇琦 谭荣韶 HUANG He;ZOU Zhizhuo;LI Qin;LIU Dong;WANG Yuqi;TAN Rongshao(Department of Preventive Medicine,Medical College of Yanbian University,Yanji 133000,China;Department of Nutrition,Guangzhou Red Cross Hospital,Guangzhou 510000,China;Department of Organ Transplantation,Guangdong Second Provincial General Hospital,Guangzhou 510000,China)

机构地区：[1]延边大学医学院预防医学教研室,吉林省延吉市133000 [2]广东省广州市红十字会医院营养科,510000 [3]广东省第二人民医院器官移植科,广东省广州市510000

出　　处：《中国全科医学》2023年第27期3403-3410,共8页Chinese General Practice

基　　金：广东省科技计划项目(2017B090904027);广东省体育局项目(GDSS2020M003);广州市卫健委高新、重点和特色项目(2019TS60);广州市科技计划项目(202201020033)。

摘　　要：背景肾移植受者的长期预后可能与肌肉减少症(肌少症)相关,因此早期快速筛查肾移植受者的肌少症非常重要,研究提示小腿围可能是早期筛查肌少症的一个良好指标。目的分析肾移植受者小腿围与肌少症的相关性,并探讨小腿围预测肾移植受者肌少症的可行性。方法选取2021年10月—2022年6月在广东省第二人民医院器官移植科治疗的80例肾移植受者为研究对象。收集研究对象的人口学信息(性别、年龄、受教育程度、婚姻状况)、人体测量学指标[身高、体质量、BMI、小腿围、上臂围(MAC)、三头肌皮褶厚度(TSF)、上臂肌围(AMC)、腰围、臀围、腰臀比]、肌肉力量指标(握力、捏力)、人体成分指标[四肢骨骼肌质量(ASM)、骨骼肌质量指数(SMI)、50 kHz相位角(PhA)、人体细胞质量(BCM)、细胞内液,细胞外液]。采用2019年亚洲肌少症工作组共识诊断标准确诊肌少症,符合诊断标准的肾移植受者纳入肌少症患者组,不符合诊断标准的纳入非肌少症患者组,按性别分层比较肌少症患者组与非肌少症患者组人口学信息、人体测量学指标、肌肉力量指标、人体成分指标的差异,并采用Pearson相关分析和Spearman秩相关分析观察肾移植受者小腿围与肌少症诊断指标(ASM、SMI、握力)的相关性;采用Logistic回归分析探讨肾移植受者肌少症的影响因素,并采用受试者工作特征(ROC)曲线分析小腿围对不同性别肾移植受者肌少症的预测价值,计算ROC曲线下面积(AUC)、灵敏度、特异度、最佳截断值。结果80例患者中男51例(63.8%)、女29例(36.2%),平均年龄为(44.3±11.7)岁,非肌少症患者61例(76.25%),肌少症患者19例(23.75%);按照性别分层后,男性肌少症患者组的体质量、BMI、小腿围、MAC、TSF、臀围、握力、捏力、ASM、SMI、PhA、BCM、细胞外液、细胞内液低于男性非肌少症患者组(P<0.05);女性肌少症患者组的体质量、BMI�Background Sarcopenia may be associated with the long-term prognosis of renal transplant recipients,so it is essential to early and rapidly screening for sarcopenia in these patients.Studies suggest that calf circumference may be an effective indicator in early screening for sarcopenia.Objective To investigate the relationship between calf circumference and sarcopenia,and to explore the feasibility of using calf circumference as a predictive marker for sarcopenia in kidney transplant recipients.Methods We selected 80 kidney transplant recipients who were treated in the department of organ transplantation of Guangdong Second Provincial General Hospital from October 2021 to June 2022 as the subjects.Demographic information(sex,age,educational attainment,marital status),anthropometric indicators〔height,weight,body mass index(BMI),calf circumference,mid-arm circumference(MAC),triceps skin-fold thickness(TSF),arm muscle circumference(AMC),waist circumference,hip circumference,waist-to-hip ratio〕,muscle strength indicators(grip strength,pinch strength),body composition indicators〔appendicular skeletal muscle mass(ASM),skeletal muscle mass index(SMI),50 kHz phase angle(PhA),body cell mass(BCM),intracellular and extracellular fluids〕were collected.Sarcopenia was diagnosed by the Asian Working Group for Sarcopenia 2019 consensus.Kidney transplant recipients who meet the diagnostic criteria were included in the sarcopenia group,and those who do not meet the diagnostic criteria were included in the non-sarcopenia group.Demographic information,anthropometric indicators,muscle strength indicators,and body composition indicators between sarcopenia and non-sarcopenia patient groups were compared by sex.Pearson correlation analysis and Spearman rank correlation analysis were used to observe the correlation of calf circumference with diagnostic indicators of sarcopenia(ASM,SMI,grip strength).Univariate and multivariate logistic regression analyses were used to explore the influencing factors of sarcopenia.The predictive v

关 键 词：肾移植 肾移植受者 肌减少症 肌肉萎缩 人体测量术 小腿围 相关性研究 

分 类 号：R699.2[医药卫生—泌尿科学] R746.4[医药卫生—外科学]