维持性血液透析患者血清25羟维生素D水平与握力和捏力的相关性分析  

Correlation between serum 25 hydroxyvitamin D level and handgrip strength and pinch strength in maintenance hemodialysis patients

作　　者：杨亚奇 刘琳 林绮婷 刘云[3] 谭荣韶[3] 刘岩 YANG Ya-qi;LIU Lin;LIN Qi-ting;LIU Yun;TAN Rong-shao;LIU Yan(Clinical Collage of Medicine,Guizhou Medical University,Guiyang 550004,China;Department of Nephrology,Maoming People's Hospital,Maoming 525099,China;Department of Nephrology,Institute of Disease-Oriented Nutritional Research,Guangzhou Red Cross Hospital,Jinan University,Guangzhou 510220,China)

机构地区：[1]贵州医科大学临床医学院,贵阳550004 [2]茂名市人民医院肾内科,茂名525099 [3]暨南大学附属广州红十字会医院肾内科病态营养研究所,广州510220

出　　处：《中国血液净化》2024年第6期436-440,共5页Chinese Journal of Blood Purification

摘　　要：目的探讨维持性血液透析(maintenance hemodialysis,MHD)患者血清25羟维生素D[25(OH)D]水平与握力(handgrip strength,HGS)和捏力(pinch strength,PS)的关系。方法采用单中心横断面研究,纳入2021年3月暨南大学附属广州红十字会医院血液净化中心行规律MHD的患者,收集受试者的一般资料,透析前测定血常规、血清生化指标和25(OH)D水平(电化学发光免疫法),使用测力计测量HGS和PS水平。根据25(OH)D水平将受试者分为25(OH)D正常组[25(OH)D>30 ng/ml]、25(OH)D不足组[20 ng/ml≤25(OH)D≤30 ng/ml]、25(OH)D缺乏组[25(OH)D<20 ng/ml],比较3组间各指标的差异。应用Spearman相关分析和线性回归评价25(OH)D水平与HGS和PS的相关性。结果共纳入126例MHD患者,25(OH)D正常组28例(22.22%)、不足组42例(33.33%)、缺乏组56例(44.44%)。Spearman相关性分析提示血清25(OH)D水平与HGS(r=0.289,P=0.001)、PS(r=0.289,P=0.001)呈正相关。在调整相关混杂因素后,多元线性回归显示血清25(OH)D水平降低与较低的HGS(β=0.199,95%CI:0.058~0.341,P=0.006)和PS(β=0.052,95%CI:0.017~0.087,P=0.004)独立相关。结论MHD患者血清25(OH)D水平降低是HGS和PS降低的独立相关因素。Objectives To investigate the correlation between serum 25 hydroxyvitamin D[25(OH)D]level and handgrip strength(HGS)and pinch strength(PS)in maintenance hemodialysis(MHD)patients.Method This was a single-center and cross-sectional study.Patients undergoing MHD in the month of March 2021 in our Hemodialysis Center were enrolled in this study.Demographic data of the patients were collected.Routine blood counts,serum biochemical parameters and 25(OH)D levels(by electrochemiluminescence immunoassay)were determined before dialysis.HGS and PS were measured using a dynamometer.Patients were categorized into 25(OH)D normal,25(OH)D insufficient,and 25(OH)D deficient groups based on 25(OH)D levels.Differences in these indexes were compared among the 3 groups.Spearman correlation analysis and linear regression were applied to evaluate the correlation between 25(OH)D level and HGS and PS.Results A total of 126 MHD patients were included in this study;28 patients(22.22%)in the normal 25(OH)D group,42 patients(33.33%)in the insufficient group,and 56 patients(44.44%)in the deficient group.Spearman correlation analysis suggested that serum 25(OH)D level was positively correlated with HGS(r=0.289,P=0.001)and PS(r=0.289,P=0.001).After adjusting for relevant confounders,multivariate linear regression showed that lower serum 25(OH)D level was independently associated with lower HGS(β=0.199,95%CI:0.058~0.341,P=0.006)and PS(β=0.052,95%CI:0.017~0.087,P=0.004).Conclusion Reduced serum 25(OH)D level was an independent factor for reduced HGS and PS in MHD patients.

关 键 词：25羟维生素D 握力 捏力 肌肉健康 维持性血液透析 

分 类 号：R459.5[医药卫生—治疗学]