Association between sarcopenia and frailty in elderly patients with chronic kidney disease

IF 8.9 1区医学

Journal of Cachexia, Sarcopenia and Muscle Pub Date : 2023-06-09 DOI:10.1002/jcsm.13275

Che Wang, Xinru Guo, Xieguanxuan Xu, Shuang Liang, Wenling Wang, Fanglei Zhu, Siyang Wang, Jie Wu, Li Zhang, Xuefeng Sun, Xiangmei Chen, Guangyan Cai, The Chinese observational prospective study of ageing population with chronic kidney disease (C-OPTION)

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Abstract

Background

Frailty and sarcopenia are prevalent in chronic kidney disease (CKD) populations and could increase the risk for adverse health outcomes. Few studies assess the correlation between frailty, sarcopenia and CKD in non-dialysis patients. Therefore, this study aimed to determine frailty-associated factors in elderly CKD stage I–IV patients, expected to early identify and intervene in the frailty of elderly CKD patients.

Methods

A total of 774 elderly CKD I–IV patients (>60 years of age) recruited from 29 clinical centers in China between March 2017 and September 2019 were included in this study. We established a Frailty Index (FI) model to evaluate frailty risk and verified the distributional property of FI in the study population. Sarcopenia was defined according to the criteria of the Asian Working Group for Sarcopenia 2019. Multinomial logistic regression analysis was used to assess the associated factors for frailty.

Results

Seven hundred seventy-four patients (median age 67 years, 66.0% males) were included in this analysis, with a median estimated glomerular filtration rate of 52.8 mL/min/1.73 m². The prevalence of sarcopenia was 30.6%. The FI exhibited a right-skewed distribution. The age-related slope of FI was 1.4% per year on a logarithmic scale (r² = 0.706, 95% CI 0.9, 1.8, P < 0.001). The upper limit of FI was around 0.43. The FI was related to mortality (HR = 1.06, 95% CI 1.00, 1.12, P = 0.041). Multivariate multinomial logistic regression analysis showed that sarcopenia, advanced age, CKD stage II–IV, low level of serum albumin and increased waist–hip ratio were significantly associated with high FI status, while advanced age and CKD stage III–IV were significantly associated with for median FI status. Moreover, the results from the subgroup were consistent with the leading results.

Conclusions

Sarcopenia was independently associated with an increased risk for frailty in elderly CKD I-IV patients. Patients with sarcopenia, advanced age, high CKD stage, high waist–hip ratio and low serum albumin level should be assessed for frailty.

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老年慢性肾病患者肌肉减少症与虚弱的关系

背景:虚弱和肌肉减少症在慢性肾脏疾病(CKD)人群中普遍存在，并可能增加不良健康结果的风险。很少有研究评估非透析患者虚弱、肌肉减少和CKD之间的相关性。因此，本研究旨在确定老年CKD I-IV期患者的衰弱相关因素，以期早期识别和干预老年CKD患者的衰弱。方法2017年3月至2019年9月，从中国29个临床中心招募774例老年CKD I-IV患者(60岁)纳入本研究。我们建立了虚弱指数(FI)模型来评估虚弱风险，并验证了FI在研究人群中的分布特性。肌少症是根据2019年亚洲肌少症工作组的标准定义的。采用多项logistic回归分析评估与衰弱相关的因素。结果774例患者(中位年龄67岁，66.0%为男性)纳入本分析，估计肾小球滤过率中位数为52.8 mL/min/1.73 m2。肌肉减少症患病率为30.6%。FI呈右偏态分布。在对数尺度上，FI的年龄相关斜率为每年1.4% (r2 = 0.706, 95% CI 0.9, 1.8, P <0.001)。FI的上限约为0.43。FI与死亡率相关(HR = 1.06, 95% CI 1.00, 1.12, P = 0.041)。多因素logistic回归分析显示，骨骼肌减少、高龄、CKD II-IV期、血清白蛋白水平低、腰臀比增高与高FI状态显著相关，高龄和CKD III-IV期与中位FI状态显著相关。此外，亚组的结果与领先结果一致。结论:老年CKD I-IV患者肌少症与衰弱风险增加独立相关。骨骼肌减少、高龄、CKD分期高、腰臀比高、血清白蛋白水平低的患者应进行虚弱评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Cachexia, Sarcopenia and Muscle Medicine-Orthopedics and Sports Medicine

自引率

12.40%

发文量

期刊介绍： The Journal of Cachexia, Sarcopenia, and Muscle is a prestigious, peer-reviewed international publication committed to disseminating research and clinical insights pertaining to cachexia, sarcopenia, body composition, and the physiological and pathophysiological alterations occurring throughout the lifespan and in various illnesses across the spectrum of life sciences. This journal serves as a valuable resource for physicians, biochemists, biologists, dieticians, pharmacologists, and students alike.