相对骨骼肌质量指数对老年维持性血液透析病人骨折的预测价值

doi:10.3969/j.issn.1003-9198.2022.07.018

Abstract

Abstract: Objective To investigate the predictive value of relative skeletal muscle mass index (RSMI) for bone fracture in the elderly patients undergoing maintenance hemodialysis. Methods A total of 163 elderly patients with maintenance hemodialysis treated in our hospital from April 2018 to January 2021 were selected as the subjects. The clinical data of the patients were collected within 24 hours after admission. The levels of serum parathyroid hormone (iPTH), albumin (ALB) and appendicular skeletal muscle mass (ASMM) were measured, and RSMI was calculated according to ASMM. All the patients were followed up for 12 months, and they were divided into fracture group and non-fracture group according to whether they suffered from non-external traumatic bone fracture. The influencing factors of bone fracture in the elderly patients undergoing maintenance hemodialysis were analyzed by multivariate Logistic regression. The receiver operating characteristic (ROC) curve was drawn to analyze the value of RSMI in predicting the bone fracture of the patients. Results No patient was lost to follow-up. During the follow-up period, 21 patients (12.88%) presented with bone fracture. There were no significant differences in gender, age, body mass index, smoking history, drinking history, duration of hemodialysis, T score of bone mineral density, and the proportion of the patients with hypertension between the two groups (P>0.05). There were significant differences in the proportion of patients with diabetes, the levels of RSMI, serum ALB and iPTH between the two groups (P<0.05). Multivariate Logistic regression analysis showed that diabetes, low levels of RSMI and serum ALB, iPTH＜150 ng/L were the independent risk factors of bone fracture in the elderly patients undergoing maintenance hemodialysis. ROC curve analysis showed that the sensitivity of RSMI in predicting the bone fracture of the elderly patients undergoing maintenance hemodialysis was 71.43%, the specificity was 78.87%, the area under the curve was 0.802 (95%CI: 0.697-0.907), and the cut-off value was 6.44. Conclusions RSMI can effectively predict the risk of bone fracture in the elderly patients undergoing maintenance hemodialysis. RSMI should be closely monitored regularly in clinical treatment.

Key words: maintenance hemodialysis, aged, relative skeletal muscle mass index, bone fracture, predictive efficiency

CLC Number:

R692.5

YU Xue-xue, YANG Zhao, SHANG Si-yu, HOU Meng, LI Sha. Value of relative skeletal muscle mass index in predicting bone fracture of elderly patients undergoing maintenance hemodialysis[J]. Practical Geriatrics, 2022, 36(7): 725-728.

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Value of relative skeletal muscle mass index in predicting bone fracture of elderly patients undergoing maintenance hemodialysis

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