中国血液净化

中国血液净化 ›› 2026, Vol. 25 ›› Issue (03): 256-261.doi: 10.3969/j.issn.1671-4091.2026.03.017

• 护理研究 • 上一篇    下一篇

维持性血液透析患者肌少性肥胖患病率的Meta分析

彭梦梅    刘 妍    张 茜    欧妙玲   

  1. 999078 澳门，1澳门镜湖护理学院
    410013 长沙，2湖南师范大学医学部
  • 收稿日期:2025-04-03 修回日期:2025-11-30 出版日期:2026-03-12 发布日期:2026-03-12
  • 通讯作者: 欧妙玲 E-mail:aml@kwnc.edu.mo

Meta-analysis of sarcopenic obesity prevalence among MHD patients

PENG Meng-mei, LIU Yan, ZHANG Xi, OU Miao-ling   

  1. Kiang Wu College of Nursing, Macau 999078, China; 2Medical Science Department, Hunan Normal University, Changsha 410013, China
  • Received:2025-04-03 Revised:2025-11-30 Online:2026-03-12 Published:2026-03-12
  • Contact: 999078 澳门，1澳门镜湖护理学院 E-mail:aml@kwnc.edu.mo

摘要： 目的  通过系统评价及Meta整合的方法，明确维持性血液透析(maintenance hemodialysis，MHD)患者肌少性肥胖(sarcopenic obesity，SO)的患病率，为临床筛查及干预提供循证依据。 方法  系统检索PubMed、Web of science、Medline、Scopus、Embase、CBM、Cochrane Library、中国知网、维普数据库和万方数据库，时限为建库至2025年1月。研究的筛选、数据提取及质量评价均由2名研究者分别独立开展，过程若出现判断分歧，通过双人讨论协商达成统一结论。采用Stata 18.0软件进行Meta分析。 结果  最终纳入9篇研究，其中3篇为队列研究，6篇为横断面研究，总样本量为9946例，MHD患者SO总患病率为20%(95%CI:17%～23%)，各研究间存在高度异质性(I²=90.52%，P＜0.001)。亚组分析显示：队列研究的患病率(21.5%，95%CI:14.9%～28.2%)与横断面研究(19.1%，  95%CI：15.3%～22.9%)无差异(P=0.536)；平均年龄＜60岁组患病率(22.1%，95%CI:19.3%～24.9%)与≥60岁组(17.7%，95%CI:9.0%～26.4%)无差异(P=0.342)；不同肌少症诊断标准对应的患病率介于15.4%～21.7%，其亚组间差异无统计学意义(P=0.178)；在肥胖诊断方面，不同诊断方法对应的患病率存在统计学差异(P=0.002)，其中，采用体脂率(body fat percentage，BFP%)联合体质量指数(body mass index，BMI)诊断肥胖的研究中患病率最高，达24.7%(95%CI:20.2%～29.2%)，其次为使用内脏脂肪面积(visceral fat area，VFA)诊断的研究(19.8%, 95%CI:14.4%～25.2%)、单一BFP诊断的研究(17.7%,95%CI:10.5%～24.9%)及单一BMI诊断的研究(16.9%,95%CI:12.6%～21.2%)。 结论 MHD患者SO患病率较高。尽管多数亚组间无统计学差异，但基于其整体高患病率，建议将SO的常规筛查与干预纳入所有MHD患者的诊疗常规。

关键词: 维持性血液透析, 肌少性肥胖, 患病率

Abstract: Objective  To clarify the overall prevalence of sarcopenic obesity (SO) in patients undergoing maintenance hemodialysis (MHD) by means of systematic review and meta-analysis, so as to provide evidence-based support for clinical screening and intervention.  Methods   A systematic search was conducted in databases including PubMed, Web of Science, Medline, Scopus, Embase, CBM, Cochrane Library, CNKI, VIP, and WanFang, with the search period ranging from the establishment of the database to January 2025. Study screening, data extraction, and quality assessment were independently carried out by two researchers respectively. In case of judgment discrepancies during the process, a unified conclusion was reached through joint discussion and negotiation between the two researchers. Stata 18.0 software was used for meta-analysis.  Results  A total of 9 studies were finally included, among which 3 were cohort studies and 6 were cross-sectional studies, with a total sample size of 9 946 cases. The overall prevalence of SO in MHD patients was 20% (95% CI: 17%～23%). High heterogeneity occurred among the studies (I²=90.52%, P＜0.001). Subgroup analysis showed that there was no significant difference in prevalence between cohort studies (21.5%, 95% CI: 14.9%～28.2%) and cross-sectional studies (19.1%, 95% CI: 15.3%～22.9%) (P=0.536); there was no significant difference in prevalence between the group with mean age ＜60 years (22.1%, 95% CI: 19.3%～24.9%) and the group with mean age ≥60 years (17.7%, 95% CI: 9.0%～26.4%) (P=0.342); the prevalence corresponding to different diagnostic criteria for sarcopenia ranged from 15.4% to 21.7%, and the difference between subgroups did not reach statistical significance (P=0.178); in terms of obesity diagnosis, there were significant differences in prevalence corresponding to different diagnostic methods (P=0.002). Among them, the studies using body fat percentage (BFP%) combined with body mass index (BMI) to diagnose obesity had the highest prevalence, reaching 24.7% (95% CI: 20.2%～29.2%), followed by studies using visceral fat area (VFA) for diagnosis (19.8%, 95% CI: 14.4%～25.2%), studies using BFP alone for diagnosis (17.7%, 95% CI: 10.5%～24.9%), and studies using BMI alone for diagnosis (16.9%, 95% CI: 12.6%～21.2%).  Conclusions  The prevalence of SO is higher among MHD patients. Although most subgroup differences were not statistically significant, the higher overall prevalence suggests that routine SO screening and intervention should be implemented as part of the standard care protocol for all MHD patients.

Key words: Maintenance hemodialysis, Sarcopenic obesity, Prevalence

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