目的  探讨维持性血液透析(maintenance hemodialysis，MHD)患者牙周炎严重程度与肌少症的相关性及影响因素。 方法  选取2024年1月—12月南通市海门区人民医院及南通大学附属医院血液净化中心接受MHD治疗的患者，依据亚洲肌少症工作组(Asian working group for sarcopenia 2019，AWGS 2019)标准诊断肌少症，分为肌少症组和非肌少症组。比较2组一般资料、实验室指标及口腔健康状况。以肌少症为因变量，采用Logistic回归分析其影响因素。 结果  本研究共纳入468例患者，其中肌少症组126例，非肌少症组342例，MHD患者肌少症发生率为26.9%。与非肌少症组比较，肌少症组探诊深度(probing depth，PD)、附着丧失(attachment loss，AL)及出血指数(bleeding index，BI)均升高(t=6.103、5.561、6.718，均P＜0.001)，口腔健康影响量表-14(oral health impact profile-14,OHIP-14)评分升高(Z=9.848，P＜0.001)。2组牙周炎严重程度分布比较差异有统计学意义(χ²=29.841，P＜0.001)。进一步分析显示无/轻度、中度及重度牙周炎患者肌少症发生率分别为16.9%、25.9%和51.6%(χ²=40.110，P＜0.001)。多因素Logistic回归分析显示：年龄(OR=1.086，95%CI：1.035～1.147,P=0.001)、透析龄(OR=1.029，95% CI：1.015～1.062，P=0.015)、牙周炎严重程度(OR=3.032，95% CI：1.531～6.411,P=0.002)及白细胞介素-6(interleukin-6，IL-6)(OR=1.619，95% CI：1.188～2.084,P=0.012)为肌少症发生的独立影响因素。边际标准化分析显示无/轻度、中度及重度牙周炎患者肌少症的调整后发生概率分别为0.091、0.223和0.321。趋势检验显示肌少症发生风险随牙周炎严重程度增加而升高(P趋势=0.022)。结论  MHD患者肌少症发生率较高，牙周炎严重程度是其独立影响因素，肌少症发生风险随牙周炎严重程度增加而呈显著上升趋势。

Objective To investigate the correlation between periodontitis severity and sarcopenia in patients undergoing maintenance hemodialysis (MHD) and to analyze the influencing factors. Methods Patients receiving MHD at the Blood Purification Centers of Nantong Haimen People's Hospital and the Affiliated Hospital of Nantong University from January to December 2024 were enrolled. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 (AWGS 2019) criteria, and patients were divided into a sarcopenia group and a non‑sarcopenia group. General data, laboratory parameters, and oral health status were compared between the two groups. Logistic regression analysis was used to identify factors influencing sarcopenia, with sarcopenia as the dependent variable. Results A total of 468 patients were included, comprising 126 in the sarcopenia group and 342 in the non‑sarcopenia group, yielding a sarcopenia prevalence of 26.9% among MHD patients. Compared with the non‑sarcopenia group, the sarcopenia group had significantly higher probing depth (PD), attachment loss (AL), and bleeding index (BI) (t=6.103, 5.561, 6.718, respectively; all P<0.001), as well as higher Oral Health Impact Profile‑14 (OHIP‑14) scores (Z=9.848, P<0.001). The distribution of periodontitis severity differed significantly between the two groups (χ²=29.841, P<0.001). Further analysis showed that the prevalence of sarcopenia in patients with no/mild, moderate, and severe periodontitis was 16.9%, 25.9%, and 51.6%, respectively (χ²=40.110, P<0.001). Multivariate logistic regression identified age (OR=1.086, 95% CI: 1.035～1.147, P=0.001), dialysis vintage (OR=1.029, 95% CI: 1.015～1.062, P=0.015), periodontitis severity (OR=3.032, 95% CI: 1.531～6.411, P=0.002), and interleukin‑6 (IL‑6) (OR=1.619, 95% CI: 1.188～2.084, P=0.012) as independent influencing factors for sarcopenia. Marginal standardization analysis revealed that the adjusted probabilities of sarcopenia for patients with no/mild, moderate, and severe periodontitis were 0.091, 0.223, and 0.321, respectively. A trend test indicated that the risk of sarcopenia increased with increasing periodontitis severity (P for trend=0.022). Conclusion The prevalence of sarcopenia is relatively high in MHD patients. Periodontitis severity is an independent influencing factor, and the risk of sarcopenia shows a significant upward trend with increasing severity of periodontitis.