中国血液净化

中国血液净化 ›› 2025, Vol. 24 ›› Issue (09): 742-745.doi: 10.3969/j.issn.1671-4091.2025.09.005

• 临床研究 • 上一篇    下一篇

血清同型半胱氨酸和铁蛋白与慢性肾脏病维持性血液透析患者并发肌少症的相关性分析

刘 丹   黄馥菡   杨珍珍    刘 波   

  1. 313000 湖州，1湖州市中心医院肾内科
  • 收稿日期:2024-11-04 修回日期:2025-07-01 出版日期:2025-09-12 发布日期:2025-09-12
  • 通讯作者: 刘丹 E-mail:fbutjj@163.com
  • 作者简介:dan901031@qq.com
  • 基金资助:
    浙江省医药卫生科技计划项目(2023KY1175)

Correlation between serum homocysteine, ferritin and sarcopenia in maintenance hemodialysis patients with chronic kidney disease

LIU Dan, HUANG Fu-han, YANG Zhen-zhen, LIU Bo   

  1. Nephrology Department，Huzhou Central Hospital, Huzhou 313000, China
  • Received:2024-11-04 Revised:2025-07-01 Online:2025-09-12 Published:2025-09-12
  • Contact: 313000 湖州，1湖州市中心医院肾内科 E-mail:fbutjj@163.com

摘要： 目的 探讨血清同型半胱氨酸(homocysteine，Hcy)、铁蛋白(SF)与维持性血液透析(maintenance hemodialysis，MHD)患者并发肌少症的相关性。 方法 回顾性收集湖州市中心医院2023年1月─2024年1月收治的125例MHD患者临床资料，将并发肌少症患者40例(32.00%)纳入肌少症组，未并发肌少症患者85例(68.00%)纳入非肌少症组，收集患者入院时基线资料、实验室指标及入院时血清Hcy、SF水平，采用Logistic回归分析慢性肾脏病患者MHD期间并发肌少症的影响因素。结果 肌少症组超敏C反应蛋白、Hcy、SF水平高于非肌少症组(t=4.400、5.169、5.650，均P＜0.001)，血红蛋白、骨骼肌质量指数、握力、步速低于非肌少症组(t=4.901、3.764、3.300、3.870，P＜0.001、＜0.001、0.001、＜0.001)；Logistic回归分析结果显示超敏C反应蛋白、Hcy、SF水平高是慢性肾脏病MHD患者并发肌少症的危险因素(OR=2.100、1.160、1.018，95% CI：1.313～3.357、1.073～1.255、1.009～1.027，P=0.002、＜0.001、＜0.001)； 血红蛋白水平高是慢性肾脏病MHD患者并发肌少症的保护因素(OR=0.930，95% CI:0.885～0.978，P=0.004)。 结论 血清Hcy、SF水平升高是慢性肾脏病MHD患者并发肌少症的影响因素。

关键词: 慢性肾脏病, 维持性血液透析, 肌少症, 同型半胱氨酸, 铁蛋白

Abstract: Objective  To investigate the association of serum homocysteine (Hcy) and ferritin (SF) with sarcopenia in maintenance hemodialysis (MHD) patients.  Method  undergoing MHD at Huzhou Central Hospital between January 2023 and January 2024 were retrospectively collected. Patients with sarcopenia (n=40, 32.00%) were assigned to the sarcopenia group, while those without sarcopenia (n=85, 68.00%) comprised the non-sarcopenia group. Baseline characteristics, laboratory parameters, and serum Hcy and SF levels at admission were collected. Logistic regression was used to identify factors influencing sarcopenia in MHD patients.  Results Compared with the non-sarcopenia group, the sarcopenia group showed significantly higher levels of high-sensitivity C-reactive protein (hs-CRP), Hcy and SF (t =4.400, 5.169, 5.650; all P＜0.001) and lower levels of hemoglobin, skeletal muscle mass index, handgrip strength and gait speed (t=4.901, 3.764, 3.300, 3.870; P＜0.001, ＜0.001, 0.001, ＜0.001, respectively). Logistic regression revealed that elevated hs-CRP (OR =2.100, 95% CI:1.313～3.357, P=0.002), Hcy (OR=1.160, 95% CI: 1.073～1.255, P＜0.001) and SF (OR =1.018, 95% CI:1.009～1.027, P＜0.001) were independent risk factors for sarcopenia, whereas higher hemoglobin level (OR=0.930, 95% CI: 0.885～0.978, P=0.004) was a protective factor.  Conclusion   Elevated serum Hcy and SF levels are independent risk factors for sarcopenia in MHD patients..

Key words: Chronic kidney disease, Maintenance hemodialysis, Sarcopenia, Homocysteine, Serum ferritin

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