PDF(Pubmed)
Abstract：
Handgrip strength (HGS) is suggested as an indirect assessment of nutritional status in chronic kidney disease (CKD) patients, but evidence is limited for non-dialysis-dependent CKD (NDD-CKD) patients. This cross-sectional study included 404 patients from the Phase II KoreaN Cohort Study for Outcome in Patients With CKD. HGS, measured twice in each hand, was the exposure, and malnutrition status was defined by a malnutrition-inflammation score (MIS) of 6 or higher. A logistic regression analysis adjusted for age, sex, diabetes mellitus (DM), hypertension, CKD stages, smoking, overhydration, education, and income status was used to assess malnutrition risk. The predictability of HGS for malnutrition was evaluated using the area under the curve (AUC). Patients with lower HGS were older, had a higher prevalence of DM, and lower estimated glomerular filtration rate. Higher HGS was significantly associated with lower malnutrition risk after adjustment (per 1 standard deviation increase, adjusted odds ratio, 0.47 [0.30-0.75]). Subgroup analyses showed no significant interaction between HGS and malnutrition risk across age, sex, DM, and CKD stage. HGS showed fair predictability for malnutrition in men (AUC 0.64 [0.46-0.83]) and women (AUC 0.71 [0.55-0.86]). In conclusion, HGS is a useful diagnostic indicator of malnutrition in NDD-CKD patients.
摘要：
握力（HGS）被建议作为慢性肾脏病（CKD）患者营养状况的间接评估，但非透析依赖性CKD(NDD-CKD)患者的证据有限.这项横断面研究包括来自KoreaN队列研究II期CKD患者结果的404名患者。HGS,每只手测量两次，是曝光，营养不良状况由营养不良-炎症评分(MIS)6或更高定义.根据年龄调整的逻辑回归分析，性别,糖尿病（DM），高血压,CKD阶段，吸烟,过度水合,教育,和收入状况被用来评估营养不良风险。使用曲线下面积（AUC）评估HGS对营养不良的可预测性。HGS较低的患者年龄较大，糖尿病患病率较高，和较低的估计肾小球滤过率。较高的HGS与调整后较低的营养不良风险显著相关(每增加1个标准差，调整后的赔率比，0.47[0.30-0.75])。亚组分析显示，不同年龄的HGS和营养不良风险之间没有显著的相互作用，性别,DM,CKD阶段。HGS对男性（AUC0.64[0.46-0.83]）和女性（AUC0.71[0.55-0.86]）的营养不良表现出相当的可预测性。总之,HGS是NDD-CKD患者营养不良的有用诊断指标。
