肌少症和衰弱在慢性肾脏病患者营养和生活质量间的中介作用
The mediating role of sarcopenia and Frailty in nutrition and quality of life in patients with chronic kidney disease
汪秦 1张祥 1王雪燕 1杨丹 1刘欢 2王翠珍 2陶明芬2
作者信息
- 1. 皖南医学院研究生学院,安徽 芜湖 241000
- 2. 皖南医学院第一附属医院,安徽 芜湖 241000
- 折叠
摘要
目的 探讨肌少症和衰弱在慢性肾脏病患者营养和生活质量间的中介作用,为制定针对性干预措施,提升患者生活质量做参考.方法 采取便利抽样法抽取605例慢性肾脏病患者为研究对象,采用一般资料调查表、肌肉减少症五条目(SARC-F)问卷、Frail衰弱量表和MNA-SF简易微型营养评定量表进行调查.结果 605例慢性肾脏病患者营养得分分别与衰弱、肌少症得分呈负相关(r=-0.581,r=-0.561,P＜0.001),肌少症得分与衰弱得分呈正相关(r=0.760,P＜0.001).进一步采用回归分析对肌少症在营养与衰弱间的中介效应进行分析,结果显示,方程1中营养得分可以负向预测衰弱得分(β=-0.435,P＜0.001),可解释因变量31.9％的变异;方程2中营养得分可负向预测肌少症得分(β=-0.763,P＜0.001),可解释因变量30.8％的变异;方程3中营养得分(β=-0.157,P＜0.001)与肌少症得分(β=0.365,P＜0.001)分别对衰弱得分的负向与正向预测作用显著,可联合解释因变量61.2％的变异.Bootstrap法检验结果显示,营养到衰弱路径的总效应、直接效应及中介效应的95％CI均不包括0,肌少症在营养与衰弱之间的中介作用显著,且中介效应的效应值占总效应值的64.0％.结论 肌少症和衰弱在慢性肾脏病患者营养和生活质量间起中介作用,要加强患者营养支持,增强体力,提高患者生存质量.
Abstract
Objective To investigate the mediating role of sarcopenia and frailty between nutrition and quality of life in patients with chronic kidney disease(CKD),providing a reference for formulating targeted in-tervention measures to improve patients'quality of life.Methods 605 patients with CKD were selected using convenience sampling method.Data were collected using a general information questionnaire,the SARC-F questionnaire,the Frail Frailty scale and MNA-SF Mini-nutrition Rating Scale.Results The study found that nutritional scores were negatively correlated with scores of frailty and sarcopenia(r=-0.581,r=-0.561,P＜0.001),while sarcopenia scores were positively correlated with frailty scores(r=0.760,P＜0.001).Further regression analysis highlighted the mediating effect of sarcopenia between nutrition and frail-ty.Equation 1 showed that nutritional scores negatively predicted frailty scores(β=-0.435,P＜0.001),ex-plaining 31.9％of the variance.Equation 2 revealed that nutritional scores negatively predicted sarcopenia scores(β=-0.763,P＜0.001),accounting for 30.8％of the variance.In equation 3,nutritional scores(β=-0.157,P＜0.001)and sarcopenia scores(β=0.365,P＜0.001)significantly predicted frailty scores,to-gether explaining 61.2％of the variance.The Bootstrap method confirmed the significant total,direct,and in-direct effects in the nutrition-frailty pathwaywith sarcopenia's mediating effect accounting for 64.0％of the to-tal effect.Conclusion Sarcopenia and frailty play significant mediating roles between nutrition and quality of life in CKD patients.Healthcare providers should implement personalized interventions based on patients'clin-ical characteristics,emphasizing nutritional support and physical strength enhancement to improve patients'quality of life.
关键词
慢性肾脏病/肌少症/衰弱/营养不良/中介效应Key words
chronic kidney disease/sarcopenia/frailty/malnutrition/mediating effect引用本文复制引用
基金项目
安徽省高等学校科学研究重大项目(2023AH040237)
出版年
2024
NETL
NSTL
万方数据