Risks of All‐Cause Mortality in Adults With Chronic Kidney Disease With Sarcopenia or Obesity: A Population‐Based Study

作者：Jine Li, Tu Hua, Yuying Zhang, Shiqi Yang, Peng Yu, Jianping Liu · 发表于：Journal of Cachexia Sarcopenia and Muscle · 年份：2025 · DOI：10.1002/jcsm.13828 · 被引用次数：11 · 研究领域：Nutrition and Health in Aging、Dialysis and Renal Disease Management、Chronic Kidney Disease and Diabetes

BACKGROUND: The relationship between obesity, sarcopenic obesity and all-cause mortality in chronic kidney disease (CKD) patients remains controversial. This study aims to investigate the role of low muscle mass and fat mass in the risk of all-cause mortality in CKD patients in the United States. METHODS: This study utilized data from the National Health and Nutrition Examination Survey (NHANES) conducted between 1999-2006 and 2011-2018, including 1553 adults with CKD. Multivariable Cox proportional hazards models were constructed to explore the relationship between sarcopenia, fat mass and all-cause mortality, with nonlinear relationships assessed using restricted cubic splines. Subgroup analyses were conducted based on sex, CKD stages and the presence of sarcopenia. RESULTS: The average age of participants was 58.15 ± 18.48 years, with 45% being male. Sarcopenia was more common in men, non-diabetic individuals and those with lower education levels. During a median follow-up of 119.5 months, 693 deaths from all causes were recorded. After adjusting for multiple variables, sarcopenia was significantly associated with increased all-cause mortality risk in CKD patients (HR 1.21; 95% CI 1.00-1.45, p = 0.047). Participants were categorized based on body mass index (BMI) into normal (reference), sarcopenia only, obesity only and sarcopenic obesity groups. Results showed that obesity alone had a protective effect in CKD Stages I-II (HR 0.45, 95% CI 0.28-0.72, p = 0.001) whereas it ...