Abstract:

Objective To explore the relationship between dietary intake and the risk of sarcopenia in patients undergoing peritoneal dialysis（PD），and to analyze the dose-response relationship between them，so as to provide accurate dietary guidance. Methods A 1 ∶ 2 matched case-control study was conducted. A total of 213 PD patients who received regular follow-up in a tertiary hospital in Nanchang from December 2024 to May 2025 were included，with 71 cases in the sarcopenia group and 142 cases in the non-sarcopenia group. Dietary intake was assessed using a 3-day 24-hour recall method，and restricted cubic splines（RCS） were applied to analyze the dose-response relationship. Results There was a non-linear dose-response relationship between energy intake and the risk of sarcopenia （non-linear P=0.029）. When energy intake was less than 1880 kcal/day，the risk of sarcopenia decreased significantly with the increase in dietary intake；when energy intake exceeded this value，the protective effect tended to stabilize. Multivariate analysis showed that high intake of vegetables（OR=1.034） and vitamin C（OR=1.253） increased the risk of sarcopenia，while high intake of tubers（OR=0.868），fruits（OR=0.965），livestock and poultry meat（OR=0.950），total vitamin A（OR=0.955），vitamin B₁（OR=0.991），vitamin D（OR=0.244），and calcium（OR=0.998） had protective effects against sarcopenia. Conclusion There is a threshold effect of energy intake（1 880 kcal/d） in PD patients. Clinical nursing should take ensuring adequate energy intake as the primary goal and optimize the dietary structure. It is recommended to prioritize increasing the intake of protective foods such as tubers，fruits，and livestock and poultry meat，while controlling vegetable intake within 300 g/d to avoid its diluting effect on the intake of key nutrients such as protein.

Key words: Peritoneal Dialysis, Sarcopenia, Case-Control Study, Dose-Response Relationship, Nursing Care

摘要：

目的 探讨腹膜透析患者膳食摄入与肌少症风险的关系，并分析其剂量-反应关系，为医护人员开展饮食指导提供依据。 方法 采取1 ∶ 2配对病例对照设计，纳入2024年12月至2025年5月于南昌市某三级甲等医院规律随访的腹膜透析患者213例（肌少症组71例，非肌少症组142例）。通过3日24 h回顾法评估膳食，采用限制性立方样条分析剂量-反应关系。 结果 能量摄入量与肌少症风险呈非线性剂量-反应关系（P_非线性=0.029）。能量摄入低于1 880 kcal/d（1 kcal=4.184 kJ）时，肌少症风险随饮食摄入增加明显降低，高于此值时保护效应趋于稳定。多因素分析结果显示，蔬菜类（OR=1.034）和维生素C（OR=1.253）过量摄入增加肌少症风险，而薯类（OR=0.868）、水果（OR=0.965）、畜禽肉（OR=0.950）、总维生素A（OR=0.955）、维生素B₁（OR=0.991）、维生素D（OR=0.244）、钙（OR=0.998）足量摄入具有保护作用。 结论 腹膜透析患者能量摄入存在1 880 kcal/d的阈值效应，临床营养护理应确保能量摄入达标并优化膳食结构。建议优先增加薯类、水果、畜禽肉等食物摄入，控制蔬菜摄入在300 g/d以内，以避免其对关键营养素摄入的稀释作用。

关键词: 腹膜透析, 肌少症, 病例对照研究, 剂量-反应关系, 护理