老年男性住院患者骨骼肌肌量与维生素D水平的相关性  

Correlation between skeletal muscle mass and vitamin D level in elderly male inpatients

作　　者：茅晓蒙 阮慧娟[1] 杨玲[2] 陆烨君 孙玉婷[1] 汤庆娅[1] MAO Xiao-Meng;RUAN Hui-Juan;YANG Ling;LU Ye-Jun;SUN Yu-Ting;TANG Qing-Ya(Department of Clinical Nutrition,2 Department of Geriatrics,Xinhua Hospital Affiliated to Shanghai Jiao Tong University Medical College,Shanghai 200092,China)

机构地区：[1]上海交通大学医学院附属新华医院临床营养科,上海200092 [2]上海交通大学医学院附属新华医院老年科,上海200092

出　　处：《中华老年多器官疾病杂志》2021年第3期182-185,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：上海交通大学中国医院管理研究院医院发展战略研究所基金(HDSI-2020-B-010);上海市科学技术委员会基金(18441905200)。

摘　　要：目的探讨老年男性住院患者骨骼肌肌量与维生素D水平的关系。方法收集2018年1月至2019年12月在上海交通大学医学院附属新华医院老年科病房住院的老年男性患者152例。收集及测量患者年龄、身高及体质量等资料,计算体质量指数(BMI),采用生物电阻抗法检测四肢骨骼肌肌量(ASM),计算四肢骨骼肌指数(ASMI),测定血清25-羟维生素D[25(OH)D]水平。采用SPSS 25.0软件进行数据分析。组间比较采用χ2检验。结果本研究患者血清25(OH)D水平为(45.2±21.4)nmol/L。严重缺乏组18例(11.8%),缺乏组80例(52.6%),不足组41例(27.0%),充足组13例(8.6%)。肌肉量减少90例(59.2%),肌肉量正常62例(40.8%)。4组ASMI分别为6.3(5.9,6.9)、6.1(6.1,7.4)、6.9(6.4,7.4)、7.6(7.0,7.8),差异有统计学意义(H=14.189;P=0.003);充足组与严重缺乏组、充足组与缺乏组ASMI比较,差异均有统计学意义(P=0.002,0.008)。血清25(OH)D水平(OR=0.976,95%CI 0.958~0.994;P=0.009)是ASMI的独立危险因素,其与ASM呈正相关(r=0.168,P=0.040)。进一步分析发现血清25(OH)D与双上肢骨骼肌肌量无相关性(r=-0.014,P=0.863),但与双下肢骨骼肌肌量呈正相关(r=0.191,P=0.020)。结论老年男性骨骼肌肌量与维生素D营养状况有关,双下肢骨骼肌肌量更易受维生素D水平影响。Objective To investigate the relationship between skeletal muscle mass and vitamin D level in the elderly male inpatients.Methods A total of 152 elderly male patients were collected,who were admitted to the Geriatric Ward of Xinhua Hospital Affiliated to Shanghai Jiaotong University Medical College from January 2018 to December 2019.General data,including height,body mass and age,were collected.Body mass index(BMI)was calculated.Appendicular skeletal muscle mass(ASM)was measured via bioimpedance analysis(BIA).Appendicular skeletal muscle index(ASMI)was calculated.Serum 25-hydroxy vitamin D[25(OH)D]was measured.SPSS 25.0 was used for data analysis.χ2 test was used for data comparison.Results The average of serum 25 hydroxyvitamin D was(45.2±21.4)nmol/L with 18 cases(11.8%)in the severely deficient group,80 cases(52.6%)in the deficient group,41 cases(27.0%)in the insufficient group and 13 cases(8.6%)in the sufficient group.The muscle mass decreased in 90 cases(59.2%)and was normal in 62 cases(40.8%).The appendicular skeletal muscle mass index of the four groups were 6.3(5.9,6.9),6.1(6.1,7.4),6.9(6.4,7.4),and 7.6(7.0,7.8)respectively,the difference being statistically significant(H=14.189;P=0.003),and the differences between the sufficient group and the other 3 groups being statistically significant(P=0.002,0.008).Serum 25(OH)D(OR=0.976,95%CI 0.958-0.994;P=0.009)was positively correlated with ASMI(r=0.168,P=0.040)and was an independent risk factor of ASMI.Further analysis showed that it had no correlation with the muscle mass of the upper limb(r=-0.014,P=0.863),but was positively correlated with the muscle mass of the lower limbs(r=0.191,P=0.020).Conclusion The skeletal muscle mass is related to nutritional status of vitamin D in the elderly males,and the skeletal muscle mass of both lower limbs is more affected by vitamin D levels.

关 键 词：老年人 维生素D 骨骼肌肌量 生物电阻抗法 

分 类 号：R453.3[医药卫生—治疗学]