慢性疾病稳定期老年患者25-羟维生素D及白介素6与衰弱的相关性研究  

Relationship of 25-Hydroxyvitamin D and Interleukin-6 with Frailty in Hospitalized Elderly Patients with Chronic Disease in the Stable Phase

作　　者：戴靖榕 李婕 何旭 李杨[1,2] 李燕 DAI Jingrong;LI Jie;HE Xu;LI Yang;LI Yan(School of Medicine,Kunming University of Science and Technology,Kunming 650500,China;Department of Geriatrics,the First People's Hospital of Yunnan Province,Kunming 650032,China)

机构地区：[1]昆明理工大学医学院,云南省昆明市650500 [2]云南省第一人民医院老年医学科,云南省昆明市650032

出　　处：《中国全科医学》2021年第36期4599-4606,共8页Chinese General Practice

基　　金：国家自然科学基金资助项目(81760109);国家重点研发计划(2018YFC2002103);云南省卫生科技计划项目(2017NS221,2017NS222);云南省临床医学开发项目(2019LCZXKF-NM08)。

摘　　要：背景随着我国人口老龄化加剧,老年衰弱问题日益严峻,而当前存在关于衰弱的诊断依据不客观、发病机制不清楚、干预方式不健全等问题,因此,当前对衰弱的研究仍处在初级阶段。目的研究慢性疾病稳定期老年患者25-羟维生素D、白介素6与衰弱的相关性,探寻衰弱的客观诊断依据及新的干预方式。方法选取2020年11月至2021年4月在云南省第一人民医院老年医学科住院的慢性疾病稳定期老年患者152例为研究对象。收集患者一般资料及实验室检查指标,并采用云南省第一人民医院老年医学科自主研发的“老年综合评估系统软件平台(住院版)”对患者进行老年综合评估,利用其中Fried表型对患者进行衰弱状态评估。结果152例患者中,无衰弱47例(30.9%)、衰弱前期51例(33.6%)、衰弱期54例(35.6%)。二元Logistic回归分析结果显示,失能〔OR=6.162,95%CI(1.091,34.789),P=0.039〕、25-羟维生素D〔OR=0.901,95%CI(0.825,0.985),P=0.022〕、白介素6〔OR=1.103,95%CI(1.012,1.201),P=0.025〕是慢性疾病稳定期老年患者衰弱的影响因素。结论25-羟维生素D是慢性疾病稳定期老年患者衰弱的保护因素,白介素6是慢性疾病稳定期老年患者衰弱的危险因素;25-羟维生素D、白介素6有望成为预测及干预慢性疾病稳定期老年患者衰弱的潜在靶点。Background Frailty-related issue is increasingly prominent with the acceleration of aging in China.However,domestic research on frailty is still in its infancy characterized by non-objective diagnosis basis,unclear pathogenesis and imperfect interventions.Objective To investigate the correlation of 25-hydroxyvitamin D and interleukin-6 with frailty in elderly patients with chronic disease in the stable phase,to explore objective diagnostic basis and new interventions for frailty.Methods A total of 152 inpatients(≥60 years old)with chronic disease in the stable phase were recruited from Department of Geriatrics,the First People's Hospital of Yunnan Province(hereinafter referred to as“the department of the hospital”)from November 2020 to April 2021.Clinic and laboratory data were collected.Comprehensive geriatric assessment was conducted via an internet-based platform of the Comprehensive Geriatric Assessment(inpatient version)developed by the department of the hospital,among which frailty was assessed by the Chinese version of Fried Frailty Phenotype,a component of the assessment scale.Results Among the 152 patients,47(30.9%)had no frailty,51(33.6%)had pre-frailty and 54(35.6%)had frailty.According to the binary Logistic regression analysis,disability〔OR=6.162,95%CI(1.091,34.789),P=0.039〕,25-hydroxyvitamin D〔OR=0.901,95%CI(0.825,0.985),P=0.022〕and interleukin-6〔OR=1.103,95%CI(1.012,1.201),P=0.025〕were influencing factors for frailty in elderly patients with chronic disease in the stable phase.Conclusion Sufficient 25-hydroxyvitamin D may be associated with decreased risk of frailty and elevated interleukin-6 may be associated with increased risk of frailty in elderly patients with chronic disease in the stable phase.So these two indicators may be potential targets for predicting and treating frailty.

关 键 词：衰弱 老年人 慢性病 25-羟维生素D 维生素D 白介素-6 

分 类 号：R151.1[医药卫生—营养与食品卫生学]