肺癌患者肌少症发生率及其影响因素分析  

The incidence of sarcopenia in lung cancer patients and its influencing factors

作　　者：祖爽 郝丽[3] 蒋建华[2] 管石侠[2] 侯丽丽[2] 程靖[2] 杨乐[2] 李会贤[2] 吴寒寒 张宝[2] Zu Shuang;Hao Li;Jiang Jianhua(Dept of Endocrinology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022;Dept of Clinical Nutriology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022;Dept of Nephrology,The Second Affiliated Hospital of Anhui Medical University,Hefei 230601)

机构地区：[1]安徽医科大学第一附属医院内分泌科,合肥230022 [2]安徽医科大学第一附属医院临床营养科,合肥230022 [3]安徽医科大学第二附属医院肾脏内科,合肥230601

出　　处：《安徽医科大学学报》2021年第12期1976-1979,共4页Acta Universitatis Medicinalis Anhui

基　　金：安徽省公益性技术应用研究联动计划项目(编号:1604f0804021)。

摘　　要：目的探讨肺癌患者肌少症的发生率及其影响因素。方法选取肺癌患者78例(肺癌组)和体检人群78例(对照组),以生物电阻抗法行人体成分测量,以身高校正的四肢骨骼肌质量指数(ASMI)定义肌少症。结果肺癌组肌少症发生率(61.5%vs 17.9%,χ^(2)=30.943,P<0.001)及内脏脂肪面积(VFA)(P<0.001)高于对照组,平均蛋白质量、去脂体质量(FFM)、肌肉量(SLM)、四肢骨骼肌量(ASM)及ASMI水平低于对照组(均P<0.05)。肌少症组肺癌患者平均体质量、体质指数(BMI)、蛋白质、FFM、SLM、ASM、ASMI及体脂肪(BFM)低于非肌少症组肺癌患者(均P<0.05)。肺癌患者不同BMI分组间肌少症发生率差异有统计学意义(100%vs 62.5%vs 33.3%,χ^(2)=13.569,P=0.001)。Pearson相关性分析结果显示ASMI与身高、体质量、BMI、蛋白质、FFM、SLM及ASM呈正相关(均P<0.001),与年龄、体脂百分比(PBF)呈负相关(均P<0.05)。二分类Logistic回归分析结果显示高BMI(OR=-1.997,95%CI:0.046~0.400,P<0.001)、高ASM(OR=-2.696,95%CI:0.012~0.389,P=0.003)是肺癌患者并发肌少症的保护因素。结论肺癌患者肌少症发生率高,维持合适的高BMI及ASM水平是肺癌患者发生肌少症的保护因素。Objective To investigate the prevalence of sarcopenia in patients with lung cancer,and to explore the influencing factor in lung cancer patients with sarcopenia.Methods A total of 78 lung cancer patients(lung cancer group)and 78 healthy subjects(control group)were selected.The body measurement of the two groups were measured by bioelectrical impedance method.Height-adjusted appendicular skeletal muscle mass index(ASMI)was used to define sarcopenia.Results The prevalence of sarcopenia in lung cancer patients was higher than that in controls(61.5%vs 17.9%,χ^(2)=30.943,P<0.001).Compared with the control group,the protein,fat free mass(FFM),soft lean mass(SLM),appendicular skeletal muscle mass(ASM)and ASMI levels of the lung cancer group decreased(all P<0.05),while the visceral fat area(VFA)of lung cancer group increased(P<0.001).The weight,body mass index(BMI),protein,FFM,SLM,ASM,ASMI and body fat mass(BFM)of lung cancer patients with sarcopenia were lower than those of lung cancer patients without sarcopenia(all P<0.05).There was a difference in the incidence of sarcopenia between different BMI groups in the lung cancer patients(100%vs 62.5%vs 33.3%,χ^(2)=13.569,P=0.001).Pearson correlation analysis showed that ASMI was positively correlated with height,weight,BMI,protein,FFM,SLM and ASM(all P<0.001),while it was negatively correlated with age and percent body fat(PBF)(all P<0.05).Binary Logistic analysis showed that higher BMI(OR=-1.997,95%CI:0.046-0.400,P<0.001)and higher ASM(OR=-2.696,95%CI:0.012-0.389,P=0.003)were the independent protective factors for the lung cancer patients with sarcopenia.Conclusion Lung cancer patients have higher prevalence of sarcopenia.Higher BMI and higher ASM are the protective factors for the incidence of sarcopenia in patients with lung cancer.

关 键 词：肺肿瘤 肌少症 发生率 影响因素 

分 类 号：R734.2[医药卫生—肿瘤]