肌肉减少症患者血清AMPK-αmRNA、SIRT1、GDF-8的水平及其临床意义  

Serum AMPK-α mRNA,SIRT1 and GDF-8 levels in patients with sarcopenia

作　　者：王琴[1] 林萍[1] 任谦[1] 冯莉[1] 谢晓枫 张彬 高康璐 WANG Qin;LIN Ping;REN Qian;FENG Li;XIE Xiao-feng;ZHANG Bin;GAO Kang-lu(Department of the Geriatrics,Hangzhou Third People’s Hospital,Hangzhou,Zhejiang 310009,China)

机构地区：[1]杭州市第三人民医院老年科,浙江杭州310009

出　　处：《中华全科医学》2022年第7期1151-1154,1229,共5页Chinese Journal of General Practice

基　　金：浙江省医药卫生科技计划项目(2019KY502);杭州市卫生计生科技计划项目(2018A29,2018Z05)。

摘　　要：目的研究肌少症患者血清腺苷酸活化蛋白激酶-α微小RNA(AMPK-αmRNA)、血清沉默信息调节因子2相关酶1(SIRT1)及血清生长分化因子-8(GDF-8)的水平。方法选择2019年1月—2020年6月杭州市第三人民医院收治的老年患者81例,根据四肢肌肉质量指数、握力及步行速度将患者分为肌肉减少症组(41例)和非肌肉减少症组(40例),检测血清AMPK-αmRNA、SIRT1及GDF-8等。采用Pearson、Spearman相关性分析相关性;采用ROC曲线分析GDF-8的诊断价值。结果肌少症组与非肌少症组患者各项指标[AMPK-αmRNA:0.26(0.24,0.29)vs.0.29(0.27,0.32);SIRT1(ng/L):582.68±35.92 vs.646.50±39.08;GDF-8(μg/L):20.97±5.10 vs.14.76±1.59]比较差异均有统计学意义(均P<0.001)。SIRT1、AMPK-αmRNA与GDF-8呈负相关(P<0.001,P=0.001)。握力与AMPK-αmRNA及SIRT1呈正相关(P=0.028,P<0.001);握力与GDF-8呈负相关(P=0.001)。GDF-8诊断肌少症的临界值是17.25μg/L,AUC值为0.884(P=0.040)。结论肌少症患者AMPK-αmRNA及SIRT1降低,GDF-8增高,GDF-8可作为肌少症诊断的辅助参考指标。Objective To investigate the level of serum AMP-activated protein kinase-α mRNA(AMPK-α mRNA),silent mating type information regulation 2 homolog-1(SIRT1)and growth differentiation factor-8(GDF-8)in patients with sarcopenia.Methods A total of 81 elderly patients treated in Hangzhou Third People’s Hospital from January 2019 to June 2020 were selected.According to appendicular skeletal mass index(ASMI),grip strength and walking speed,the patients were divided into sarcopenia group(41 cases)and non-sarcopenia group(40 cases).The level of AMPK-α mRNA,SIRT1 and GDF-8 in serum were detected.The correlation was analyzed by Pearson and Spearman correlation.The diagnostic value of GDF-8 was analyzed by ROC curve.Results The data of several indexes of patients in sarcopenia group and non sarcopenia group were as follows[AMPK-αmRNA:0.26(0.24,0.29)vs.0.29(0.27,0.32),SIRT1(ng/L):582.68±35.92 vs.646.50±39.08,GDF-8(μg/L):20.97±5.10 vs.14.76±1.59],the difference was statistically significant(all P<0.01).SIRT1 and AMPK-αmRNA were negatively correlated with GDF-8(P<0.001,P=0.001).The grip strength was positively correlated with AMPK-αmRNA and SIRT1(P=0.028,P<0.001),and was negatively correlated with GDF-8(P=0.001).The critical value of GDF-8 for the diagnosis of sarcopenia was 17.25μg/L,and AUC was 0.884(P=0.040).Conclusion AMPK-αmRNA and SIRT1 are decreased and GDF-8 is increased in sarcopenia group.GDF-8 can be used as an auxiliary reference index for the diagnosis of sarcopenia.

关 键 词：肌肉减少症 腺苷酸活化蛋白激酶-α微小RNA 血清沉默信息调节因子2相关酶1 生长分化因子-8 

分 类 号：R685[医药卫生—骨科学]