肌肉减少性肥胖与老年患者冠心病发病率及死亡风险的相关性研究  

Correlation of sarcopenic obesity with incidence of coronary heart disease and death risk in elderly patients

作　　者：刘海明[1] 张娜[1] 张俊仕[1] Liu Haiming;Zhang Na;Zhang Junshi(Department of Hypertension,Center for Cardiovascular Diseases,First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,Xinjiang Uygur Autonomors Reginn China)

机构地区：[1]新疆医科大学第一附属医院心血管病中心高血压科,乌鲁木齐830054

出　　处：《中华老年心脑血管病杂志》2023年第7期680-683,共4页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

基　　金：新疆维吾尔自治区自然科学基金(2022D01C238)。

摘　　要：目的研究肌肉减少性肥胖(肌少性肥胖)与老年患者冠心病发病率及死亡风险的相关性。方法选取2020年6月至2021年6月于新疆医科大学第一附属医院心内科、内分泌科、老年科就诊的1256例患者,其中冠心病患者452例,依据亚洲肌少症工作组(AWGS)标准将冠心病患者分为肌少性肥胖组184例、非肌少性肥胖组268例。全面评估患者并存疾病及综合征,统计冠心病发病以及死亡情况,采用Cox生存分析探讨肌少性肥胖对死亡的影响。结果肌少性肥胖组患者年龄≥85岁、BMI、跌倒、尿失禁、听力障碍、视力障碍、疼痛、便秘、睡眠障碍、焦虑抑郁发病率均高于非肌少性肥胖组,差异有统计学意义(P<0.05,P<0.01)。肌少性肥胖组Course积分、半定量积分、等级积分、斑块数量均高于非肌少性肥胖组(P<0.05,P<0.01)。随访期间2组共死亡30例(6.64%),死亡原因主要为心源性休克、心力衰竭、心肌梗死、猝死等,肌少性肥胖组总病死率高于非肌少性肥胖组(10.87%vs 3.73%,P=0.003)。校正性别、年龄、基础疾病等因素后,Cox生存分析结果显示,Course积分(OR=1.706,95%CI:1.121~2.595,P=0.013)、半定量积分(OR=1.578,95%CI:1.124~2.215,P=0.008)、等级积分(OR=1.852,95%CI:1.154~2.969,P=0.011)、斑块数量(OR=1.730,95%CI:1.031~2.902,P=0.038)、肌少性肥胖(OR=1.709,95%CI:1.330~2.197,P=0.000)是冠心病患者全因死亡的独立风险预测因素。结论AWGS标准肌少性肥胖与老年冠心病发病密切关联,是导致老年患者死亡的危险因素。Objective To study the relationship of sarcopenic obesity with the incidence rate of coronary heart disease(CHD)and the risk of death in elderly patients.Methods A total of 1256 patients admitted to the Department of Cardiology,Endocrinology and Geriatrics of the First Affiliated Hospital of Xinjiang Medical University from June 2020 to June 2021 were recruited,and 452 of them were identified with CHD.According to the criteria of the Asian Sarcopenia Working Group(AWGS),the CHD patients were divided into sarcopenic(n=184)and non-sarcopenic obesity(n=268)groups.Comorbidities and syndromes of the patients were comprehensively evaluated,the CHD incidence and death were observed,and the effect of sarcopenic obesity on death was studied with Cox survival analysis.Results Older than 85 years,higher BMI,and increased incidences of falls,urinary incontinence,hearing impairment,visual impairment,pain,constipation,sleep disorders,anxiety and depression were observed in the patients in the sarcopenic obesity group than those in the non-sarcopenic obesity group(P<0.05,P<0.01).The sarcopenic obesity group had higher Course score,semi-quantitative score,grade score,and larger number of plaques than the non-sarcopenic obesity group(P<0.05,P<0.01).During the follow-up period,30 patients died(6.64%)in the two groups,with main causes of cardiogenic shock,heart failure,myocardial infarction and sudden death.The total mortality rate was significantly higher in the sarcopenic obesity group than non-sarcopenic obesity group(10.87%vs 3.73%,P=0.003).After adjustment for factors such as gender,age and comorbidities,Cox survival analysis showed that Course score(OR=1.706,95%CI:1.121-2.595,P=0.013),semi-quantitative score(OR=1.578,95%CI:1.124-2.215,P=0.008),grade score(OR=1.852,95%CI:1.154-2.969,P=0.011),plaque number(OR=1.730,95%CI:1.031-2.902,P=0.038),and sarcopenic obesity(OR=1.709,95%CI:1.330-2.197,P=0.000)were independent risk predictors of all-cause mortality in CHD patients.Conclusion Sarcopenic obesity based on AWGS criteria is clo

关 键 词：冠心病 数据相关性 心脏病危险因素 肌少症性肥胖 

分 类 号：R541.4[医药卫生—心血管疾病]