血清TWEAK和IL-17与老年肌少症的相关性研究  

A study on the correlation between serum TWEAK and IL-17 levels and elderly sarcopenia

作　　者：苏莉 张兆岩 崔娟 孙晓平 于新宇 Su Li;Zhang Zhaoyan;Cui Juan;Sun Xiaoping;Yu Xinyu(Department of Geriatrics,The 960 Hospital of the People's Liberation Army Joint Service Support Force,Shandong Province,Jinan 250031,China)

机构地区：[1]中国人民解放军联勤保障部队第九六〇医院干部病房一科,济南250031

出　　处：《疑难病杂志》2023年第9期967-971,976,共6页Chinese Journal of Difficult and Complicated Cases

基　　金：军委后勤保障部卫生局课题(22BJ248)。

摘　　要：目的探讨血清肿瘤坏死因子样凋亡微弱诱导剂(TWEAK)和白介素-17(IL-17)与老年肌少症的相关性。方法选择2021年10月—2023年3月中国人民解放军联勤保障部队第九六〇医院干部病房一科收治的老年肌少症患者93例为肌少症组,体检志愿者60例为健康对照组。根据骨骼肌质量指数(SMI)、握力和步速将肌少症组患者分为前期亚组(29例)、中期亚组(39例)、严重期亚组(25例)。检测各组血清TWEAK和IL-17水平,Pearson分析TWEAK、IL-17与SMI、握力、步速之间的相关性;多因素Logistic回归分析老年肌少症的危险因素;受试者工作特征曲线(ROC)分析血清TWEAK、IL-17预测老年肌少症的价值。结果肌少症组血清TWEAK、IL-17水平高于健康对照组(t/P=27.192/<0.001、19.823/<0.001),SMI、握力和步速显著低于健康对照组(t/P=8.601/<0.001、8.450/<0.001、13.635/<0.001),血清TWEAK、IL-17水平比较,严重期亚组>中期亚组>前期亚组(F/P=66.493/<0.001、19.902/<0.001),SMI、握力和步速比较,严重期亚组<中期亚组<前期亚组(F/P=19.746/<0.001、86.254/<0.001、32.765/<0.001)。肌少症患者血清TWEAK、IL-17水平与SMI、握力和步速均呈负相关(P<0.01)。骨质疏松、高TWEAK、高IL-17是老年肌少症发病的危险因素,高SMI是其保护因素[OR(95%CI)=1.958(1.216~3.153)、1.650(1.091~2.496)、1.621(1.110~2.366)、0.258(0.086~0.775)]。血清TWEAK、IL-17及二者联合诊断老年肌少症的曲线下面积(AUC)分别为0.734、0.790、0.898,二者联合诊断老年肌少症的AUC大于单独TWEAK、IL17诊断(Z/P=4.210/<0.001、2.865/0.016)。结论老年肌少症患者血清TWEAK、IL-17水平增高,且与骨骼肌质量减少、握力及步速降低有关,联合检测血清TWEAK、IL-17有助于识别老年人肌少症潜在风险。Objective To investigate the correlation between serum tumor necrosis factor like weak inducer of apoptosis(TWEAK)and interleukin-17(IL-17)in elderly sarcopenia.Methods Ninety-three elderly patients with sarcopenia admitted to the Cadre Ward One Department of the 96O Hospital of the Joint Support Force of the Chinese People's Liberation Army from October 2021 to March 2023 were selected as the sarcopenia group,and 60 physical examination volunteers were selected as the healthy control group.Patients in the sarcopenia group were divided into early subgroups(29 cases),intermediate subgroups(39 cases),and severe subgroups(25 cases)based on skeletal muscle mass index(SMI),grip strength,and walking speed.Detect the serum levels of TWEAK and IL-17 in each group,and analyze the correlation between TWEAK and IL-17 with SMI,grip strength,and gait speed by Pearson analysis;Multivariate logistic regression analysis of risk factors for elderly sarcopenia;The value of TWEAK and IL-17 in predicting sarcopenia in the elderly using receiver operating characteristic curve(ROC)analysis.Results The serum levels of TWEAK and IL-17 in the sarcopenia group were higher than those in the healthy control group(t/P=27.192/<0.001,19.823/<0.001),and SMI,grip strength,and walking speed were lower than those in the healthy control group(t/P=8.601/<0.001,8.450/<0.001,13.635/<0.001).The comparison of serum TWEAK and IL-17 levels showed that the severe subgroup>the intermediate subgroup>the early subgroup(t/P=66.493/<0.001,19.902/<0.001),and the comparison of SMI,grip strength,and walking speed,Severe subgroup<intermediate subgroup<early subgroup(t/P=19.746/<0.001,86.254/<0.001,32.765/<0.001).The serum levels of TWEAK and IL-17 in patients with sarcopenia were negatively correlated with SMI,grip strength,and walking speed(P<0.05).Osteoporosis,high TWEAK,and high IL-17 are risk factors for the onset of sarcopenia in the elderly,and high SMI is a protective factor[OR(95%CI)=1.958(1.216-3.153),1.650(1.091-2.496),1.621(1.110-2.366),0.258(0.086-0.775

关 键 词：肌少症 肿瘤坏死因子样凋亡微弱诱导剂 白介素-17 老年人 

分 类 号：R685[医药卫生—骨科学]