老年肌少症人群中血浆褪黑素水平变化的临床分析  

Clinical analysis of the plasma level of melatonin in the elderly patients with sarcopenia

作　　者：周灵杉 张海燕 骆颖[1] 敖小君 刘蓉[1] 杨渊 乔成栋[1] ZHOU Lingshan;ZHANG Haiyan;LUO Yin;AO Xiaojun;LIU Rong;YANG Yuan;QIAO Chengdong(Department of Geriatric Ward 2,the First Hospital of Lanzhou University,Lanzhou 730000,China;Department of Clinical Nutrition,the First Hospital of Lanzhou University,Lanzhou 730000,China;Department of Geriatrics,Nanchong Central Hospital,Nanchong 637000,China;Department of Gastroenterology,the First Hospital of Nanhua University,Hengyang 421000,China)

机构地区：[1]兰州大学第一医院老年病科二病区,甘肃省兰州市730000 [2]兰州大学第一医院营养科,甘肃省兰州市730000 [3]南充市中心医院老年病科,四川省南充市637000 [4]南华大学附属第一医院消化科,湖南省衡阳市421000

出　　处：《实用老年医学》2024年第5期465-469,共5页Practical Geriatrics

基　　金：甘肃省自然科学基金资助项目(21JR7RA372)。

摘　　要：目的探讨老年肌少症人群血浆褪黑素水平变化及其临床意义。方法采取病例对照研究,纳入2022年12月至2023年5月在兰州大学第一医院老年病科就诊的60例老年肌少症病人(≥60岁)作为病例组,以性别1∶1匹配选取同期60例老年非肌少症病人作为对照组,收集2组病人的基本临床资料、肌少症相关指标,以及常规检验指标和血浆褪黑素水平,并进行比较分析。采用Pearson相关系数评估褪黑素水平与肌少症相关指标的相关性,采用多因素Logistic回归分析肌少症的独立相关因素,采用ROC曲线评估褪黑素水平预测肌少症的价值。结果病例组的血浆褪黑素水平明显低于对照组(P<0.01)。血浆褪黑素水平与四肢骨骼肌指数(ASMI)呈正相关(r=0.520,P<0.01)。条件Logistic回归分析结果显示,在校正了性别、年龄、血小板、CRP、营养危险指数(NRI)后,血浆褪黑素水平是肌少症的独立保护因素(OR=0.807,P=0.017)。ROC曲线分析结果显示,血浆褪黑素水平预测肌少症的AUC为0.715(P<0.01),最佳界值为3.2 ng/L,敏感度为76.7%,特异度为68.3%。结论血浆褪黑素水平在老年肌少症人群中明显下降,可作为肌少症的潜在生物标记物。Objective To investigate the level and the clinical significance of plasma level of melatonin in the elderly patients with sarcopenia.Methods A case-control study was conducted.Forty elderly patients with sarcopenia(≥60 years old)who visited Department of Geriatrics,the First Hospital of Lanzhou University from December 2022 to May 2023 were enrolled in the sarcopenia group.Forty elderly patients without sarcopenia in the same period were enrolled in the control group with gender 1∶1 matching condition.The basic clinical data,sarcopenia-related indicators,routine laboratory indicators and plasma level of melatonin were collected and compared between the two groups.Pearson correlation analysis was used to evaluate the correlation between plasma level of melatonin and sarcopenia-related indicators.Multivariate Logistic regression analysis was performed to analyze the independent influencing factors of sarcopenia.And receiver operating characteristic(ROC)curve was used to evaluate the value of melatonin in predicting sarcopenia.Results The plasma level of melatonin in the sarcopenia group was significantly lower than that in the control group(P<0.01).Plasma level of melatonin was positively correlated with appendicular skeletal muscle index(ASMI)(r=0.520,P<0.01).Conditional Logistic regression analysis showed that plasma level of melatonin was an independent protective factor for sarcopenia(OR=0.807,P=0.017).ROC curve showed that the best cut-off value of plasma melatonin level in predicting sarcopenia was 3.2 ng/L,with sensitivity of 76.7%,specificity of 68.3%,and the area under the ROC curve was 0.715(P<0.01).Conclusions The level of plasma melatonin in the elderly patients with sarcopenia is significantly decreased,which can be used as a potential biomarker for sarcopenia.

关 键 词：肌少症 老年人 褪黑素 生物标记物 

分 类 号：R685[医药卫生—骨科学]