成人甲状腺功能减退症患者合并肌少症的危险因素研究  

Study on the risk factors of adult hypothyroidism complicated with sarcopenia

作　　者：杨瑞霞 温子英 杨帆[1] 张琦[1,2] YANG Ruixia;WEN Ziying;YANG Fan;ZHANG Qi(The First Clinical College of Medicine,Gansu University of Chinese Medicine,Lanzhou 730000;Department of Gerontology,Gansu Provincial Hospital,Lanzhou 730000,China)

机构地区：[1]甘肃中医药大学第一临床医学院,甘肃兰州730000 [2]甘肃省人民医院老年医学科,甘肃兰州730000

出　　处：《中国骨质疏松杂志》2024年第7期985-988,1005,共5页Chinese Journal of Osteoporosis

基　　金：国家自然科学基金(81960173,82160166);甘肃中医药大学大学生创新创业基金项目(2022-CX60)。

摘　　要：目的 分析成人甲状腺功能减退症(简称“甲减”)患者肌少症的患病情况及危险因素,为肌少症的早期防治提供思路。方法 选取2022年4月至2023年6月就诊于甘肃省人民医院老年医学科门诊的243例成人原发性甲减患者。记录一般临床资料;检测血清学指标及甲状腺功能;使用生物电阻抗体成分分析仪(型号:BCA-2A)检测体成分脂肪含量(fat content, FM)、骨质量、瘦体重(lean body mass, FFM)、体脂率(body fat percentage, BF%)、骨骼肌质量(appendicular skeletal muscle, ASM)及基础代谢率(basal metabolic rate, BMR);肌少症评估指标有握力、6 m步速、四肢骨骼肌质量指数(appendicular skeletal muscle mass index, ASMI);根据2019年亚洲肌少症工作组诊断标准将患者分为肌少症组和非肌少症组。比较两组一般临床资料和体成分差异,利用Logistic回归分析肌少症发生的危险因素;绘制受试者工作特征(receiver operating characteristic, ROC)曲线。结果 检出肌少症62例(25.5%),其中女性41例。男女性肌少症组患者年龄高于非肌少症组,体质量指数(body mass index, BMI)、FM、骨质量、FFM、BF%及BMR均低于非肌少症组(P<0.05或P<0.01)。年龄越大,BMI、FM、FFM、BMR越低,肌少症的患病风险越高。步速的ROC曲线下面积最大。结论 增龄及BMI、FM、FFM、BMR减低是肌少症的危险因素。Objective To analyze the prevalence and risk factors of sarcopenia in adult patients with hypothyroidism,and to provide ideas for the early prevention and treatment of sarcopenia.Methods A total of 243 adult patients with primary hypothyroidism were selected from the Department of Geriatrics of Gansu Provincial People’s Hospital from April 2022 to June 2023.General clinical data were recorded.Serological indexes and thyroid function were detected.Body compositions,including fat content(FM),bone mass,lean body mass(FFM),body fat percentage(BF%),skeletal muscle mass(ASM),and basal metabolic rate(BMR),were measured with a bioresistive antibody analyzer(Model:BCA-2A).Sarcopenia evaluation indicators included grip strength,6 m stride speed,and appendicular skeletal muscle mass index(ASMI).Patients were divided into sarcopenia group and non-sarcopenia group according to the diagnostic criteria of the Asian Sarcopenia Working Group 2019.The general clinical data and body composition of the two groups were compared.The risk factors of sarcopenia were analyzed with logistic regression.The receiver operating characteristic(ROC)curve was drawn.Results Sarcopenia was detected in 62 cases(25.5%),of which 41 were female.The age of patients in male and female sarcopenia group was higher than that in non-sarcopenia group,and the body mass index(BMI),FM,bone mass,FFM,BF%,and BMR were lower than those in non-sarcopenia group(P<0.05 or P<0.01).The older in age,the lower the BMI,FM,FFM,and BMR,and the higher the risk of developing sarcopenia.The area under the ROC curve of the pace was the largest.Conclusion Aging and decreased BMI,FM,FFM,and BMR are risk factors of sarcopenia.

关 键 词：肌少症 甲状腺功能减退症 体成分 

分 类 号：R581.2[医药卫生—内分泌] R592[医药卫生—内科学]