骨骼肌质量指数、握力及肌肉脂肪比与ASCVD相关性研究  

Correlation among skeletal muscle mass index,grip strength,and muscle-fat ratio,and the risk of atherosclerotic cardiovascular disease

作　　者：史岚平 林青青 刘焕兵[1] 王赎[1] SHI Lanping;LIN Qinqin;LIU Huanbing;WANG Shu(Department of General Medicine and Geriatrics,the First Affiliated Hospital of Nanchang University,Nanchang 330000,China)

机构地区：[1]南昌大学第一附属医院全科与老年医学科,江西南昌330000

出　　处：《中国骨质疏松杂志》2024年第9期1281-1286,1328,共7页Chinese Journal of Osteoporosis

基　　金：中央引导地方科技发展资金(20221ZDG020070)。

摘　　要：目的探讨骨骼肌质量指数(SMI)、握力、肌肉脂肪比(SVR)与中老年住院患者动脉粥样硬化性心血管疾病(ASCVD)风险的相关性。方法纳入2023年1月至2023年7月在南昌大学第一附属医院全科与老年医学科中老年患者469例。根据China-PAR风险预测模型评估10年发生ASCVD风险,分为低、中、高风险3组。测定所有受试者身体成分、握力,并收集相关血液学指标。采用Pearson或Spearman相关性分析探讨SMI、握力、SVR与ASCVD风险相关性。采用多因素Logistic回归分析高风险ASCVD的独立影响因素。结果高风险ASCVD患者更易出现低SMI、低握力和低SVR(P<0.005)。握力和SVR与ASCVD风险呈显著负相关(P<0.001)。在矫正混在因素后,SMI、握力和SVR是65岁以上老年女性人群发生高风险ASCVD的独立危险因素(OR=0.109,95%CI=0.038~0.317,P<0.001;OR=0.899,95%CI=0.824~0.981,P=0.017;OR=0.042,95%CI=0.013~0.140,P<0.001),而握力是65岁以上男性的独立危险因素(OR=0.910,95%CI=0.845~0.980,P=0.013)。结论中老年人群低SMI、低握力和低SVR显著增加10年ASCVD风险,宜早期进行预防和干预。Objective To investigate the correlation among skeletal muscle mass index(SMI),grip strength,the ratio of skeletal muscle mass to visceral fat area(SVR),and the risk of atherosclerotic cardiovascular disease(ASCVD)in middle-aged and elderly inpatients.Methods A total of 469 middle-aged and elderly patients were included from January 2023 to July 2023 in the Department of General Practice and Geriatrics of the First Affiliated Hospital of Nanchang University.The 10-year risk of ASCVD was assessed according to the China-PAR risk prediction model and categorized into low,moderate,and high risk groups.Body composition and grip strength were measured and relevant hematological indicators were collected from all subjects.Pearson or Spearman correlation analysis was used to explore the correlation among SMI,grip strength,SVR,and ASCVD risk.Multifactorial logistic regression was used to analyze the independent influencing factors of high-risk ASCVD.Results Patients at high risk for ASCVD were more likely to have low SMI,low grip strength,and low SVR(P<0.005).Grip strength and SVR were significantly negatively associated with ASCVD risk(P<0.001).After correcting for confounding factors,SMI,grip strength,and SVR decline were independent risk factors for ASCVD in women over 65 years of age(OR=0.109,95%CI=0.038~0.317,P<0.001;OR=0.899,95%CI=0.824~0.981,P=0.017;OR=0.042,95%CI=0.013~0.140,P<0.001).However,grip strength was an independent risk factor for men in this age group(OR=0.910,95%CI=0.845-0.980,P=0.013).Conclusion Low SMI,low grip strength,and low SVR in middle-aged and elderly people significantly increase the risk of 10-year risk of ASCVD.Early prevention and intervention should be carried out.

关 键 词：骨骼肌质量指数 肌少症 心血管风险 肥胖 内脏脂肪 

分 类 号：R592[医药卫生—老年医学]