腰臀比、肌酸激酶与不同性别老年原发性高血压患者发生肌少症的关系研究  

Relationship between Waist-to-Hip Ratio,Creatine Kinase and Sarcopenia in Elderly Patients with Essential Hypertension of Different Gender

作　　者：蒲喜霞 李维辛[2] 马雄滨 蔡亚男 PU Xixia;LI Weixin;MA Xiongbin;CAI Yanan(The 1st School of Clinical Medicine,Lanzhou University,Lanzhou 730030,China;Department of Geriatrics,the First Hospital of Lanzhou University,Lanzhou 730030,China)

机构地区：[1]兰州大学第一临床医学院,甘肃省兰州市730030 [2]兰州大学第一医院老年病科二病区,甘肃省兰州市730030

出　　处：《实用心脑肺血管病杂志》2025年第1期50-55,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：甘肃省自然科学基金资助项目(22JR5RA925)。

摘　　要：目的腰臀比(WHR)、肌酸激酶(CK)与不同性别老年原发性高血压患者发生肌少症的关系。方法回顾性选取2022—2023年兰州大学第一医院老年病科收治的原发性高血压患者429例作为研究对象,其中男198例,女231例。根据肌少症发生情况将男性患者分为肌少症A组(n=50)和无肌少症A组(n=148),将女性患者分为肌少症B组(n=77)和无肌少症B组(n=154)。收集患者的临床资料,采用多因素Logistic回归分析探讨不同性别老年原发性高血压患者发生肌少症的影响因素;绘制限制性立方样条(RCS)曲线以分析WHR和/或CK与不同性别老年原发性高血压患者发生肌少症的剂量-反应关系。结果肌少症A组与无肌少症A组年龄、高WHR发生率、脂肪肝发生率、ALT、白蛋白(Alb)、TG、HDL-C、空腹血糖(FBG)、CK比较,差异有统计学意义(P<0.05)。肌少症B组与无肌少症B组年龄、高WHR发生率、脂肪肝发生率、CRP、AST、ALT比较,差异有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,高WHR[OR=0.235,95%CI(0.087~0.635)]、HDL-C[OR=12.493,95%CI(2.329~67.005)]、CK[OR=0.981,95%CI(0.970~0.993)]是男性老年原发性高血压患者发生肌少症的独立影响因素(P<0.05);年龄[OR=1.054,95%CI(1.006~1.104)]、高WHR[OR=0.052,95%CI(0.021~0.131)]、脂肪肝[OR=0.235,95%CI(0.091~0.606)]是女性老年原发性高血压患者发生肌少症的独立影响因素(P<0.05)。RCS曲线分析结果显示,WHR、CK与男性老年原发性高血压患者肌少症发生风险均可能存在线性剂量-反应关系(P整体值均<0.001,P非线性值分别为0.170、0.708);WHR与女性老年原发性高血压患者肌少症发生风险具有非线性剂量-反应关系(P整体<0.001,P非线性<0.001)。结论WHR、CK是男性老年原发性高血压患者发生肌少症的独立影响因素,且二者与男性老年原发性高血压患者肌少症发生风险均可能存在线性剂量-反应关系;WHR是女性老年原发性高血压患者发生Objective To discuss the relationship between waist-to-hip ratio(WHR),creatine kinase(CK)and sarcopenia in elderly patients with essential hypertension of different gender.Methods A total of 429 patients with essential hypertension admitted to Department of Geriatrics of the First Hospital of Lanzhou University from 2022 to 2023 were retrospectively selected as the research objects,including 198 males and 231 females.According to the occurrence of sarcopenia,the males were divided into the sarcopenia group A(n=50)and the non-sarcopenia group A(n=148),the females were divided into the sarcopenia group B(n=77)and the non-sarcopenia group B(n=154).The clinical data of patients were collected,and multivariate Logistic regression analysis was used to analyze the influencing factors of sarcopenia in elderly patients with essential hypertension of different gender.Restricted cubic spline(RCS)curve was drawn to explore the dose-response relationship between WHR and/or CK and sarcopenia in elderly patients with essential hypertension of different gender.Results There were statistically significant differences in age,incidence of high WHR,incidence of fatty liver,ALT,albumin(Alb),TG,HDL-C,fasting blood glucose(FBG),and CK between the sarcopenia group A and the non-sarcopenia group A(P<0.05).There were statistically significant differences in age,incidence of high WHR,incidence of fatty liver,CRP,AST and ALT between the sarcopenia group B and the non-sarcopenia group B(P<0.05).Multivariate Logistic regression analysis results showed that,high WHR[OR=0.235,95%CI(0.087-0.635)],HDL-C[OR=12.493,95%CI(2.329-67.005)]and CK[OR=0.981,95%CI(0.970-0.993)]were independent influencing factors of sarcopenia in male elderly patients with essential hypertension(P<0.05),and age[OR=1.054,95%CI(1.006-1.104)],high WHR[OR=0.052,95%CI(0.021-0.131)]and fatty liver[OR=0.235,95%CI(0.091-0.606)]were independent influencing factors of sarcopenia in female elderly patients with essential hypertension(P<0.05).RCS curve analysis results showed that,the

关 键 词：原发性高血压 肌少症 腰臀比 肌酸激酶 影响因素分析 

分 类 号：R544.1[医药卫生—心血管疾病]