老年住院患者肌少症与心脏结构功能的关联性及影响因素分析  

Correlation and influencing factors of sarcopenia with cardiac structure and function in elderly inpatients

作　　者：宋雨[1] 邢怡文 刘盼 潘一鸣 李嘉潼 张亚欣[1] 陈雨濛 李静[1] 马丽娜[1] Song Yu;Xing Yiwen;Liu Pan;Pan Yiming;Li Jiatong;Zhang Yaxin;Chen Yumeng;Li Jing;Ma Lina(Department of Geriatrics,Xuanwu Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学宣武医院老年医学科、国家老年疾病临床医学研究中心,北京100053

出　　处：《中华老年医学杂志》2024年第12期1556-1561,共6页Chinese Journal of Geriatrics

基　　金：国家重点研发计划(2023YFC3605204);北京市属医学科研院所公益发展改革试点项目(JYY2023-13);高层次公共卫生技术人才建设项目(学科骨干-03-14);首都医科大学临床专科学院(系)培养基金开放课题(CCMU2022ZKYXZ007)。

摘　　要：目的探讨老年住院患者肌少症与心脏结构功能的关联及影响因素。方法纳入首都医科大学宣武医院老年医学科住院且年龄≥60岁的老年患者共945例,对患者进行肌少症评估,根据评估结果分为肌少症组和非肌少症组。通过超声心动图及N末端脑钠肽前体(NT-proBNP)评估患者心脏结构及功能。结果患者分为肌少症组185例(19.6%)及非肌少症组760例(80.4%)。肌少症组通过超声心动图测定的左房前后径(LAD)、左室舒张末内径(LVEDD)、左室心肌质量(LVM)、每搏输出量(SV)、心输出量(CO)小于非肌少症组(均P<0.05),NT-proBNP高于非肌少症组(P<0.001)。多因素Logistic回归显示,增龄(OR=1.080,P<0.001)、NT-proBNP升高(OR=1.001,P<0.001)是肌少症的独立危险因素,较高的LAD(OR=0.858,P<0.001)与LVM(OR=0.988,P=0.002)是独立保护因素。NT-proBNP与握力(r=-0.241,P<0.001)、步速(r=-0.215,P<0.001)、简易体能状况量表(SPPB)得分(r=-0.270,P<0.001)、四肢骨骼肌质量(ASM)(r=-0.208,P<0.001)呈负相关,与5次起坐时间(r=0.169,P<0.001)呈正相关;LVM与握力(r=0.213,P<0.001)、ASM(r=0.456,P<0.001)呈正相关;LAD与握力(r=0.071,P=0.029)、ASM(r=0.305,P<0.001)呈正相关。结论肌少症与非肌少症老年患者存在心脏结构及功能的差异,肌少症指标与心脏结构及功能具有相关性。ObjectiveTo investigate the correlation and influencing factors between sarcopenia and cardiac structure and function in elderly inpatients.MethodsA total of 945 elderly patients,aged 60 years and older,were recruited from the Geriatrics Department at Xuanwu Hospital.Sarcopenia was assessed,while cardiac structure and function were evaluated through echocardiography and NT-proBNP measurements.ResultsPatients were classified into two groups:a sarcopenia group(n=185,19.6%)and a non-sarcopenia group(n=760,80.4%).Compared to the non-sarcopenia group,the sarcopenia group exhibited a reduction in left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular mass(LVM),stroke volume(SV),and cardiac output(CO)(all P<0.05).In contrast,NT-proBNP levels were significantly elevated in the sarcopenia group(P<0.001).Multivariate logistic regression analysis identified older age(OR=1.080,P<0.001)and elevated NT-proBNP(OR=1.001,P<0.001)as independent risk factors for sarcopenia.Conversely,higher LAD(OR=0.858,P<0.001)and LVM(OR=0.988,P=0.002)were recognized as independent protective factors.Additionally,NT-proBNP demonstrated a negative correlation with handgrip strength(r=-0.241,P<0.001),gait speed(r=-0.215,P<0.001),SPPB score(r=-0.270,P<0.001),and appendicular skeletal muscle mass(ASM)(r=-0.208,P<0.001),while exhibiting a positive correlation with the 5-time chair stand test(r=0.169,P<0.001).LVM was positively correlated with handgrip strength(r=0.213,P<0.001)and ASM(r=0.456,P<0.001).Furthermore,LAD was positively correlated with handgrip strength(r=0.071,P=0.029)and ASM(r=0.305,P<0.001).ConclusionsNotably,significant differences exist in cardiac structure and function between elderly patients with sarcopenia and those without.Furthermore,indicators related to sarcopenia are correlated with alterations in cardiac structure and function.

关 键 词：肌少症 心脏结构 心功能 老年 

分 类 号：R685[医药卫生—骨科学]