脑小血管病患者体脂百分比与步态特征及跌倒的相关性分析  

Relationship between body fat percentage,gait characteristics and falls in patients with cerebral small vessel disease

作　　者：夏振西 谢鸿阳 夏翠俏 张楠[1] 曹俊杰 赵弘轶 黄勇华[1] Xia Zhenxi;Xie Hongyang;Xia Cuiqiao;Zhang Nan;Cao Junjie;Zhao Hongyi;Huang Yonghua(Department of Neurology,Seventh Medical Center of PLA General Hospital,Beijing 100700,China)

机构地区：[1]解放军总医院第七医学中心神经内科,北京100700

出　　处：《中华脑血管病杂志(电子版)》2024年第6期556-563,共8页Chinese Journal of Cerebrovascular Diseases(Electronic Edition)

基　　金：吴阶平医学基金会临床科研专项资助基金项目(320.6750.18456)。

摘　　要：目的探讨脑小血管病(CSVD)患者体脂百分比(BF)与单任务行走(STW)和双重任务行走(DTW)时步态参数之间的关联,并明确BF与CSVD患者跌倒风险是否存在关联。方法选择2022年1月1日至2023年6月1日于解放军总医院第七医学中心神经内科住院的95例CSVD患者,收集其脂肪质量、BF等数据。男性中BF超过25.7%被视为身体脂肪含量过高,女性患者中这一比例则为35.9%。以此为标准,将入组患者分为正常BF组(46例)和高BF组(49例)。同时在STW及DTW条件下,收集患者基本参数、时相协调指数(PCI)、变异系数(CV)以及步态不对称性(GA)等指标。此外,统计所有参与者的跌倒次数。采用广义估算方程(GEE)以及二元Logistic回归分析验证上述参数的相互关联。结果GEE结果提示,除GA外其余步态参数在组间及组内均存在显著交互作用。事后分析验证参数在组间及组内的差异显示:组间比较,在STW情况下,高BF组患者仅在基础步态参数(STW、认知DTW、运动DTW下的跨步长、跨步时间、步频、速度)和间接步态参数(STW、认知DTW、运动DTW下的跨步时间CV)较正常BF组差异有统计学意义(P均<0.05);组内比较,在DTW情况下,尤其是认知DTW,正常BF组和高BF组所有基础步态参数及间接步态参数相较于STW时均呈现出明显恶化,差异均有统计学意义(P均<0.05)。此外,不论性别如何,BF是跌倒发生的独立危险因素(男性:OR=1.132,95%CI:1.009~1.270;女性:OR=1.145,95%CI:1.058~1.239)。结论CSVD患者中,STW及DTW条件下的步态参数与BF之间存在显著关联,BF亦是跌倒发生的独立危险因素。Objective To investigate the correlation between body fat percentage(BF)and gait parameters during single task walking(STW)and dual task walking(DTW)in patients with cerebral small vessel disease(CSVD),and to determine whether BF is associated with the risk of falls in CSVD patients.Methods A total of 95 hospitalized patients diagnosed with CSVD in Neurology Department of Seventh Medical Center of PLA General Hospital from January 1,2022,to June 1,2023,were collected.Data on their fat mass and BF were collected.High BF was defined as exceeding 25.7%in males and 35.9%in females.Based on this criterion,the enrolled patients were categorized into a normal BF group(46 cases)and a high BF group(49 cases).Additionally,gait parameters such as cadence,stride time,speed,and stride length,as well as phase coordination index(PCI),coefficient of variation(CV),and gait asymmetry(GA)were measured during both STW and DTW conditions.The number of falls was also recorded.Generalized estimating equations(GEE)and binary Logistic regression analyses were conducted to explore the relationship among these parameters.Results The GEE results indicate significant interaction effects for all gait parameters except for GA,both between and within groups.Therefore,post-hoc analyses were conducted to further investigate these differences:between-group comparison showed that during STW,the high BF group had significant differences in the basal gait parameters(STW,cognitive DTW,motor DTW)and indirect gait parameters(STW,cognitive DTW,motor DTW CV)compared to the normal BF group(all P<0.05);within-group comparison indicated that during DTW,particularly cognitive DTW,all basal and indirect gait parameters in normal BF and high BF groups compared with STW,the differences were significant(all P<0.05).Additionally,regardless of gender,BF was identified as an independent risk factor for falls(male:odds ratio=1.132,95%confidence interval:1.009-1.270;female:odds ratio=1.145,95%confidence interval:1.058-1.239).Conclusion There is a significant correlati

关 键 词：脑小血管病 身体成分 体脂 步态 

分 类 号：R743[医药卫生—神经病学与精神病学]