骨骼肌减少症与老年患者心脏结构及功能的相关性研究  

Correlation of skeletal muscle atrophy with cardiac structure and function in elderly patients

作　　者：钱锦华 曹超 徐敏[1] 左迪迪 曹洁[2] 张婷[2] 翁玉蓉[2] 胡耀敏[2] Qian Jinhua;Cao Chao;Xu Min;Zuo Didi;Cao Jie;Zhang Ting;Weng Yurong;Hu Yaomin(Department of Geriatric Medicine,Huangshan City People's Hospital,Huangshan 245000,China;Department of Geriatric Medicine,Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai 200127,China)

机构地区：[1]黄山市人民医院老年医学科,245000 [2]上海交通大学医学院附属仁济医院老年医学科,上海200127

出　　处：《中华老年病研究电子杂志》2024年第3期14-18,共5页Chinese Journal of Geriatrics Research(Electronic Edition)

基　　金：国家自然科学基金项目(U22A20287)

摘　　要：目的探讨骨骼肌质量与心脏结构及功能之间的相关性。方法收集2021年5月至2023年8月就诊于上海交通大学医学院附属仁济医院老年医学科的911例年龄在60岁及以上患者的一般资料、化验检查及体成分指标,并结合超声心动图评估心脏结构和功能。采用Logistic回归模型分析肌少症对心脏结构和功能相关指标的影响,进一步采用Pearson相关性分析法分析骨骼肌质量指数与心脏结构和功能指标的相关性。结果911例患者中183例(20.1%)被诊断为肌少症。肌少症组与非肌少症组左室舒张末期内径、左室收缩末期内径、左房内径、左室后壁厚度、室间隔厚度、B型脑钠肽(BNP)差异具有统计学意义(P<0.05)。Logistic回归分析结果显示,肌少症对患者心脏结构相关指标如左房内径、室间隔厚度、左室舒张末期内径、左室收缩末期内径、左室后壁厚度存在一定的影响(P<0.01),而对心脏功能相关指标左室心内膜缩短分数、左室射血分数和BNP未见显著影响(P>0.05)。Pearson相关性分析结果显示,183例肌少症患者中,四肢骨骼肌质量指数与左房内径(r=0.185,95%CI:0.041~0.321,P<0.05)、室间隔厚度(r=0.338,95%CI:0.203~0.461,P<0.01)、左室舒张末期内径(r=0.285,95%CI:0.146~0.413,P<0.01)、左室收缩末期内径(r=0.247,95%CI:0.105~0.378,P<0.01)、左室后壁厚度(r=0.436,95%CI:0.301~0.546,P<0.01)存在相关性。结论骨骼肌质量与心脏结构和功能之间存在相关性,可作为预测心血管疾病的独立危险因素。Objective To explore the correlation of skeletal muscle mass with cardiac structure and function.Methods General information,laboratory tests and body composition indicators of 911 patients aged 60 and above who visited the Department of Geriatrics in Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from May 2021 to August 2023 were collected.The cardiac structure and function were evaluated using echocardiography.Logistic regression was used to analyze the impact of sarcopenia on cardiac structure and function,and Pearson correlation analysis was further used to analyze the correlation of skeletal muscle mass index with cardiac structure and function indicators.Results Out of 911 patients,183(20.1%)were diagnosed with sarcopenia.The differences in left ventricular end diastolic internal diameter,left ventricular end systolic internal diameter,left atrial internal diameter,left ventricular posterior wall thickness,interventricular septal thickness,and brain natriuretic peptide were statistically significant between the sarcopenia group and the non-sarcopenia group(P<0.05).Logistic regression analysis showed that there was some effect of sarcopenia on the patient&apos;s cardiac structure-related indexes such as left atrial internal diameter,interventricular septal thickness,left ventricular end diastolic internal diameter,left ventricular end systolic internal diameter,and left ventricular posterior wall thickness(P<0.01),while no significant effect was seen on the cardiac function-related indexes such as left ventricular endocardial shortening fraction,left ventricular ejection fraction,and brain natriuretic peptide(P>0.05).Pearson&apos;s correlation analysis showed that in 183 patients with sarcopenia,appendicular skeletal muscle mass index was associated with the left atrial internal diameter(r=0.185,95%CI:0.041-0.321,P<0.05),interventricular septal thickness(r=0.338,95%CI:0.203-0.461,P<0.01),left ventricular end diastolic internal diameter(r=0.285,95%CI:0.146-0.413,P<0.01),left ven

关 键 词：骨骼肌减少症 老年人 骨骼肌质量 心脏结构 心功能 

分 类 号：R685.5[医药卫生—骨科学] R685[医药卫生—外科学]