肌酐/胱抑素C值与衰弱发生风险的关系  

The relationship between the ratio of creatinine to cystatin C and the risk of debilitation

作　　者：邢辉 朱靖[2] XING Hui

机构地区：[1]山东中医药大学第一临床医学院,山东济南250035 [2]山东中医药大学第二附属医院,山东济南250001

出　　处：《中医临床研究》2025年第2期123-127,共5页Clinical Journal Of Chinese Medicine

基　　金：山东省中医药管理局(2015-121)。

摘　　要：目的:探讨血清肌酐/胱抑素C值(Creatinine/Cystatin C Ratio,CCR)与衰弱发生风险之间的关系,为衰弱的早期识别和预防提供理论依据。方法:从2011年中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS)中收集45岁以上中老年人群的血清CCR,评估其肌肉水平,并收集调查对象的患病情况、日常活动能力、认知功能、感觉障碍、慢性病患病情况等32项信息,计算衰弱指数,评估衰弱状态。使用多因素Logistic回归分析和限制性立方样条模型分析CCR水平与衰弱发生风险之间的关系。结果:本研究共纳入4 039例45岁及以上的中老年人,平均年龄为(59.8±9.4)岁,其中男性群体占57.0%(2 303/4 039),女性群体占43.0%(1 736/4 039);有464例发生衰弱,衰弱患病率为11.5%(464/4 039)。衰弱组与非衰弱组在性别、年龄、婚姻状况、教育水平、吸烟饮酒情况、胱抑素C、CCR方面的差异有统计学意义(P <0.05)。多因素Logistic回归分析结果显示,调整混杂因素后,CCR水平增加1个单位,衰弱发生风险降低78%(OR=0.22,95%CI:0.12~0.41)。与CCR水平最低组(T1组)相比,CCR水平最高组(T3组)衰弱发生风险降低42%(OR=0.58,95%CI:0.45~0.76)。限制性立方样条函数分析结果显示,CCR与衰弱发生风险呈近似“L”型曲线关系,随着肌肉量水平升高,衰弱发生风险降低。结论:CCR与衰弱发生风险密切相关,较低的CCR水平可能影响衰弱进展,二者呈非线性关系。Objective:To investigate the relationship between serum creatinine/cystatin C ratio(CCR)and the risk of debilitation,so as to provide a theoretical basis for the early recognition and prevention of debilitation.Methods:Serum CCR in middle-aged and elderly people over 45 years old was obtained from 2011 China Health and Retirement Longitudinal Study to assess their muscle levels.Moreover,A total of 32 items of information such as disease status,daily activity ability,cognitive function,sensory impairment and chronic disease prevalence of research objects were collected to calculate debilitation index for assessing the debilitation status.The relationship between CCR level and the risk of debilitation was analyzed by multivariate Logistic regression analysis and restricted cubic spline model.Results:A total of 4039 middle-aged and elderly people aged 45 years and above were included in this study.The average age of these research objects was(59.8±9.4)years old,of which 57.0%(2303/4039)were male and 43.0%(1736/4039)were female.There were 464 debilitation patients,with a debilitation prevalence rate of 11.5%(464/4039).There were significant differences between the debilitated group and nondebilitated group in gender,age,marital status,education level,smoking and drinking status,cystatin C,and CCR(P<0.05).The results of multivariate Logistic regression analysis showed that the risk of debilitation was decreased by 78%when CCR level was increased by one unit after adjusting for confounding factors(OR=0.22,95%CI:0.12-0.41).Compared with the group with the lowest CCR level(T1 group),the occurrence risk of debilitation was reduced by 42%(OR=0.58,95%CI:0.45-0.76)in the group with the highest CCR level(T3 group).The result of restricted cubic spline function analysis showed that the relationship between CCR and debilitation risk was approximately“L”shaped curve,and with the increase of muscle mass,the risk of debilitation decreases.Conclusion:CCR is strongly associated with the risk of debilitation,and lower CCR level

关 键 词：肌酐 胱抑素C 衰弱 

分 类 号：R592[医药卫生—老年医学]