住院冠心病患者肌肉减少性肥胖的现状及相关因素研究  

Study on the currentstatus and related factors of sarcopenic obesity in hospitalized patients with coronary heart disease

作　　者：魏晓蕾 孙超[2] 苑秋辰 沈雪莉 崔玲玲 黄佳慧 梁涛[1] Wei Xiaolei;Sun Chao;Yuan Qiuchen;Shen Xueli;Cui Lingling;Huang Jiahui;Liang Tao(School of Nursing,Peking Union Medical College,Chinese Academy of Medical Sciences,Beijing 100144,China;Department of Nursing,Beijing Hospital/National Center of Gerontology/Institute of Geriatric Medicine,Chinese Academy of Medical Science,Beijing 100730,China;Department of Cardiology,Beijing Hospital/National Center of Gerontology/Institute of Geriatric Medicine,Chinese Academy of Medical Science,Beijing 100730,China)

机构地区：[1]中国医学科学院北京协和医学院护理学院,北京100144 [2]北京医院护理部国家老年医学中心中国医学科学院老年医学研究院,北京100730 [3]北京医院心血管内科国家老年医学中心中国医学科学院老年医学研究院,北京100730

出　　处：《中国医学前沿杂志(电子版)》2025年第2期48-57,共10页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

基　　金：2023年北京协和医学院护理学院课题(PUMCSON202302);中央高水平医院临床科研业务费(BJ-2023-136)。

摘　　要：目的 分析住院冠心病患者合并肌肉减少性肥胖(sarcopenic obesity,SO)的发生情况及其相关因素。方法 连续选取2023年10月至2024年4月在北京医院心血管内科诊断为冠心病的患者并分为SO组和非SO组。比较两组患者一般资料、生化及检查指标及营养、衰弱风险专项评估结果。将所有P<0.1的自变量纳入二元Logistic回归分析冠心病患者合并SO的相关因素。结果 本研究共纳入冠心病患者343例,其中SO组39例,非SO组304例,合并SO的患病率为11.4%(39/343),其中男性和女性患者患病率分别为10.2%(21/205)、13.0%(18/138)。SO组患者年龄显著大于非SO组,无规律运动习惯、存在吸烟史、饮酒史和糖尿病史的比例更高,文化程度明显低于非SO组(P<0.05),B型利钠肽(BNP)、甘油三酯(TG)、糖化血红蛋白(HBA1c)、低密度脂蛋白胆固醇(LDL-C)、全身免疫炎症指数(SII)和体脂率显著高于非SO组(P<0.05),衰弱、营养和日常生活活动状况较非SO组更差(P<0.05);白细胞(WBC)、高敏肌钙蛋白(hsTNT)、C反应蛋白(CRP)和左心室射血分数(LVEF)差异无统计学意义(P<0.1)。二元Logistic回归分析结果显示,年龄、吸烟史、糖尿病史、衰弱状态、SII、BNP、TG、WBC、hsTNT、CRP以及是否有规律运动习惯是冠心病患者合并SO的相关因素(P<0.05)。结论 冠心病患者合并SO患病率较高,年龄、吸烟史、糖尿病史、衰弱状态、SII、BNP、TG、WBC、hsTNT、CRP以及是否有规律运动习惯是住院冠心病患者合并肌肉减少性肥胖的重要相关因素。Objective To analyze the incidence and associated factors of sarcopenic obesity(SO)in hospitalized patients with coronary artery disease(CAD).Methods Patients diagnosed with CAD in the cardiology department of Beijing Hospital from October 2023 to April 2024 were consecutively enrolled and divided into SO group and non-SO groups.General information,biochemical and examination indicators,and nutritional and frailty risk assessments of the two groups were compared.Variables with P<0.1 in univariate analysis were included in a binary logistic regression to determine factors associated with SO in CAD patients.Results A total of 343 patients with coronary heart disease were included in this study,with 39 in the SO group and 304 in the non-SO group.Patients in the SO group were significantly older than those in the non-SO group.Additionally,the SO group had higher proportions of irregular exercise habits,history of smoking,history of alcohol consumption,and history of diabetes,and a significantly lower education level than the non-SO group(all P<0.05).Patients in the SO group had significantly higher levels of B-type natriuretic peptide(BNP),triglycerides(TG),glycated hemoglobin(HbA1c),low-density lipoprotein cholesterol(LDL-C),systemic immune-inflammatory index(SII),and body fat percentage compared to the non-SO group(P<0.05).Furthermore,the SO group exhibited poorer frailty,nutrition,and activities of daily living statuses than the non-SO group(all P<0.05).There were no significant difference in white blood cell count(WBC),high-sensitivity troponin T(hsTNT),C-reactive protein(CRP),and left ventricular ejection fraction(LVEF)between the two groups,but P values within 0.1.Binary logistic regression analysis revealed that age,history of smoking,history of diabetes,frailty status,SII,BNP,TG,WBC,hsTNT,CRP and regular exercise habits had significant influence on SO in hospitalized CAD patients(P<0.05).Conclusions SO is commonly seen in hospitalized CAD patients.Age,smoking history,diabetes history,frailty status,SII,BNP,TG

关 键 词：肌肉减少性肥胖 冠心病 LOGISTIC回归 

分 类 号：R54[医药卫生—心血管疾病]