社区老年人肌少症与非酶糖基化水平和心血管疾病的相关性研究

doi:10.3969/j.issn.1003-9198.2021.09.005

摘要/Abstract

摘要： 目的探讨社区老年人群肌少症的发病特征及其与非酶糖基化水平、常见心血管疾病的相关性。方法纳入符合标准的入住江苏省老年公寓的老年人110例,根据亚洲肌少症工作组指南将其分为肌少症组(n=38)及非肌少症组(n=72)。比较2组人群的临床资料、心血管疾病(心力衰竭、冠心病、高血压)患病情况,采用多因素Logistic回归分析肌少症的危险因素。采用ELISA法进一步检测60例受试者的羧甲基赖氨酸(CML)、晚期糖基化终产物可溶性受体(sRAGE)水平,比较肌少症与非肌少症人群的CML、sRAGE水平及晚期糖基化终产物(AGEs)/sRAGE比值。结果肌少症组的年龄明显大于非肌少症组,而BMI、骨骼肌质量指数(SMI)、握力、4 m步速均显著小于非肌少症组,差异有统计学意义(P＜0.01)。肌少症组的Hb、白蛋白水平显著低于非肌少症组,而CRP、HDL-C水平显著高于非肌少症组,差异均有统计学意义(P＜0.05)。肌少症组合并心力衰竭及冠心病的比例较非肌少症组明显增多(均P＜0.05),2组高血压患病率差异无统计学意义(P>0.05)。在校正性别、年龄、BMI、SMI、Hb、白蛋白、HDL-C、CRP等因素后,多因素Logistic回归分析结果显示,冠心病和心力衰竭并不是肌少症的独立影响因素(P>0.05)。老年肌少症人群的CML水平及AGEs/sRAGE比值较老年非肌少症人群明显升高(P＜0.05),2组sRAGE水平差异无统计学意义(P=0.587)。结论老年肌少症人群CML水平及AGEs/sRAGE比值显著高于老年非肌少症人群。社区老年人群中合并冠心病、心力衰竭病人患肌少症的概率较大。

关键词: 老年人, 心血管疾病, 肌少症, 非酶糖基化

Abstract: Objective To investigate the characteristics of sarcopenia in the community elderly and the correlation between sarcopenia and non-enzymatic glycosylation level and common cardiovascular diseases. Methods A total of 110 participants who lived in Jiangsu Province Elderly Apartment were selected, and they were divided into sarcopenia group (n=38) and non-sarcopenia group (n=72) according to the guidelines of Asian Working Group for Sarcopenia. The clinical data and the incidence rates of cardiovascular diseases (heart failure, coronary heart disease, hypertension) were compared between the two groups, and the risk factors of sarcopenia were evaluated by Logistic regression analysis.The levels of carboxymethyl lysine(CML) and soluble receptor for advanced glycation end products(sRAGE) in 60 subjects were detected by enzyme linked immunosorbent assay, and the levels of CML, sRAGE,advanced glycation end products (AGEs)/sRAGE in sarcopenia group and non-sarcopenia group were compared. Results Compared with non-sarcopenia group, the age, and the levels of C-reaction protein (CRP) and high density lipoprotein cholesterol (HDL-C) in sarcopenia group were significantly higher, while the levels of body mass index (BMI), skeletal muscle mass index (SMI), grip strength, 4 m walking speed, hemoglobin and albumin were significantly lower(P＜0.05 or P＜0.01). The incidence rates of heart failure and coronary heart disease in sarcopenia group were significantly higher than those in non-sarcopenia group (P＜0.05), but there was no difference in the incidence rate of hypertension between the two groups (P>0.05). After adjustment for gender, age, BMI, SMI, HDL-C and CRP, multivariate Logistic regression analysis showed that coronary heart disease and heart failure were not independent influencing factors for sarcopenia in the elderly. The levels of CML and AGEs/sRAGE in sarcopenia population were significantly higher than those in non-sarcopenia population (P＜0.05), and there was no difference in sRAGE level between the two groups (P=0.587). Conclusions The levels of CML and AGEs/sRAGE in the sarcopenia population are significantly higher than those in the non-sarcopenia population. The community elderly with coronary heart disease and heart failure are more likely to suffer from carcopenia.

Key words: aged, cardiovascular disease, sarcopenia, non-enzymatic glywsylation

中图分类号:

R 592

范天舒, 赵文雪, 卢妙, 王向明, 查志敏, 曹雅茹, 郭妍. 社区老年人肌少症与非酶糖基化水平和心血管疾病的相关性研究[J]. 实用老年医学, 2021, 35(9): 910-913.

FAN Tian-shu, ZHAO Wen-xue, LU Miao, WANGXiang-ming, ZHA Zhi-min, CAO Ya-ru, GUO Yan. Correlation between sarcopenia and non-enzymatic glycosylation and cardiovascular disease in the community elderly[J]. Practical Geriatrics, 2021, 35(9): 910-913.

参考文献

[1] CRUZ-JENTOFT A J, BAHAT G, BAUER J, et al. Sarcopenia: revised European consensus on definition and diagnosis[J]. Age Ageing, 2019, 48(4):16-31.
[2] CHEN L K, LIU L K, WOO J, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia[J]. J Am Med Dir Assoc, 2014, 15(2):95-101.
[3] HIDA T, ISHIGURO N, SHIMOKATA H, et al. High prevalence of sarcopenia and reduced legmuscle mass in Japanese patients immediately after a hip fracture[J]. Geriatr Gerontol Int, 2013, 13(2):413-420.
[4] RYU M, JO J, LEE Y, et al. Association of physical activity with sarcopenia and sarcopenic obesity in community-dwelling older adults: the Fourth Korea National Health and Nutrition Examination Survey[J]. Age Ageing, 2013, 42(6):734-740.
[5] LEE W J, LIU L K, PENG L N, et al. Comparisons of sarcopenia defined by IWGS and EWGSOP criteria among older people: results from the I-Lan longitudinal aging study[J]. J Am Med Dor Assoc, 2013, 14(7):528.e1-e7.[6] LAU E M C, LYNN H S H, WOO J W, et al. Prevalence of and risk factors for sarcopenia in elderly Chinese men and women[J]. J Gerontol A Biol Sci, 2005, 60(2):213-216.
[7] PONGCHAIYAKUL C, LIMPAWATTANA P, KOTRUCHIN P, et al. Prevalence of sarcopenia and associated factors among Thai population[J]. J Bone Miner Metab, 2013, 31(3):346-350.
[8] VON HAEHLING S, MORLEY J E, ANKER S D. An overview of sarcopenia: facts and numbers on prevalence and clinical impact[J]. J Cachexia Sarcopenia Muscle, 2010, 1(2):129-133.
[9] DODDS R M, GRANIC A, DAVIES K, et al. Prevalence and incidence of sarcopenia in the very old: findings from the Newcastle 85+ Study[J]. J Cachexia Sarcopenia Muscle, 2017, 8(2):229-237.
[10] NICHOLS S, O’DOHERTY A F, TAYLOR C, et al. Low skeletal muscle mass is associated with low aerobic capacity and increased mortality risk in patients with coronary heart disease - a CARE CR study[J]. Clin Physiol Funct Imaging, 2019, 39(1): 93-102.
[11] ERUSALIMSKY J D. The use of the soluble receptor for advanced glycation-end products (sRAGE) as a potential biomarker of disease risk and adverse outcomes[J]. Redox Biol, 2021, 42: 101958.
[12] DOZIO E, VETTORETTI S, CALDIROLI L, et al. Advanced glycation end products (AGE) and soluble forms of AGE receptor: Emerging Role as Mortality Risk Factors in CKD[J]. Biomedicines, 8(12): 638-649.

[1]	丛晓飞, 李铭麟, 石春来. 老年口腔衰弱与多重用药的关系及干预策略[J]. 实用老年医学, 2024, 38(9): 872-875.
[2]	李毛毛, 张飞, 沈鑫, 李洁华. 老年人口腔衰弱与跌倒关系的研究进展[J]. 实用老年医学, 2024, 38(9): 876-879.
[3]	张飞, 李毛毛, 李铭麟, 王佳贺. 老年人口腔衰弱与抑郁症的相关性研究进展[J]. 实用老年医学, 2024, 38(9): 884-888.
[4]	李江, 邱雁, 王婷, 王丹, 虞一帆, 濮玲丽, 卜玲. 老年肺腺癌病人术前全身免疫炎症指数/血清白蛋白与临床病理特征的相关性研究[J]. 实用老年医学, 2024, 38(9): 893-896.
[5]	戚嘉萤, 殷曈曈, 王芳芳, 张慧, 王丽. 老年人体力活动水平与肌少症发生风险关系的剂量-反应Meta分析[J]. 实用老年医学, 2024, 38(9): 905-910.
[6]	戴静, 崔焱. 糖化血红蛋白变异性与老年2型糖尿病病人认知功能障碍的相关性分析[J]. 实用老年医学, 2024, 38(9): 931-935.
[7]	张星星, 张海洋, 何小菁, 鲁翔. 不同肥胖指标与老年人糖尿病患病风险的调查研究[J]. 实用老年医学, 2024, 38(9): 940-943.
[8]	倪红艳, 陈云, 张其兵, 马一鸣, 解成兰. 电针对老年病人下肢骨科手术围术期认知功能及炎症因子的影响[J]. 实用老年医学, 2024, 38(9): 944-947.
[9]	李晓敏, 李晓林, 栗杰, 吴蕾, 郝冉冉. 老年病人经肛双气囊小肠镜进镜效率及其影响因素研究[J]. 实用老年医学, 2024, 38(9): 958-961.
[10]	蔡荟萃, 陈燕, 王燕, 叶劲军, 朱钰颖. 多形式健康教育模式联合简易呼吸功能锻炼对老年肺癌放疗病人癌因性疲乏及遵医行为的影响[J]. 实用老年医学, 2024, 38(9): 968-972.
[11]	李湘, 栗萱, 田应选. 肺衰老与慢性呼吸系统疾病研究现状及进展[J]. 实用老年医学, 2024, 38(8): 761-765.
[12]	王小娇, 王宁, 崔宏, 叶童, 王晓明. 运动康复对老年轻中度慢性心力衰竭病人的疗效评价[J]. 实用老年医学, 2024, 38(8): 775-778.
[13]	郝世杰, 邹建鹏, 卫晨, 刘清江. 综合呼吸训练对老年帕金森病病人运动减少型构音障碍的影响[J]. 实用老年医学, 2024, 38(8): 783-787.
[14]	向超, 罗彩东. 心电图avL导联T波变化对老年冠心病病人冠脉狭窄程度的诊断价值[J]. 实用老年医学, 2024, 38(8): 788-791.
[15]	李慧颖, 蔡力力, 朱启伟. 血浆N末端脑钠肽前体对高龄左室肥厚病人预后的预测价值[J]. 实用老年医学, 2024, 38(8): 797-801.