摘要
目的探讨老年患者血浆同型半胱氨酸(Hcy)水平与肌少症及认知功能状况的相关性。方法连续入选2017年6月—2020年3月在南京医科大学附属老年医院住院的老年患者346例,采用步行速度、握力、四肢骨骼肌指数(ASMI)切点诊断肌少症,行简易精神状态量表(MMSE)评定认知功能。共入选老年患者346例,其中肌少症122例(35.3%),非肌少症224例(64.7%)。比较老年患者肌少症组、非肌少症组Hcy水平及认知功能差异,分析Hcy水平与肌少症严重程度及认知功能状况之间的关系,多因素分析肌少症相关因素。结果(1)与非肌少症组相比,肌少症组人群的年龄更高(P<0.001),BMI、白蛋白、MMSE评分、受教育程度更低(均P<0.001),Hcy水平更高(P=0.011)。(2)Pearson相关分析显示男性、女性患者的Hcy水平和步速、四肢骨骼肌指数(ASMI)、MMSE评分均呈负相关关系(均P<0.05)。(3)多因素logistic回归分析结果显示,年龄(OR=1.064,95%CI 1.023~1.106,P=0.002)、BMI(OR=0.658,95%CI 0.589~0.734,P<0.001)、受教育程度(OR=0.519,95%CI 0.331~0.812,P=0.004)是肌少症的影响因素。对性别进行分层,受教育程度和BMI是男性肌少症患者的影响因素,Hcy水平、年龄、受教育程度、BMI是女性肌少症患者的影响因素。结论老年患者Hcy水平与肌少症之间存在相关性。高Hcy水平是老年女性肌少症的危险因素,受教育程度高和高BMI是肌少症人群的保护因素。Hcy可作为肌少症的一项监测指标,对疾病的评估、预后预测均有一定的临床意义。
Objective To explore the association of serum homocysteine(Hcy)levels with sarcopenia and cognitive function in elderly inpatients.Methods A total of 346 elderly patients hospitalized in The Affiliated Geriatric Hospital of Nanjing Medical University from June 2017 to March 2020 were selected,including 122 cases(35.3%)with sarcopenia and 224 cases(64.7%)without sarcopenia.Walking speed,grip strength and limb skeletal muscle index(ASMI)were used to diagnose sarcopenia,and MMSE was used to assess cognitive function.The differences in Hcy level and cognitive function between the sarcopenia group and the non-sarcopenia group were compared,the relationship between Hcy level and the severity and cognitive function of sarcopenia was analyzed,and the influencing factors related to sarcopenia were analyzed by multiple factors.Results(1)Compared with the non-sarcopenia group,the sarcopenia group was older and had lower body mass index(BMI),serum albumin level,MMSE score and education level(all P<0.001)and higher Hcy level(P=0.011).(2)Pearson correlation analysis showed that high Hcy level was negatively correlated with low gait speed,low ASMI and low MMSE score(all P<0.05).(3)Multivariate logistic regression analysis revealed that age,high BMI and high education level were related to sarcopenia in total subjects.High education level and high BMI in males and age,high Hcy level,high BMI and high education level in females were associated with the presence of sarcopenia.Conclusions The higher Hcy level in elderly patients with sarcopenia,the more severe the decline of ASMI,gait speed and cognitive function.High Hcy level is a risk factor for sarcopenia in elderly women.High education level and high BMI are protective factors for sarcopenia.Serum Hcy level may be used as a monitoring index for sarcopenia,which has a certain clinical significance in disease evaluation and prognosis prediction.
作者
陆冰
刘晔
陈吉海
顾刘宝
樊垚
欧阳晓俊
LU Bing;LIU Ye;CHEN Ji-hai;GU Liu-bao;FAN Yao;OUYANG Xiao-jun(Department of Geriatrics,Geriatric Hospital of Nanjing Medical University,Nanjing,Jiangsu 210024,China;不详)
出处
《中华全科医学》
2021年第11期1819-1822,共4页
Chinese Journal of General Practice
基金
江苏省卫生健康委保健局科研项目(BJ16025)
江苏省卫生健康委科研项目(H2019038)
南京医科大学科技发展基金(NMUB2020186)。
