老年人肌肉减少症发生频率及危险因素分析

Y. Safonova, N. Toroptsova
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摘要

的目标。目的探讨居家老年人肌肉减少症(SP)发生频率及危险因素。材料和方法。该研究包括230名65岁及以上的老人,他们住在家里,并在门诊进行观察。为了检测SP,测量握力并使用双能吸收仪(DXA)测定肌肉质量。根据短物理性能电池(SPPB)和“Up and Go”测试结果诊断为重度SP。根据EWGSOP2(2018)标准诊断SP。实验室检查包括临床和血液生化分析,测定25 (OH) d水平。64.8%的老年人发现可能SP, 28.7%的老年人发现确诊SP, 21.3%的老年人发现严重SP。SP发生率随年龄增加,65 ~ 74岁为19.6%,85岁及以上为52.9% (p <0.05)。多因素分析结果显示,BMI小于25 kg / m2时,SP的发生概率增加(OR 5,459;95% ci: 1939 - 15,369;p = 0.0013), Charlson指数计算的严重合并症(OR 5178;95% ci: 1,597-14,128;p = 0.0030),且25 (OH) D水平小于20 ng / ml (OR 4,989;95% ci: 1321 - 12626;p = 0.0420),总蛋白小于64 g / l (OR 8,567;95% ci: 2658 - 27617;p = 0.00032), CRP大于5 mg / l (OR 14,279;95% ci: 3,511-58,071;p = 0.00020)和中度肾功能降低(GFR <60 ml / min / 1.73 m (OR 12,108;95% ci: 3944 - 37170;p = 0.00001)。在老年人中,SP的检出率较高(28.7%),随年龄的增长而增加。BMI小于25kg / m2, 25(OH)D缺乏,总蛋白水平小于64g / l, CRP大于5mg / l, GFR下降小于60ml / min均与SP的存在相关。
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Frequency and risk factors of sarcopenia in the elderly people
Aim. To determine the frequency and assess the risk factors of sarcopenia (SP) in elderly people living at home.Materials and methods. The study included 230 people aged 65 years and older who lived at home and were observed in outpatient clinic. To detect SP, grip strength was measured and muscle mass was determined using dual-energy absorptiometry (DXA). Severe SP was diagnosed based on the results of Short physical performance battery (SPPB) and the “Up and Go” test. The diagnosis of SP was made according to the criteria of EWGSOP2 (2018). The laboratory examination included clinical and biochemical blood analysis, determination of the level of 25 (OH) D.Results. Probable SP was found in 64.8 %, confirmed SP – in 28.7 %, and severe SP – in 21.3 % of older people. The frequency of SP increased with age from 19.6 % in 65–74 years to 52.9 % in 85 years and older (p <0.05). The results of multivariate analysis showed that the probability of SP increased with a BMI of less than 25 kg / m2 (OR 5,459; 95 % CI: 1,939–15,369; p = 0.0013), severe comorbidity calculated by the Charlson index (OR 5,178; 95 % CI: 1,597–14,128; p = 0.0030) and the presence of such laboratory indicators like level 25 (OH) D less than 20 ng / ml (OR 4,989; 95 % CI: 1,321–12,626; p = 0.0420), total protein less than 64 g / l (OR 8,567; 95 % CI: 2,658–27,617; p = 0.00032), CRP more than 5 mg / l (OR 14,279; 95 % CI: 3,511–58,071; p = 0.00020) and moderately reduced renal function (GFR <60 ml / min / 1.73 m (OR 12,108; 95 % CI: 3,944–37,170; p = 0.00001).Conclusions. Among elderly people, a high frequency (28.7 %) of SP was detected, which increased with age. A BMI of less than 25 kg / m2, a deficiency of 25(OH)D, total protein level of less than 64 g / l and CRP of more than 5 mg / l, a decrease in GFR of less than 60 ml / min were associated with the presence of SP.
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