[1]贡歌,万文辉,刘新晖,等.高龄患者共病指数与肌少症的相关性研究[J].中华老年骨科与康复电子杂志,2019,(06):327-331.[doi:10.3877/cma.j.issn.2096-0263.2019.06.005]
 Gong Ge,Wan Wenhui,Liu Xinhui,et al.Correlation between comorbidity index and sarcopenia in elderly patients[J].Chin J Geriatr Orthop Rehabil(Electronic Edition),2019,(06):327-331.[doi:10.3877/cma.j.issn.2096-0263.2019.06.005]
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高龄患者共病指数与肌少症的相关性研究()
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中华老年骨科与康复电子杂志[ISSN:1674-3911/CN:11-9292/R]

卷:
期数:
2019年06期
页码:
327-331
栏目:
临床论著
出版日期:
2019-12-05

文章信息/Info

Title:
Correlation between comorbidity index and sarcopenia in elderly patients
作者:
贡歌1万文辉1刘新晖2殷建2
210002 南京,东部战区总医院干部病房一科1;211100 南京医科大学附属江宁医院骨科2
Author(s):
Gong Ge1 Wan Wenhui1 Liu Xinhui2 Yin Jian2
1Department of Geriatrics,Jinling Hospital, Medical School of Nanjing University, Nanjing 211002, China; 2Department of Orthopedics, the Affiliated Jiangning Hospital with Nanjing Medical University, Nanjing 211100, China
关键词:
肌少症 老年人80以上 共病评估工具
Keywords:
Sarcopenia Aged 80 and over Comorbidity assessment tool
DOI:
10.3877/cma.j.issn.2096-0263.2019.06.005
文献标志码:
A
摘要:
目的 探讨高龄老年患者共病指数与肌少症的相关性。方法 回顾性收集东部战区总医院干部病房2017年6月至2018年6月收治的65例年龄大于80岁的老年住院患者。利用胸部CT测量胸12椎体(T12)椎弓根水平肌肉组织的横截面积(cm2)及肌肉密度(HU)。以T12椎弓根水平肌肉横截面积除以患者身高计算得到胸部骨骼肌指数(TSMI)。分析肌少症和非肌少症组患者Charlson共病指数(CCI)、体重指数(BMI)及实验室指标的差异性,分析肌肉密度及面积在不同年龄、CCI分组及是否卧床患者中方面的差异,并通过多因素回归法分析TSMI与CCI、BMI及年龄的关系。结果 65例高龄老年患者中,80~90岁组的肌肉密度高于90~100岁组,差异具有统计学意义(t=2.294,P<0.05),但肌肉面积的差异无统计学意义;男性和女性之间的肌肉密度差异无统计学意义,而肌肉面积差异有统计学意义(t=4.815,P<0.05);CCI评分6~9分组肌肉密度及肌肉面积均大于评分为10~14分组,差异有统计学意义(t=3.108,P<0.05;t=3.468,P<0.05)。肌少症组与非肌少症组的CCI评分差异有统计学意义(t=7.754,P<0.05)。两组的BMI、血白蛋白、血肌酐、血红蛋白及肌红蛋白差异无统计学意义。TSMI与CCI呈线性相关关系(r=-0.534,P<0.05)。结论 共病指数与高龄老年患者肌少症的发生密切相关。
Abstract:
Objective To explore the correlation between comorbidity index and sarcopenia in elderly patients. Methods Sixty-five elderly patients over 80 years old were included in this study. Chest CT was used to measure the cross-sectional area (cm2) and muscle density (HU) of the muscle tissue at the pedicle level of the 12 thoracic vertebral (T12). The thoracic skeletal muscle index (TSMI) was calculated by dividing the cross sectional area of the T12 pedicle level with the height of the patient. The difference of the Charlson comorbidity index (CCI), BMI and the laboratory indexes of patients with sarcopenia and non sarcopenia were analyzed by t test. The difference of muscle density and area between different age groups, CCI groups and bed rest groups were analyzed also by t test. The relationship between TSMI and CCI, BMI, age were analyzed using multivariate regression analysis. Results All 65 elderly patients were over 80 years old, the muscle density of the 80-90 year old group was higher than that of the 90-100 year old group, the difference was statistically significant (t=2.294, P<0.05), but the difference of muscle area was not statistically significant. The muscle density and muscle area of the patients in the male and female had not significance difference (t=4.815, P<0.05), and the CCI score 6-9 groups. Muscle density and muscle area were larger than those of the 10-14 groups, and the difference was statistically significant (t=3.108, P<0.05; t=3.468, P<0.05). There was a statistically significant difference in CCI score between sarcopenia group and non sarcopenia group (t=7.754, P<0.05). There was no significant difference in BMI, serum albumin, serum creatinine, hemoglobin and myoglobin between the two groups. The linear correlation between TSMI and CCI was statistically significant (r=-0.534, P<0.05). Conclusion The comorbidity index is closely related to the occurrence of sarcopenia in elderly patients.

参考文献/References:

1 Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis:report of the European working group on sarcopenia in older People [J]. Age Ageing, 2010, 39(4): 412-423.
2 Cruz-Jentoft AJ, Bahat G, Bauer JA, et al. Sarcopenia: revised European consensus on definition and diagnosis [J]. Age Ageing, 2019, 48(1): 16-31.
3 Boutin RD, Yao L, Canter RJ, et al. Sarcopenia: current concepts and imaging implications [J]. AJR Am J Roentgenol, 2015, 205(3): W255-W266.
4 von Haehling S, Anker MS, Anker SD. Prevlence and clinical impact of cachexia in chronic illness in Europe, USA, and Japan: facts and numbers update 2016 [J]. J Cachexia Sarcopenia Muscle, 2016, 7(5): 507-509.
5 Calvani R, Joseph AM, Adhihetty PJ, et al. Mitochondrial pathways in sarcopenia of aging and disuse muscle atrophy [J]. Biol Chem, 2013, 394(3): 393-414.
6 Santos VRD, Christofaro DGD, Gomes IC, et al. Relationship between obesity, sarcopenia, sarcopenic obesity, and bone mineral density in elderly subjects aged 80 years and over [J]. Rev Bras Ortop, 2018, 53(3): 300-305.
7 Chen LK, Lee WJ, Peng LN, et al. Recent advances in sarcopenia research in Asia: 2016 update from the Asian working group for sarcopenia [J]. J Am Med Dir Assoc, 2016, 17(8): 767.e1-767.e7.
8 Zemedikun DT, Gray LJ, Khunti K, et al. Patterns of multimorbidity in Middle-Aged and older adults: an analysis of the UK biobank data [J]. Mayo Clin. Proc, 2018, 93(7): 857-866.
9 Ondeck NT, Bovonratwet P, Ibe IK, et al. Discriminative ability for adverse outcomes after surgical management of hip fractures: a comparison of the charlson comorbidity index, elixhauser comorbidity measure, and modified frailty index [J]. J Orthop Trauma, 2018, 32(5): 231-237.
10 Nemec U, Heidinger B, Sokas C, et al. Diagnosing sarcopenia on thoracic computed tomography: quantitative assessment of skeletal muscle mass in patients undergoing transcatheter aortic valve replacement [J]. Acad Radiol, 2017, 24(9): 1154-1161.
11 Chang CD, Wu JS, Mhuircheartaigh JN, et al. Effect of sarcopenia on clinical and surgical outcome in elderly patients with proximal femur fractures [J]. Skeletal Radiol, 2018, 47(6): 771-777.
12 Martin L, Birdsell L, Macdonald N, et al. Cancer cachexia in the age of obesity: skeletal muscle depletion is a powerful prognostic factor, Independent of body mass index [J]. J Clin Oncol, 2013, 31(12): 1539-1547.
13 Recio-Boiles A, Galeas JN, Goldwasser B, et al. Enhancing evaluation of sarcopenia in patients with non-small cell lung cancer (NSCLC) by assessing skeletal muscle index (SMI) at the first lumbar (L1) level on routine chest computed tomography (CT) [J]. Support Care Cancer, 2018, 26(7): 2353-2359.
14 狄娜, 郑嘉堂, 王鹏飞, 等. 北京市老年人慢性病及共病分析 [J]. 中国全科医学, 2018 (3): 265-268.
15 Katz PP, Yelin EH. Prevalence and correlates of depressive symptoms among persons with rheumatoid arthritis [J]. J Rheumatol, 1993, 20(5): 790-796.
16 Ibrahim K, May C, Patel HP, et al. A feasibility study of implementing grip strength measurement into routine hospital practice (GRImP): study protocol [J]. Pilot and feasibility studies, 2016, 2: 27.
17 Dodds RM, Syddall HE, Cooper R, et al. Grip strength across the Life course: normative data from twelve British studies [J]. PLoS One, 2014, 9(12): e113637.
18 Beaudart C, McCloskey E, Bruyère O, et al. Sarcopenia in daily practice: assessment and management [J]. BMC Geriatr, 2016, 16(1): 170.
19 胡世莲, 方向. 老年肌少症的评估及干预 [J]. 中国临床保健杂志, 2017, 20(2): 113-117.
20 Lee CS, Cron DC, Terjimanian MN, et al. Dorsal muscle group area and surgical outcomes in liver transplantation [J]. Clin Transplant, 2014, 28(10): 1092-1098.
21 Joglekar S, Asghar A, Mott SL, et al. Sarcopenia is an Independent predictor of complications following pancreatectomy for adenocarcinoma [J]. J Surg Oncol, 2015, 111(6): 771-775.
22 Larson KJ, Hamlin RJ, Sprung J, et al. Associations between Charlson Comorbidity Index and surgical risk severity and the surgical outcomes in advanced-age patients [J]. Am Surg, 2014, 80(6): 555-560.
23 Toptas M, Yalcin M, Akkoc ?, et al. The relation between sarcopenia and mortality in patients at intensive care unit [J]. Biomed Res Int, 2018: 5263208.
24 Rosário R, Barros R, Padrão P, et al. Body mass index categories and attained height in Portuguese adults [J]. Obes Facts, 2018, 11(4): 287-293.

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备注/Memo

备注/Memo:
基金项目:南京军区医学卫生科研基金(11MA101),全军保健专项课题(17BJZ17),江苏省自然科学基金(SBK2019022658)
更新日期/Last Update: 2019-12-11