摘要
目的 探讨老年住院患者肌少症与心脏结构功能的关联及影响因素.方法 纳入首都医科大学宣武医院老年医学科住院且年龄≥60岁的老年患者共945例,对患者进行肌少症评估,根据评估结果分为肌少症组和非肌少症组.通过超声心动图及N末端脑钠肽前体(NT-proBNP)评估患者心脏结构及功能.结果 患者分为肌少症组185例(19.6％)及非肌少症组760例(80.4％).肌少症组通过超声心动图测定的左房前后径(LAD)、左室舒张末内径(LVEDD)、左室心肌质量(LVM)、每搏输出量(SV)、心输出量(CO)小于非肌少症组(均P＜0.05),NT-proBNP高于非肌少症组(P＜0.001).多因素Logistic回归显示,增龄(OR=1.080,P＜0.001)、NT-proBNP升高(OR=1.001,P＜0.001)是肌少症的独立危险因素,较高的LAD(OR=0.858,P＜0.001)与LVM(OR=0.988,P=0.002)是独立保护因素.NT-proBNP 与握力(r=-0.241,P＜0.001)、步速(r=-0.215,P＜0.001)、简易体能状况量表(SPPB)得分(r=-0.270,P＜0.001)、四肢骨骼肌质量(ASM)(r=-0.208,P＜0.001)呈负相关,与 5 次起坐时间(r=0.169,P＜0.001)呈正相关;LVM与握力(r=0.213,P＜0.001)、ASM(r=0.456,P＜0.001)呈正相关;LAD 与握力(r=0.071,P=0.029)、ASM(r=0.305,P＜0.001)呈正相关.结论 肌少症与非肌少症老年患者存在心脏结构及功能的差异,肌少症指标与心脏结构及功能具有相关性.
Abstract
Objective To investigate the correlation and influencing factors between sarcopenia and cardiac structure and function in elderly inpatients.Methods A total of 945 elderly patients,aged 60 years and older,were recruited from the Geriatrics Department at Xuanwu Hospital.Sarcopenia was assessed,while cardiac structure and function were evaluated through echocardiography and NT-proBNP measurements.Results Patients were classified into two groups:a sarcopenia group(n=185,19.6％)and a non-sarcopenia group(n=760,80.4％).Compared to the non-sarcopenia group,the sarcopenia group exhibited a reduction in left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),left ventricular mass(LVM),stroke volume(SV),and cardiac output(CO)(all P＜0.05).In contrast,NT-proBNP levels were significantly elevated in the sarcopenia group(P＜0.001).Multivariate logistic regression analysis identified older age(OR=1.080,P＜0.001)and elevated NT-proBNP(OR=1.001,P＜0.001)as independent risk factors for sarcopenia.Conversely,higher LAD(OR=0.858,P＜0.001)and LVM(OR=0.988,P=0.002)were recognized as independent protective factors.Additionally,NT-proBNP demonstrated a negative correlation with handgrip strength(r=-0.241,P＜0.001),gait speed(r=-0.215,P＜0.001),SPPB score(r=-0.270,P＜0.001),and appendicular skeletal muscle mass(ASM)(r=-0.208,P＜0.001),while exhibiting a positive correlation with the 5-time chair stand test(r=0.169,P＜0.001).LVM was positively correlated with handgrip strength(r=0.213,P＜0.001)and ASM(r=0.456,P＜0.001).Furthermore,LAD was positively correlated with handgrip strength(r=0.071,P=0.029)and ASM(r=0.305,P＜0.001).Conclusions Notably,significant differences exist in cardiac structure and function between elderly patients with sarcopenia and those without.Furthermore,indicators related to sarcopenia are correlated with alterations in cardiac structure and function.
维普
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