Meng Yongxia, Wu Hongmei, Yang Yi, Du Huanmin, Xia Yang, Guo Xiaoyan, Liu Xing, Li Chunlei, Niu Kaijun
Chinese People's Liberation Army 254 Hospital, Tianjin, China.
Nutritional Epidemiology Institute and School of Public Health, Tianjin Medical University, Tianjin, China.
BMC Musculoskelet Disord. 2015 Aug 19;16:202. doi: 10.1186/s12891-015-0654-7.
Previous studies have found inflammation, growth factors, and androgen signaling pathways all contribute to sarcopenia. However, few studies simultaneously have investigated the association between these potential risk factors and sarcopenia among older people. The aim of the study was to investigate whether elevated levels of inflammatory cytokines combined with low levels of anabolic hormone have a synergy effect on muscle strength and functional decline in older people.
We designed a cross-sectional study of 1,131 subjects aged 60 years and older. Concentrations of serum C-reactive protein, insulin-like growth factor 1 and dehydroepiandrosteronesulphate were assessed using chemiluminescent immunoassays. Handgrip strength was measured using a dynamometer, and physical performance was assessed using a four-meter gait speed and Timed Up and Go test. We defined poor physical performance as a 4-m gait speed <0.8 m/s or Timed Up and Go test ≥13.5 s.
After adjustment for potential confounding factors, in multiple linear regression analysis, C-reactive protein levels are inversely related to handgrip strength (P <0.01), and in multiple logistic regression analysis, C-reactive protein levels are inversely related to poor physical performance (P for trend <0.05) in males, but not in females. After combining three biomarkers, no significant results were observed between biomarker scores and muscle strength or physical performance.
In older males, higher serum C-reactive protein levels, but not insulin-like growth factor 1 and dehydroepiandrosteronesulphate levels, are independently related to lower muscle strength and poor physical performance. In this study we did not observe that a combination of higher catabolic biomarkers and lower anabolic biomarkers were better predictors for muscle strength and physical performance.
以往研究发现,炎症、生长因子和雄激素信号通路均与肌肉减少症有关。然而,很少有研究同时调查这些潜在风险因素与老年人肌肉减少症之间的关联。本研究的目的是调查炎症细胞因子水平升高与合成代谢激素水平降低是否对老年人的肌肉力量和功能下降具有协同作用。
我们设计了一项针对1131名60岁及以上受试者的横断面研究。采用化学发光免疫分析法评估血清C反应蛋白、胰岛素样生长因子1和硫酸脱氢表雄酮的浓度。使用握力计测量握力,并使用4米步态速度和计时起立行走测试评估身体性能。我们将身体性能差定义为4米步态速度<0.8米/秒或计时起立行走测试≥13.5秒。
在对潜在混杂因素进行调整后,多元线性回归分析显示,C反应蛋白水平与握力呈负相关(P<0.01);多元逻辑回归分析显示,男性中C反应蛋白水平与身体性能差呈负相关(趋势P<0.05),而女性中则不然。综合三种生物标志物后,未观察到生物标志物评分与肌肉力量或身体性能之间有显著结果。
在老年男性中,较高的血清C反应蛋白水平,而非胰岛素样生长因子1和硫酸脱氢表雄酮水平,与较低的肌肉力量和较差的身体性能独立相关。在本研究中,我们未观察到较高的分解代谢生物标志物与较低的合成代谢生物标志物相结合能更好地预测肌肉力量和身体性能。