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卒中后患者中与卒中相关的肌肉减少症的流行情况及其与口腔健康不良的关系:对口腔肌肉减少症的影响。

Prevalence of stroke-related sarcopenia and its association with poor oral status in post-acute stroke patients: Implications for oral sarcopenia.

机构信息

Department of Dental Surgery, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.

Department of Rehabilitation Medicine, Kumamoto Rehabilitation Hospital, Kumamoto, Japan.

出版信息

Clin Nutr. 2018 Feb;37(1):204-207. doi: 10.1016/j.clnu.2016.12.002. Epub 2016 Dec 10.

Abstract

BACKGROUND & AIMS: The aim of the study was to investigate the prevalence of stroke-related sarcopenia and its association with poor oral status in post-acute stroke patients.

METHODS

This cross-sectional study included 202 consecutive stroke patients who were admitted to convalescent rehabilitation wards in Japan. The Revised Oral Assessment Guide (ROAG) was used to assess oral status. Sarcopenia was defined as a loss of skeletal muscle mass index (SMI) with bioelectrical impedance and decreased muscle strength as measured by handgrip strength; cut-off values were adopted from the Asian Working Group for Sarcopenia. Univariate and multivariate analyses were applied to examine the associations between oral status, SMI, and HG.

RESULTS

Study participants included 107 males and 95 females with a mean age of 72 ± 12 years. According to the ROAG, 82.2% of participants had slight to severe oral problems (median score: 11 [9-14]). The prevalence of stroke-related sarcopenia was 53.5%. Both SMI (mean: 6.1 ± 1.3) and handgrip strength (median: 15 [7-25]) were significantly lower in the group with oral problems (SMI = 5.8 ± 1.2, handgrip strength = 12 [6-20]) compared to individuals without oral problems (SMI = 7.4 ± .8, handgrip strength = 27 [23-34]) (p < .001). The ROAG score was independently associated with SMI and handgrip strength, after adjusting for sex, age, stroke severity, activities of daily living, cognitive level, nutritional status, comorbidities, and time from stroke onset.

CONCLUSIONS

Poor oral status was associated with sarcopenia, reduced muscle mass and strength in post-acute stroke patients. Poor oral status and stroke-related sarcopenia were very common among the patients in this study, suggesting that healthcare providers should monitor for oral sarcopenia in post-acute stroke patients.

摘要

背景与目的

本研究旨在调查急性脑卒中后患者中与脑卒中相关的肌肉减少症的流行情况及其与口腔状况不良的关系。

方法

本横断面研究纳入了 202 例连续入住日本康复病房的急性脑卒中患者。采用修订后的口腔评估指南(ROAG)评估口腔状况。肌肉减少症定义为骨骼肌质量指数(SMI)通过生物电阻抗降低和握力(手部力量)降低,采用亚洲肌肉减少症工作组的临界值。采用单因素和多因素分析方法,探讨口腔状况、SMI 和 HG 之间的关系。

结果

研究对象包括 107 名男性和 95 名女性,平均年龄为 72±12 岁。根据 ROAG,82.2%的参与者有轻度至重度口腔问题(中位数评分:11[9-14])。与脑卒中相关的肌肉减少症的患病率为 53.5%。有口腔问题的患者的 SMI(平均值:6.1±1.3)和握力(中位数:15[7-25])均显著低于无口腔问题的患者(SMI=5.8±1.2,握力=12[6-20])(p<0.001)。在校正性别、年龄、脑卒中严重程度、日常生活活动能力、认知水平、营养状况、合并症和脑卒中发病时间后,ROAG 评分与 SMI 和握力独立相关。

结论

口腔状况不良与急性脑卒中后患者的肌肉减少症、肌肉质量和力量下降有关。本研究中的患者口腔状况不良和与脑卒中相关的肌肉减少症非常常见,这表明医疗保健提供者应在急性脑卒中后患者中监测口腔肌肉减少症。

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