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老年康复住院患者舌肌力、唇肌力与营养相关肌少症的关系:一项横断面研究。

Relationship between tongue strength, lip strength, and nutrition-related sarcopenia in older rehabilitation inpatients: a cross-sectional study.

作者信息

Sakai Kotomi, Nakayama Enri, Tohara Haruka, Kodama Keiji, Takehisa Takahiro, Takehisa Yozo, Ueda Koichiro

机构信息

Department of Rehabilitation Medicine, Setagaya Memorial Hospital.

Department of Dysphagia Rehabilitation, Nihon University School of Dentistry.

出版信息

Clin Interv Aging. 2017 Aug 3;12:1207-1214. doi: 10.2147/CIA.S141148. eCollection 2017.

Abstract

OBJECTIVE

The objective of this study was to clarify the relationship between tongue strength, lip strength, and nutrition-related sarcopenia (NRS).

PATIENTS AND METHODS

A total of 201 older inpatients aged ≥65 years (70 men, median age: 84 years, interquartile range: 79-89 years) consecutively admitted for rehabilitation were included in this cross-sectional study. The main factors evaluated were the presence of NRS diagnosed by malnutrition using the Mini-Nutrition Assessment - Short Form, sarcopenia based on the criteria of the Asian Working Group for Sarcopenia, tongue strength, and lip strength. Other factors such as age, sex, comorbidity, physical function, cognitive function, and oral intake level were also assessed.

RESULTS

In all, 78 (38.8%) patients were allocated to the NRS group, and 123 (61.2%) patients were allocated to the non-NRS group. The median tongue strength and lip strength (interquartile range) were significantly lower in the NRS group (tongue: 22.9 kPa [17.7-27.7 kPa] and lip: 7.2 N [5.6-9.8 N]) compared with the non-NRS group (tongue: 29.7 kPa [24.8-35.1 kPa] and lip: 9.9 N [8.4-12.3 N], <0.001 for both). Multivariable logistic regression analysis showed that NRS was independently associated with tongue strength (odds ratio [OR] =0.93, 95% confidence interval [CI] 0.87-0.98, =0.012) and lip strength (OR =0.76, 95% CI 0.66-0.88, <0.001), even after adjusting for age, sex, comorbidity, physical function, cognitive function, and oral intake level.

CONCLUSION

The likelihood of occurrence of NRS decreased when tongue strength or lip strength increased. Tongue strength and lip strength may be important factors for preventing and improving NRS, regardless of the presence of low oral intake level in older rehabilitation inpatients.

摘要

目的

本研究的目的是阐明舌肌力、唇肌力与营养相关肌少症(NRS)之间的关系。

患者与方法

本横断面研究纳入了201名年龄≥65岁的老年住院患者(70名男性,中位年龄:84岁,四分位间距:79 - 89岁),这些患者因康复治疗而连续入院。评估的主要因素包括使用微型营养评定简表诊断营养不良所确定的NRS的存在情况、基于亚洲肌少症工作组标准的肌少症、舌肌力和唇肌力。还评估了其他因素,如年龄、性别、合并症、身体功能、认知功能和经口摄入量水平。

结果

总共78名(38.8%)患者被分配到NRS组,123名(61.2%)患者被分配到非NRS组。与非NRS组相比,NRS组的中位舌肌力和唇肌力(四分位间距)显著更低(舌肌:22.9 kPa [17.7 - 27.7 kPa],唇肌:7.2 N [5.6 - 9.8 N]),而非NRS组为(舌肌:29.7 kPa [24.8 - 35.1 kPa],唇肌:9.9 N [8.4 - 12.3 N],两者均P<0.001)。多变量逻辑回归分析表明,即使在调整了年龄、性别、合并症、身体功能、认知功能和经口摄入量水平后,NRS仍与舌肌力独立相关(比值比[OR]=0.93,95%置信区间[CI] 0.87 - 0.98,P = 0.012)和唇肌力(OR = 0.76,95% CI 0.66 - 0.88,P<0.001)。

结论

当舌肌力或唇肌力增加时,NRS发生的可能性降低。无论老年康复住院患者经口摄入量水平是否较低,舌肌力和唇肌力可能是预防和改善NRS的重要因素。

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