健康的社区生活老年男性与女性在肌肉生长抑制素水平和骨骼肌质量之间的关联存在差异。
Healthy community-living older men differ from women in associations between myostatin levels and skeletal muscle mass.
机构信息
Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Rd, Taipei, 11217, Taiwan.
Aging and Health Research Center, National Yang Ming University, No. 155, Sec. 2, Linong St, Taipei, 11221, Taiwan.
出版信息
J Cachexia Sarcopenia Muscle. 2018 Aug;9(4):635-642. doi: 10.1002/jcsm.12302. Epub 2018 Apr 13.
BACKGROUND
Myostatin is a negative regulator of muscle growth but the relationship between serum myostatin levels and muscle mass is unclear. This study investigated the association between serum myostatin levels and skeletal muscle mass among healthy older community residents in Taiwan, to evaluate the potential of serum myostatin as a biomarker for diagnosing sarcopenia and/or evaluating the effect of its treatment.
METHODS
Study data were excerpted from a random subsample of the I-Lan Longitudinal Aging Study population. Serum myostatin levels were determined and categorized into tertiles (low, medium, high). Relative appendicular skeletal muscle mass (RASM) was calculated as appendicular lean body mass by dual-energy X-ray absorptiometry divided by height squared (kg/m ). Low muscle mass was defined as recommended by the Asian Working Group for Sarcopenia.
RESULTS
The analytic study sample comprised 463 adults (mean age: 69.1 years; 49.5% men). Compared with subjects with normal RASM, those with lower RASM were older and frailer, with significantly higher prevalence of malnutrition, lower serum dehydroepiandrosterone (DHEA) levels, and were more likely to have low serum myostatin status. Multivariable logistic regression analysis showed that male sex (OR 3.60, 95% CI 1.30-9.92), malnutrition (OR 4.39, 95% CI 1.56-12.36), DHEA (OR 0.99, 95% CI 0.99-1.00), and low myostatin (OR 3.23, 95% CI 1.49-7.01) were all independent risk factors for low RASM (all P < 0.05). In men, DHEA (OR 0.99, 95% CI 0.98-1.00) and low myostatin (OR 4.89, 95% CI 1.79-13.37) were significantly associated with low RASM (both P < 0.05); however, only malnutrition was associated with low RASM in women (OR 13.59, 95% CI 2.22-83.25, P < 0.05).
CONCLUSIONS
Among healthy community-living older adults, low serum myostatin levels were associated with low skeletal muscle mass in men, but not in women. Our results do not support using serum myostatin levels to diagnose sarcopenia, or to monitor how it responds to treatments. Further research is needed to understand why men apparently differ from women in the interrelationship between their myostatin levels and muscle mass.
背景
肌肉生长抑制素是一种负向调节肌肉生长的物质，但血清肌肉生长抑制素水平与肌肉质量之间的关系尚不清楚。本研究旨在探讨台湾地区健康老年社区居民中血清肌肉生长抑制素水平与骨骼肌质量之间的关系，评估血清肌肉生长抑制素作为诊断肌少症和/或评估其治疗效果的生物标志物的潜力。
方法
研究数据取自宜兰县纵向老龄化研究的随机亚组人群。测定血清肌肉生长抑制素水平并分为三分位（低、中、高）。通过双能 X 射线吸收法计算相对四肢骨骼肌质量（RASM），即四肢瘦体重除以身高的平方（kg/m ）。肌肉质量低定义为亚洲肌少症工作组推荐的标准。
结果
分析研究样本包括 463 名成年人（平均年龄：69.1 岁；49.5%为男性）。与正常 RASM 相比，低 RASM 组年龄更大，身体更虚弱，营养不良的发生率明显更高，血清脱氢表雄酮（DHEA）水平更低，且更有可能处于低血清肌肉生长抑制素状态。多变量逻辑回归分析显示，男性（OR 3.60，95%CI 1.30-9.92）、营养不良（OR 4.39，95%CI 1.56-12.36）、DHEA（OR 0.99，95%CI 0.99-1.00）和低肌肉生长抑制素（OR 3.23，95%CI 1.49-7.01）均为低 RASM 的独立危险因素（均 P<0.05）。在男性中，DHEA（OR 0.99，95%CI 0.98-1.00）和低肌肉生长抑制素（OR 4.89，95%CI 1.79-13.37）与低 RASM 显著相关（均 P<0.05）；然而，只有营养不良与女性的低 RASM 相关（OR 13.59，95%CI 2.22-83.25，P<0.05）。
结论
在健康的社区居住的老年人中，低血清肌肉生长抑制素水平与男性的骨骼肌质量降低有关，但与女性无关。我们的研究结果不支持使用血清肌肉生长抑制素水平来诊断肌少症，或监测其对治疗的反应。需要进一步研究以了解为什么男性和女性之间的肌肉生长抑制素水平与肌肉质量之间的关系存在差异。
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