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肌肉减少症在心血管疾病中的流行情况及其亚型,以及一种新的诊断方法。

The prevalence of sarcopenia and subtypes in cardiovascular diseases, and a new diagnostic approach.

机构信息

Division of Cardiovascular Medicine, Department of Internal Medicine, Kurume University School of Medicine, Kurume, Japan.

Biostatistics Center, Kurume University, Kurume, Japan.

出版信息

J Cardiol. 2020 Sep;76(3):266-272. doi: 10.1016/j.jjcc.2020.03.004. Epub 2020 Apr 16.

Abstract

BACKGROUND

The prevalence of sarcopenia and its subtypes, such as sarcopenic obesity, osteosarcopenia, and osteosarcopenic obesity, is little known in patients with cardiovascular diseases (CVD).

METHODS

Physical, motor functional, and nutritional assessments were performed for 230 community-dwelling (CD) adults who came to receive a physical check-up, and 160 patients with CVD who were admitted to our hospital. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia guidelines. The subtypes of sarcopenia were consecutively diagnosed according to increased body fat percentage and decreased bone density.

RESULTS

The CVD patients had malnutrition when compared to the CD adults. Impaired motor function of the CVD patients occurred in females as compared with males. The prevalence of sarcopenia, osteosarcopenia, and osteosarcopenic obesity was higher in the CVD patients than in the CD adults (16.9% vs. 4.4%, p<0.001; 8.8% vs. 2.6%, p=0.009; and 4.4% vs. 0.9%, p=0.036, respectively). The prevalence of sarcopenia in the participants positively correlated with the serum N-terminal prohormone of brain natriuretic peptide concentration. Sarcopenia in the CVD patients was present in a younger population as compared with sarcopenia in the CD adults. The prevalence odds ratio of sarcopenia in the CVD patients was higher in females (6.40, 95% CI: 2.38-17.25, p<0.001) than males (4.03, 95% CI: 1.02-15.90, p=0.047). Based on the data of this study, we determined a calculation formula to get an index alternative to skeletal muscle index, followed by an easy diagnosis of sarcopenia. The formula was composed of sex, weight, and calf circumference. The sensitivity and specificity for the diagnosis with the index were 80.8% and 95.6%, respectively.

CONCLUSIONS

CVD may accelerate sarcopenia, osteosarcopenia, and osteosarcopenic obesity. Our calculation formula for the easy diagnosis of sarcopenia may help in an early diagnosis and prevent it before worsening the patient's prognosis.

摘要

背景

肌肉减少症及其亚型(如肌少症性肥胖、骨肌减少症和骨肌减少性肥胖)在心血管疾病(CVD)患者中的流行情况鲜为人知。

方法

对 230 名前来接受体检的社区居民(CD)成年人和 160 名因 CVD 住院的患者进行了身体、运动功能和营养评估。根据亚洲肌肉减少症工作组的指南诊断肌肉减少症。根据体脂百分比增加和骨密度降低,连续诊断出肌肉减少症的亚型。

结果

与 CD 成年人相比,CVD 患者存在营养不良。与男性相比,女性 CVD 患者的运动功能受损。与 CD 成年人相比,CVD 患者的肌肉减少症、骨肌减少症和骨肌减少性肥胖的患病率更高(16.9%对 4.4%,p<0.001;8.8%对 2.6%,p=0.009;4.4%对 0.9%,p=0.036)。参与者中肌肉减少症的患病率与血清 N 末端脑钠肽前体浓度呈正相关。与 CD 成年人相比,CVD 患者的肌肉减少症发生在更年轻的人群中。与男性相比,女性 CVD 患者的肌肉减少症患病几率更高(6.40,95%CI:2.38-17.25,p<0.001)。基于本研究的数据,我们确定了一个计算公式,以获得一种替代骨骼肌指数的指标,从而更容易诊断肌肉减少症。该公式由性别、体重和小腿围组成。该指数的诊断敏感性和特异性分别为 80.8%和 95.6%。

结论

CVD 可能会加速肌肉减少症、骨肌减少症和骨肌减少性肥胖。我们用于简易诊断肌肉减少症的计算公式可能有助于早期诊断,并在病情恶化之前预防其发生。

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