Department of Geriatrics, Shanghai Jiaotong University Affiliated Sixth People's Hospital, No. 600, Yi Shan road, Shanghai 200233, China.
Department of Geriatrics, Shanghai Jiaotong University Affiliated Sixth People's Hospital, No. 600, Yi Shan road, Shanghai 200233, China.
Exp Gerontol. 2020 Sep;138:111007. doi: 10.1016/j.exger.2020.111007. Epub 2020 Jun 23.
This study aimed to compare the prognostic value of malnutrition and sarcopenia for mortality in old adults over 80 years.
A prospective analysis was performed in 427 hospitalized old adults. Anthropometric measures and biochemical parameters were carried out for each patient. Sarcopenia was defined according to the revised consensus definition of the European Working Group on Sarcopenia in Older People (EWGSOP2). Malnutrition was defined according to the European Society of Clinical Nutrition and Metabolism (ESPEN) criteria. Mortality data were available for up to 32 months of follow-up.
The overall prevalence of sarcopenia and malnutrition was 35.1% and 19.4%, respectively. The percentage of coexistence of sarcopenia and malnutrition was 12.2%. Of the 427 participants, 83 deaths were reported during the mean follow-up periods of 24.9 months. Compared with non-sarcopenic subjects with well-nutrition, sarcopenic subjects with well-nutrition and non-sarcopenic subjects with well-nutrition had higher mortality risk (Hazard Ratio (HR), 2.36; 95% confidence interval (CI), 1.31-4.24, P < 0.001; HR, 4.33; 95% CI, 2.12-8.85, P = 0.004; respectively). The patients who coexisted with sarcopenia and malnutrition had the highest risk of mortality (HR, 7.31; 95% CI, 4.21-12.69, P < 0.001). Both sarcopenia and malnutrition could predict mortality separately. Still, from the components of the Cox regression multivariate models, the malnutrition was one of the independent factors influencing the death, sarcopenia was not.
When malnutrition and sarcopenia were compared together in a longitude cohort, malnutrition was an independent risk factor for mortality, while sarcopenia was not. The coexistence of malnutrition and sarcopenia showed a synergistically accumulated risk for death.
本研究旨在比较营养不良和肌肉减少症对 80 岁以上老年人死亡率的预后价值。
对 427 名住院老年人进行前瞻性分析。对每位患者进行人体测量测量和生化参数检测。根据欧洲肌肉减少症工作组（EWGSOP2）修订的共识定义，肌肉减少症定义为。根据欧洲临床营养与代谢学会（ESPEN）标准，营养不良定义为。死亡率数据可获得长达 32 个月的随访。
总体而言，肌肉减少症和营养不良的患病率分别为 35.1%和 19.4%。肌肉减少症和营养不良共存的比例为 12.2%。在 427 名参与者中，在平均 24.9 个月的随访期间报告了 83 例死亡。与营养良好的非肌肉减少症患者相比，营养良好的肌肉减少症患者和营养良好的非肌肉减少症患者的死亡率风险更高（风险比（HR），2.36；95%置信区间（CI），1.31-4.24，P<0.001；HR，4.33；95%CI，2.12-8.85，P=0.004；分别）。同时存在肌肉减少症和营养不良的患者的死亡率风险最高（HR，7.31；95%CI，4.21-12.69，P<0.001）。肌肉减少症和营养不良都可以单独预测死亡率。然而，从 Cox 回归多变量模型的组成部分来看，营养不良是影响死亡的独立因素之一，而肌肉减少症不是。
当在纵向队列中同时比较营养不良和肌肉减少症时，营养不良是死亡的独立危险因素，而肌肉减少症不是。营养不良和肌肉减少症共存表现出死亡风险的协同累积。
