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肌少症与直立性低血压的关系。

Relationship between sarcopenia and orthostatic hypotension.

机构信息

Department of Geriatric Medicine, Bezmialem Vakif University, Faculty of Medicine, Istanbul, Turkey.

Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

出版信息

Age Ageing. 2020 Oct 23;49(6):959-965. doi: 10.1093/ageing/afaa077.

Abstract

BACKGROUND

The relationship between sarcopenia and orthostatic hypotension (OH) is unclear.

OBJECTIVES

The aim of the present study was to investigate associations between sarcopenia/sarcopenia severity and OH.

DESIGN

A total of 511 patients attending a geriatric outpatient clinic were included. OH was defined as a decrease in systolic and/or diastolic blood pressure of ≥ 20 mmHg and/or ≥ 10 mmHg, respectively, when one transitions from the supine to an upright position. OH was measured by the Head-up Tilt Table test at 1, 3 and 5 min (OH1, OH3 and OH5, respectively). Sarcopenia and its severity were defined according to the revised European consensus on definition and diagnosis.

RESULTS

The mean age of the sample was 75.40 ± 7.35 years, and 69.9% were female. The prevalence of probable sarcopenia, sarcopenia and severe sarcopenia was 42.2%, 6.06% and 11.1%, respectively. After adjustment for all covariates, systolic OH1, OH1 and systolic OH5 were statistically significantly different between severe sarcopenia and the robust group (odds ratio [OR]: 3.26, confidence interval [CI] 0.98-10.84; P = 0.05 for systolic OH1; OR 4.31, CI 1.31-14.15; P = 0.016 for OH1; OR 4.09, CI 1.01-16.55; P = 0.048 for systolic OH5). Only systolic OH1 was statistically different between the sarcopenia and severe sarcopenia groups (OR 2.64, CI 1.87-8.73; P = 0.012). OH1 and OH5 were statistically significant different between severe sarcopenia and probable sarcopenia groups (P < 0.05); there was no relationship between the robust group and probable sarcopenia (P > 0.05).

CONCLUSIONS

There is a close relationship between sarcopenia and severe sarcopenia and OH in older adults. Therefore, when a healthcare practitioner is evaluating an older patient with sarcopenia, OH should also be evaluated, and vice versa.

摘要

背景

肌少症与直立性低血压(OH)之间的关系尚不清楚。

目的

本研究旨在探讨肌少症/肌少症严重程度与 OH 之间的关系。

设计

共纳入 511 名在老年门诊就诊的患者。OH 定义为从仰卧位转为直立位时收缩压和/或舒张压下降≥ 20mmHg 和/或≥ 10mmHg。OH 通过仰卧倾斜试验在 1、3 和 5 分钟时(分别为 OH1、OH3 和 OH5)进行测量。根据修订后的欧洲肌少症定义和诊断共识,定义肌少症及其严重程度。

结果

样本的平均年龄为 75.40±7.35 岁,69.9%为女性。可能的肌少症、肌少症和严重肌少症的患病率分别为 42.2%、6.06%和 11.1%。调整所有协变量后,严重肌少症与强壮组之间的收缩压 OH1、OH1 和收缩压 OH5 存在统计学差异(比值比 [OR]:3.26,95%置信区间 [CI]:0.98-10.84;P=0.05 用于收缩压 OH1;OR 4.31,CI 1.31-14.15;P=0.016 用于 OH1;OR 4.09,CI 1.01-16.55;P=0.048 用于收缩压 OH5)。只有收缩压 OH1 在肌少症和严重肌少症组之间存在统计学差异(OR 2.64,CI 1.87-8.73;P=0.012)。严重肌少症和可能的肌少症组之间的 OH1 和 OH5 存在统计学差异(P<0.05);强壮组与可能的肌少症之间无关系(P>0.05)。

结论

老年人中肌少症与严重肌少症和 OH 密切相关。因此,当医疗保健提供者评估患有肌少症的老年患者时,也应评估 OH,反之亦然。

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