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在患有严重肥胖症的成年女性中,与肌肉减少症相关变量相关的因素有哪些?

What are the factors associated with sarcopenia-related variables in adult women with severe obesity?

作者信息

Silveira Erika Aparecida, Souza Jacqueline Danesio de, Santos Annelisa Silva E Alves de Carvalho, Canheta Andrea Batista de Souza, Pagotto Valéria, Noll Matias

机构信息

Health Science Post-Graduation Program, Faculty of Medicine, Universidade Federal de Goiás, 1a. s/n - Setor Leste Universitário, Goiânia, Goiás CEP 74605-020 Brazil.

University North of Paraná, Londrina, Brazil.

出版信息

Arch Public Health. 2020 Aug 3;78:71. doi: 10.1186/s13690-020-00454-7. eCollection 2020.

Abstract

BACKGROUND

Understanding the association between sarcopenia-related variables and several risk factors may help to implement interventions aimed at preventing its occurrence by reducing or controlling the identified risk factors. Although changes in body composition occur in both sexes, in women, muscle loss is accentuated due to decreased estrogen levels following menopause. This study aims to determine the factors associated with sarcopenia-related parameters in middle-aged women identified with class II/III obesity (body mass index [BMI] ≥ 35 kg/m).

METHODS

The study included 104 women with severe obesity (40.23 ± 8.49 years) with an average body fat percentage of 52.45 ± 4.14%. Sarcopenia was assessed using total appendicular skeletal muscle mass (ASMM), appendicular skeletal muscle mass index (ASMMI), and appendicular skeletal muscle mass adjusted by BMI (ASMM/BMI) as evaluated using dual energy X-ray absorptiometry (DXA). Hand grip strength (HGS) and HGS adjusted by BMI (HGS/BMI) were evaluated using dynamometry. Functional performance was assessed using the walking speed test (WS). The explanatory variables were age, lifestyle, comorbidities, food consumption, and metabolic parameters. A multivariate linear regression was performed.

RESULTS

Factors associated with sarcopenia-related variables in 104 severely obese women with a mean BMI of 43.85 kg/m were as follows: ASMMI negatively correlated with serum levels of tetraiodothyronine (T4) and tobacco use; ASMM/BMI negatively correlated with age, serum T4 levels, and diabetes; ASMM negatively correlated with T4 serum levels and diabetes; HGS negatively correlated with age and hypercholesterolemia, and positively correlated with low-density lipoprotein cholesterol (LDL-c); HGS/BMI negatively correlated with age and hypercholesterolemia and positively correlated with LDL-c; and WS negatively correlated with hypothyroidism and diabetes.

CONCLUSION

In severely obese women, muscle mass and function were inversely associated with age, smoking status, endocrine parameters, hypercholesterolemia, and comorbidities such as diabetes. Thus, the results of this investigation are relevant in supporting the development of clinical interventions to aid in the prevention of sarcopenia in adult women with severe obesity.

摘要

背景

了解肌肉减少症相关变量与多种风险因素之间的关联,可能有助于通过减少或控制已确定的风险因素来实施旨在预防其发生的干预措施。尽管身体成分的变化在男女中都会出现,但在女性中,由于绝经后雌激素水平下降,肌肉流失会加剧。本研究旨在确定在被诊断为II/III级肥胖(体重指数[BMI]≥35kg/m²)的中年女性中,与肌肉减少症相关参数有关的因素。

方法

该研究纳入了104名重度肥胖女性(40.23±8.49岁),平均体脂百分比为52.45±4.14%。使用双能X线吸收法(DXA)评估的总四肢骨骼肌质量(ASMM)、四肢骨骼肌质量指数(ASMMI)以及经BMI调整的四肢骨骼肌质量(ASMM/BMI)来评估肌肉减少症。使用握力计评估握力(HGS)以及经BMI调整的握力(HGS/BMI)。通过步行速度测试(WS)评估功能表现。解释变量包括年龄、生活方式、合并症、食物摄入和代谢参数。进行了多变量线性回归分析。

结果

在104名平均BMI为43.85kg/m²的重度肥胖女性中,与肌肉减少症相关变量有关的因素如下:ASMMI与血清甲状腺素(T4)水平和吸烟呈负相关;ASMM/BMI与年龄、血清T4水平和糖尿病呈负相关;ASMM与血清T4水平和糖尿病呈负相关;HGS与年龄和高胆固醇血症呈负相关,与低密度脂蛋白胆固醇(LDL-c)呈正相关;HGS/BMI与年龄和高胆固醇血症呈负相关,与LDL-c呈正相关;WS与甲状腺功能减退和糖尿病呈负相关。

结论

在重度肥胖女性中,肌肉质量和功能与年龄、吸烟状况、内分泌参数、高胆固醇血症以及糖尿病等合并症呈负相关。因此,本研究结果有助于支持制定临床干预措施,以帮助预防成年重度肥胖女性的肌肉减少症。

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