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血清生长分化因子 15 水平与中老年合并心血管代谢疾病患者的肌肉力量和下肢功能相关。

Serum growth differentiation factor 15 level is associated with muscle strength and lower extremity function in older patients with cardiometabolic disease.

机构信息

Departments of Diabetes, Metabolism, and Endocrinology, Tokyo, Japan.

Cardiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.

出版信息

Geriatr Gerontol Int. 2020 Oct;20(10):980-987. doi: 10.1111/ggi.14021. Epub 2020 Sep 4.

Abstract

AIMS

Sarcopenia is a serious problem because of its poor prognosis. Growth differentiation factor 15 (GDF15) is associated with mitochondrial dysfunction, inflammation, insulin resistance and oxidative stress, which may play crucial roles for the development of sarcopenia. We aimed to examine whether serum GDF15 level is associated with muscle mass, strength and lower extremity function in older patients with cardiometabolic disease.

METHODS

Serum GDF15 levels were measured in 257 patients with cardiometabolic diseases (including 133 patients with diabetes) who had visited the frailty clinic, using a latex turbidimetric immunoassay. Appendicular skeletal muscle index, handgrip strength, timed-up-and-go test and gait speed were evaluated. Power, speed, balance and total scores based on the sit-to-stand test were calculated to assess lower extremity function.

RESULTS

The highest tertile of serum GDF15 was independently associated with low handgrip strength, low gait speed, long timed-up-and-go time and scores of lower extremity function but not an appendicular skeletal muscle index in multiple logistic regression analyses after adjustment for covariates. Patients in the highest tertile of GDF15 were at the risk of having three to nine times lower grip strength, three times lower gait speed, five to six times lower mobility and five to 11 times reduction in lower extremity function as compared with those in the lowest GDF15 tertile dependent on the models.

CONCLUSIONS

Elevated serum GDF15 level was independently associated with low muscle strength and lower extremity function in older patients with cardiometabolic disease. Serum GDF15 could be one of the biomarkers for muscle weakness and low physical performance. Geriatr Gerontol Int 2020; 20: 980-987.

摘要

目的

肌肉减少症预后较差,是一个严重的问题。生长分化因子 15(GDF15)与线粒体功能障碍、炎症、胰岛素抵抗和氧化应激有关,这些可能对肌肉减少症的发生起着关键作用。我们旨在研究血清 GDF15 水平与患有心脏代谢疾病的老年患者的肌肉质量、力量和下肢功能是否相关。

方法

使用胶乳增强免疫比浊法检测了 257 名患有心脏代谢疾病(包括 133 名糖尿病患者)的患者的血清 GDF15 水平,这些患者曾就诊于虚弱门诊。评估了四肢骨骼肌指数、握力、计时起立行走测试和步速。根据坐站测试计算了功率、速度、平衡和总分,以评估下肢功能。

结果

在调整协变量后,多变量逻辑回归分析显示,血清 GDF15 的最高三分位与低握力、低步速、较长的起立行走时间和较低的下肢功能评分独立相关,但与四肢骨骼肌指数无关。与最低 GDF15 三分位相比,GDF15 最高三分位的患者握力降低 3 至 9 倍,步速降低 3 倍,活动能力降低 5 至 6 倍,下肢功能降低 5 至 11 倍,具体取决于模型。

结论

血清 GDF15 水平升高与患有心脏代谢疾病的老年患者的肌肉力量和下肢功能降低独立相关。血清 GDF15 可能是肌肉无力和身体机能下降的生物标志物之一。老年医学与老年病学杂志 2020;20:980-987。

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