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肌肉功能低下的老年人骨骼与左心室质量的相互作用

Interaction of Skeletal and Left Ventricular Mass in Older Adults with Low Muscle Performance.

作者信息

Pelà Giovanna, Tagliaferri Sara, Perrino Felice, Bussolati Giacomo, Longobucco Yari, Zerbinati Luna, Adorni Elisa, Calvani Riccardo, Cesari Matteo, Cherubini Antonio, Bernabei Roberto, Di Bari Mauro, Landi Francesco, Marzetti Emanuele, Lauretani Fulvio, Maggio Marcello

机构信息

Department of Medicine and Surgery, University of Parma, Parma, Italy.

Department of General and Specialistic Medicine, University-Hospital of Parma, Parma, Italy.

出版信息

J Am Geriatr Soc. 2020 Sep 16. doi: 10.1111/jgs.16812.

Abstract

BACKGROUND

It was recently hypothesized the existence of "cardiac-skeletal muscle axis." However, the relationship between skeletal muscle mass (SMM) and left ventricular mass (LVM) has never been investigated in the specific group of older individuals with low skeletal mass and physical performance. We tested this hypothesis in the SPRINT-T (Sarcopenia and Physical Frailty IN older people: multicomponenT Treatment strategies Trial) population using LVM as independent variable and SMM as dependent variable.

METHODS

SMM was assessed by dual-energy X-ray absorptiometry scan and expressed as appendicular lean mass (ALM), and LVM was estimated through echocardiography. Low ALM was defined according to Foundation for the National Institutes of Health Sarcopenia Project criteria, and Short Physical Performance Battery (SPPB) was used to assess physical performance.

RESULTS

The population consisted of 100 persons (33 men and 67 women), aged 70 years or older (mean age = 79 ± 5 years) with low ALM and SPPB ranged between 3 and 9, suggestive of physical frailty. Charlson Comorbidity Index median score was 0. Mean value of LVM was 193 ± 67 g, indexed LVM/body surface area (LVM/BSA) was 112 ± 33 g/m, and cardiac output (CO) was 65 ± 19 L/min. ALM was strongly and positively correlated with LVM (r = 0.54602; P < .0001), LVM/BSA (r = 0.30761; P < .002), CO (r = 0.49621; P < .0001), body mass index (BMI) (r = 0.52461; P < .0001), sex (r = 0.77; P < .001), fat mass (r = 0.38977; P < .0001), and hemoglobin (Hb) (r = 0.26001; P < .01). In the multivariate analysis, LVM (β = .019 ± .005; P < .0001), CO (β = .038 ± .016; P = .019), BMI (β = .286 ± .051; P < .0001), and Hb (β = .544 ± .175; P = .0025) remained associated to ALM.

CONCLUSIONS

In a sample of older persons with low muscle mass and physical performance, LVM was positively and significantly correlated with ALM, independently from blood pressure, physical activity, and other potential confounders. Future studies are needed to address the effect of interventions targeting LVM and SMM.

摘要

背景

最近有人提出存在“心肌-骨骼肌轴”的假说。然而,在骨骼肌质量低且身体机能差的特定老年人群体中,骨骼肌质量(SMM)与左心室质量(LVM)之间的关系从未被研究过。我们在SPRINT-T(老年人肌肉减少症和身体虚弱:多成分治疗策略试验)人群中,以LVM作为自变量、SMM作为因变量来验证这一假说。

方法

通过双能X线吸收法扫描评估SMM,并表示为四肢瘦体重(ALM),通过超声心动图估计LVM。根据美国国立卫生研究院肌肉减少症项目基金会的标准定义低ALM,并使用简短身体机能量表(SPPB)评估身体机能。

结果

该人群由100人组成(33名男性和67名女性),年龄在70岁及以上(平均年龄 = 79±5岁),ALM低,SPPB在3至9分之间,提示身体虚弱。Charlson合并症指数中位数为0。LVM的平均值为193±67 g,LVM/体表面积(LVM/BSA)为112±33 g/m²,心输出量(CO)为65±19 L/min。ALM与LVM(r = 0.54602;P <.0001)、LVM/BSA(r = 0.30761;P <.002)、CO(r = 0.49621;P <.0001)、体重指数(BMI)(r = 0.52461;P <.0001)、性别(r = 0.77;P <.001)、脂肪量(r = 0.38977;P <.0001)和血红蛋白(Hb)(r = 0.26001;P <.01)呈强正相关。在多变量分析中,LVM(β =.019±.005;P <.0001)、CO(β =.038±.016;P =.019)、BMI(β =.286±.051;P <.0001)和Hb(β =.544±.175;P =.0025)仍与ALM相关。

结论

在肌肉质量低且身体机能差的老年样本中,LVM与ALM呈正相关且具有显著相关性,独立于血压、身体活动和其他潜在混杂因素。未来需要开展研究以探讨针对LVM和SMM的干预措施的效果。

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