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体脂肪和炎症标志物与与年龄相关的肌肉变化是否独立相关?

Are body fat and inflammatory markers independently associated with age-related muscle changes?

机构信息

Department of Gerontology, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, 13565-905, Brazil.

Department of Nursing, Federal University of São Carlos (UFSCar), São Carlos, São Paulo, 13565-905, Brazil.

出版信息

Clin Nutr. 2021 Apr;40(4):2009-2015. doi: 10.1016/j.clnu.2020.09.021. Epub 2020 Sep 18.

Abstract

BACKGROUND & AIMS: A growing number of studies have shown that body fat and inflammation are associated with age-related changes in body muscle composition. However, most of these studies did not control for potential confounders. The aim was to determine whether there is an association between body fat and inflammatory cytokines with muscle mass/strength decline in community-dwelling older adults.

METHODS

Anthropometric, physical and functionality variables were collected. Nutritional status was assessed by the MNA form. Dynapenia was assessed with handgrip strength on the dominant hand using a dynamometer. Sarcopenia was determined using adapted criteria from the European Working Group on Sarcopenia in Older People 2 (EWGSOP2). Inflammatory cytokines were evaluated in plasma using a multiplex assay. Associations to muscle mass/strength decline were analyzed using a multinominal logistic regression, adjusted for potential confounders.

RESULTS

We recruited a convenience sample of 311 adults aged 60 years or older. Most of subjects were sufficiently active females with a median age of 68 years (interquartile range [IQR], 64-74 years), whereas about a half (46.3%) were at risk of malnutrition. The prevalence of dynapenia was 38.3%, whereas sarcopenia was 13.2%. After controlling for potential confounders, we found that relative fat mass index is independently associated with sarcopenia. Loss of strength was independently associated only with female sex, lower physical activity, worse nutrition and IL-10/TNF-α ratio, whereas female sex, an insufficiently active lifestyle and relative fat mass index were the key determinants of sarcopenia.

CONCLUSIONS

These findings highlight the importance of physical activity and healthy diet as effective interventions to prevent muscle mass/strength decline, and points to IL-10/TNF-α ratio and body fat as independently associated factors for dynapenia and sarcopenia, respectively.

摘要

背景与目的

越来越多的研究表明,体脂肪和炎症与与年龄相关的身体肌肉成分变化有关。然而,这些研究大多没有控制潜在的混杂因素。本研究旨在确定社区居住的老年人中体脂肪和炎症细胞因子与肌肉质量/力量下降之间是否存在关联。

方法

收集人体测量学、身体和功能变量。通过 MNA 表格评估营养状况。使用测力计评估优势手握力来评估动力不足。使用欧洲老年人肌肉减少症工作组 2 (EWGSOP2)的标准确定肌少症。使用多指标免疫分析法评估炎症细胞因子。使用多变量逻辑回归分析肌肉质量/力量下降的关联,调整潜在混杂因素。

结果

我们招募了一个方便样本,共 311 名 60 岁或以上的成年人。大多数受试者是足够活跃的女性,中位年龄为 68 岁(四分位间距[IQR],64-74 岁),而约一半(46.3%)有营养不良的风险。动力不足的患病率为 38.3%,肌少症为 13.2%。在控制潜在混杂因素后,我们发现相对脂肪质量指数与肌少症独立相关。力量下降仅与女性、较低的体力活动、较差的营养状况和 IL-10/TNF-α 比值独立相关,而女性、不够活跃的生活方式和相对脂肪质量指数是肌少症的关键决定因素。

结论

这些发现强调了身体活动和健康饮食作为预防肌肉质量/力量下降的有效干预措施的重要性,并指出 IL-10/TNF-α 比值和体脂肪分别是动力不足和肌少症的独立相关因素。

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