Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan.
Department of Rehabilitation Sciences, Kitasato University Graduate School of Medical Sciences, Sagamihara, Japan; Department of Rehabilitation, Kitasato University School of Allied Health Sciences, Sagamihara, Japan.
Clin Nutr. 2021 Apr;40(4):2210-2218. doi: 10.1016/j.clnu.2020.09.050. Epub 2020 Oct 13.
Dynapenia, defined as age-associated loss of skeletal muscle strength, is associated with increased mortality rate, poor activities of daily living, and reduced quality of life. Therefore, dynapenia appears to be a better independent predictor of mortality than sarcopenia in the elderly. However, the prognostic utility of dynapenia in patients with cardiovascular disease (CVD) is not clear. This study was performed to examine the prognostic utility of dynapenia defined by the criteria of Manini et al. in patients with CVD.
The findings of 4192 consecutive patients ≥30 years old (median [interquartile range (IQR)] age 69 [60-76] years, 2874 males) with CVD were reviewed. Grip strength and quadriceps isometric strength (QIS) were measured just before hospital discharge, and low grip strength (<26 kg in males and <18 kg in females), low QIS (<45.0% body mass [BM] and <35.0% BM in males and females, respectively) were considered to indicate dynapenia. The endpoint was all-cause mortality.
A total of 507 deaths occurred during follow-up (median 2.0 years, IQR 0.8-4.4 years). The overall prevalence of dynapenia was 33.6% and increased with age (p for trend < 0.01). Females showed a significantly higher prevalence rate of dynapenia than males (43.3% vs. 29.2%, respectively; p < 0.01). Patients with dynapenia showed higher all-cause mortality rate than non-dynapenia patients (adjusted hazard ratio: 1.84; 95% confidence interval: 1.51-2.23; p < 0.01).
Dynapenia has a high prevalence among patients with CVD and is associated with increased mortality rate.
动力减退症定义为与年龄相关的骨骼肌力量丧失，与死亡率增加、日常生活活动能力下降和生活质量降低有关。因此，动力减退症似乎比老年人的肌肉减少症更能独立预测死亡率。然而，动力减退症在心血管疾病（CVD）患者中的预后价值尚不清楚。本研究旨在检查 Manini 等人定义的动力减退症标准在 CVD 患者中的预后价值。
回顾了 4192 例连续≥30 岁（中位数[四分位距（IQR）]年龄 69[60-76]岁，2874 例男性）的 CVD 患者的发现。在出院前测量握力和股四头肌等长强度（QIS），低握力（男性<26kg，女性<18kg）、低 QIS（男性和女性分别为<45.0%体重[BM]和<35.0%BM）被认为是动力减退症。终点是全因死亡率。
在随访期间共发生 507 例死亡（中位数 2.0 年，IQR 0.8-4.4 年）。动力减退症的总患病率为 33.6%，并随年龄增长而增加（趋势 p<0.01）。女性的动力减退症患病率明显高于男性（分别为 43.3%和 29.2%；p<0.01）。与非动力减退症患者相比，动力减退症患者的全因死亡率更高（调整后的危险比：1.84；95%置信区间：1.51-2.23；p<0.01）。
动力减退症在 CVD 患者中患病率较高，与死亡率增加相关。
