Keskin Kudret, Çiftçi Selda, Öncü Jülide, Melike Doğan Güneş, Çetinkal Gökhan, Sezai Yıldız Süleyman, Sığırcı Serhat, Orta Kılıçkesmez Kadriye
Department of Cardiology, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
Department of Physical Medicine and Rehabilitation, University of Health Sciences, Şişli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey.
Turk J Phys Med Rehabil. 2021 Mar 4;67(1):25-31. doi: 10.5606/tftrd.2021.5461. eCollection 2021 Mar.
This study aims to determine the association of sarcopenia with orthostatic hypotension (OH) which is a significant precursor to falls and related injuries in elderly patients.
A total of 91 outpatients (18 males, 73 females; mean age 79.3±4.0 years; range, 75 to 91 years) were prospectively enrolled and those who were eligible underwent comprehensive sarcopenia assessment including measurement of muscle mass, strength, physical performance, anthropometric measurements along with frailty tests. Patients classified as sarcopenic or non-sarcopenic based on these measurements underwent supine and standing blood pressure (BP) measurements. The frequency of OH was compared between the two groups.
Of the 91 patients, 29 (31.9%) had sarcopenia. There was no statistical difference in measurements of functional tests which consisted of gait speed, timed up-and-go test and handgrip strength. However, timed sit-to-stand test values were higher in sarcopenic patients (18.2±7.9 vs. 15.0±5.1, p=0.04). Patients with sarcopenia developed OA and intolerance more often compared to the non-sarcopenic patients (n=15 [50.0%] vs. n=14 [23.0%], p<0.01 and n=13 [44.8%] vs. n=9 [15.3%], p<0.01, respectively). The adjusted odds ratio for sarcopenia was 7.80 (95% confidence interval 1.77-34.45), p=0.007.
Age-related sarcopenia increases the risk of OA in the elderly. This may in part explain the increased incidence of falls and also help identification of risky elderly patients for orthostatic BP drops.
本研究旨在确定肌肉减少症与体位性低血压（OH）之间的关联，OH是老年患者跌倒及相关损伤的重要先兆。
前瞻性纳入91例门诊患者（18例男性，73例女性；平均年龄79.3±4.0岁；范围75至91岁），符合条件者接受全面的肌肉减少症评估，包括肌肉质量、力量、身体机能测量、人体测量以及衰弱测试。根据这些测量结果分为肌肉减少症组和非肌肉减少症组的患者，均进行仰卧位和站立位血压（BP）测量。比较两组OH的发生率。
91例患者中，29例（31.9%）患有肌肉减少症。在包括步速、计时起立行走测试和握力的功能测试测量中，两组无统计学差异。然而，肌肉减少症患者的定时坐立测试值更高（18.2±7.9对15.0±5.1，p=0.04）。与非肌肉减少症患者相比，肌肉减少症患者发生OH和不耐受的情况更常见（分别为n=15 [50.0%]对n=14 [23.0%]，p<0.01；n=13 [44.8%]对n=9 [15.3%]，p<0.01）。肌肉减少症的校正优势比为7.80（95%置信区间1.77 - 34.45），p=0.007。
与年龄相关的肌肉减少症增加了老年人发生OH的风险。这可能部分解释了跌倒发生率的增加，也有助于识别体位性血压下降的高危老年患者。
