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骨骼肌减少症与老年人顶叶萎缩独立相关。

Sarcopenia is independently associated with parietal atrophy in older adults.

机构信息

Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Chia Nan University of Pharmacy and Science, Tainan, Taiwan.

Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Division of Neurology, Department of Internal Medicine, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Aging and Health Research Center, National Yang Ming Chiao Tung University Taipei, Taiwan; Department of Geriatric Medicine, National Yang Ming University School of Medicine, Taipei, Taiwan.

出版信息

Exp Gerontol. 2021 Aug;151:111402. doi: 10.1016/j.exger.2021.111402. Epub 2021 May 10.

Abstract

INTRODUCTION

As populations age, sarcopenia becomes a major health problem among adults aged 65 years and older. However, little information is available about the relationship between sarcopenia and brain structure abnormalities. The objective of this study was to investigate associations between sarcopenia and brain atrophy in older adults and relationships with regional brain areas.

METHODS

This prospective cohort study recruited 102 retirement community residents aged 65 years and older. All participants underwent gait speed measurement, handgrip strength measurement and muscle mass measurement by dual X-ray absorptiometry. Diagnosis of sarcopenia was made according to criteria of the Asian Working Group for Sarcopenia (AWGSOP). All patients underwent magnetic resonance imaging (MRI), and images were analysed for global cortical atrophy (GCA) (range 0-3), parietal atrophy (PA) (range 0-3) and medial temporal atrophy (MTA) (range 0-4).

RESULTS

Among 102 older adult participants (81.4 ± 8.2 years), 47 (46.1%) were diagnosed with sarcopenia according to AWGSOP criteria. The sarcopenia group had more moderate to severe PA (Grade 2: 19.1% vs. 5.5%; grade 3:6.4% vs. 0%, P = 0.016) and GCA (Grade 2: 40.4% vs. 18.2%, P = 0.003) and a trend of more moderate to severe MTA (Grade 2: 46.8% vs. 30.9%; grade 3: 8.5% vs. 1.8%, P = 0.098) than the non-sarcopenia group. In univariate logistic regression, sarcopenia was significantly associated with PA (OR 5.94, 95% CI 1.56-22.60, P = 0.009), GCA (OR 3.05, 95% CI 1.24-7.51, P = 0.015), and MTA (OR 2.55, 95% CI 1.14-5.69, P = 0.023). In multivariable logistic regression analysis, sarcopenia was an independent risk factor for PA (adjusted OR 6.90, 95% CI 1.30-36.47, P = 0.023). After adjusting for all covariates, only age had a significant relationship with GCA (Adjusted OR 1.09, 95% CI 1.00-1.19, P = 0.044) and MTA (Adjusted OR 1.09, 95% CI 1.01-1.17, P = 0.022).

CONCLUSIONS

This is the first study to explore associations between sarcopenia and global as well as regional brain atrophy in older adults. The sarcopenia group had higher rates of moderate to severe PA, GCA and MTA than the non-sarcopenia group. PA was significantly associated with sarcopenia in older adults. Further longitudinal studies are needed to address the mechanism and pathogenesis of brain atrophy and sarcopenia.

摘要

简介

随着人口老龄化,肌少症成为 65 岁及以上成年人的主要健康问题。然而,关于肌少症与大脑结构异常之间的关系,信息有限。本研究旨在探讨肌少症与老年人脑萎缩之间的关系,并研究与区域性脑区的关系。

方法

本前瞻性队列研究招募了 102 名来自退休社区的 65 岁及以上的居民。所有参与者均接受了步态速度测量、手握力测量和双能 X 线吸收法测量肌肉质量。根据亚洲肌少症工作组(AWGSOP)的标准诊断肌少症。所有患者均接受了磁共振成像(MRI)检查,并对图像进行了分析,以评估总体皮质萎缩(GCA)(范围 0-3)、顶叶萎缩(PA)(范围 0-3)和内侧颞叶萎缩(MTA)(范围 0-4)。

结果

在 102 名老年参与者(81.4±8.2 岁)中,根据 AWGSOP 标准,47 名(46.1%)被诊断为肌少症。肌少症组的中度至重度 PA(Grade 2:19.1%比 5.5%;Grade 3:6.4%比 0%,P=0.016)和 GCA(Grade 2:40.4%比 18.2%,P=0.003)以及中度至重度 MTA(Grade 2:46.8%比 30.9%;Grade 3:8.5%比 1.8%,P=0.098)的发生率均高于非肌少症组。在单变量逻辑回归中,肌少症与 PA(比值比 5.94,95%置信区间 1.56-22.60,P=0.009)、GCA(比值比 3.05,95%置信区间 1.24-7.51,P=0.015)和 MTA(比值比 2.55,95%置信区间 1.14-5.69,P=0.023)显著相关。在多变量逻辑回归分析中,肌少症是 PA 的独立危险因素(调整比值比 6.90,95%置信区间 1.30-36.47,P=0.023)。在调整所有协变量后,只有年龄与 GCA(调整比值比 1.09,95%置信区间 1.00-1.19,P=0.044)和 MTA(调整比值比 1.09,95%置信区间 1.01-1.17,P=0.022)显著相关。

结论

这是第一项探讨肌少症与老年人全脑和区域性脑萎缩之间关系的研究。肌少症组的中度至重度 PA、GCA 和 MTA 发生率均高于非肌少症组。PA 与老年人的肌少症显著相关。需要进一步的纵向研究来解决脑萎缩和肌少症的发病机制。

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