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住院老年患者死亡率、肌内脂肪组织与肌肉减少症之间的关系。

The relation between mortality, intramuscular adipose tissue and sarcopenia in hospitalized geriatric patients.

作者信息

Perkisas Stany, Lamers Scott, Degerickx Robin, Van Mieghem Eugénie, Vandewoude Maurits, Verhoeven Veronique, De Cock Anne-Marie

机构信息

University Center for Geriatrics, ZNA (ZiekenhuisNetwerk Antwerpen), Leopoldstraat 26, 2000, Antwerp, Belgium.

Belgian Ageing Muscle Society, Brussels, Belgium.

出版信息

Eur Geriatr Med. 2018 Dec;9(6):801-807. doi: 10.1007/s41999-018-0110-y. Epub 2018 Oct 1.

Abstract

INTRODUCTION

One of the biggest healthcare challenges that arises with increasing age expectations is sarcopenia. However, as a multi-dimensional construct with both neurological and musculoskeletal factors involved, the exact contribution of these different components of sarcopenia to mortality outcomes is not clear. Therefore, in mortality assessment, it is advisable to use subitems of sarcopenia such as the intramuscular adipose tissue (IMAT), instead of using sarcopenia as a construct itself. IMAT is negatively correlated with strength and performance, and positively correlated with mortality, both all-cause and cardiovascular. In this study, IMAT and its relation to long-term mortality, muscle strength and function is studied.

MATERIALS AND METHODS

Patients admitted to the University Geriatrics Department during 6 months were screened for muscle mass, strength and function through computed tomography (upper leg), Jamar dynamometer and short physical performance battery, respectively. After 4 years, health status (mortality) was obtained by telephone.

RESULTS

Three hundred and two patients were included (69.6% female). Mean IMAT was 29.3 ± 12.3%. There was a positive correlation between IMAT and mortality in the male 70-79-year-old age group (n = 20), but not in the whole cohort. IMAT was negatively correlated with muscle strength and function.

CONCLUSION

IMAT is negatively correlated with muscle strength and muscle function. IMAT is correlated with mortality in a specific subgroup of this cohort. This data adds to the discussion of the value of IMAT in the construct of sarcopenia. More studies need to be done regarding the evolution of IMAT in function of time and functional decline.

摘要

引言

随着预期寿命的增加,出现的最大医疗保健挑战之一是肌肉减少症。然而,由于肌肉减少症是一个涉及神经和肌肉骨骼因素的多维度概念,其不同组成部分对死亡率结果的确切贡献尚不清楚。因此,在死亡率评估中,建议使用肌肉减少症的子项目,如肌内脂肪组织(IMAT),而不是将肌肉减少症本身作为一个整体来使用。IMAT与力量和功能呈负相关,与全因死亡率和心血管死亡率呈正相关。在本研究中,对IMAT及其与长期死亡率、肌肉力量和功能的关系进行了研究。

材料与方法

对6个月内入住大学老年病科的患者分别通过计算机断层扫描(大腿)、握力计和简短体能测试电池筛查肌肉质量、力量和功能。4年后,通过电话获取健康状况(死亡率)。

结果

纳入302例患者(69.6%为女性)。平均IMAT为29.3±12.3%。在70 - 79岁男性年龄组(n = 20)中,IMAT与死亡率呈正相关,但在整个队列中并非如此。IMAT与肌肉力量和功能呈负相关。

结论

IMAT与肌肉力量和肌肉功能呈负相关。在该队列的一个特定亚组中,IMAT与死亡率相关。这些数据增加了关于IMAT在肌肉减少症构成中的价值的讨论。关于IMAT随时间和功能下降的演变,还需要进行更多研究。

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