Kao Tung-Wei, Peng Tao-Chun, Chen Wei-Liang, Chi Yu-Chiao, Chen Chi-Ling, Yang Wei-Shiung
Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
J Inflamm Res. 2021 Nov 3;14:5817-5825. doi: 10.2147/JIR.S335694. eCollection 2021.
Leptin plays an important role in regulating the energy homeostasis of fat and muscle. Paradoxical findings existed between serum leptin levels and muscle health conditions. Here, we aimed to investigate the relationship between serum leptin levels and the risk of sarcopenia or dynapenia among older adults.
Adults aged 65 and older living in the community were recruited at annual health checkups. Body composition, gait speed, and handgrip strength were examined. The cutoff values of muscle mass and strength to define sarcopenia and dynapenia were based on the consensus by the Asia Working Group of Sarcopenia in 2019. Serum leptin level was measured by an immunoassay.
Four hundred sixty participants (55.65% females) were enrolled. There were 16.08% and 23.91% with sarcopenia and dynapenia, respectively. Higher serum leptin levels were positively associated with muscle and fat mass but negatively associated with handgrip strength and gait speed for both sexes. In the logistic regression models adjusted for various confounders, a higher serum leptin level was associated with an increased risk of dynapenia with dose-response effects among both male and female participants (odds ratio [OR]=3.74, 95% confidence interval [CI]= 0.99-14.17; OR= 3.32, 95% CI=1.03-10.74, respectively), and a positive trend existed in both genders (p for trend=0.040 and 0.042, respectively). In contrast, a higher leptin level was associated with a reduced risk of sarcopenia with dose-response trends for both sexes (OR= 0.06, 95% CI=0.01-0.48; OR= 0.26, 95% CI=0.06-1.17, respectively) in models of multivariate logistic regression analyses, and a negative trend existed in both genders (p for trend = 0.002 and 0.023, respectively).
A positive trend existed between the serum leptin level and the dynapenia risk, whereas it revealed a negative trend in the serum leptin level and sarcopenia risk in both male and female elderly individuals. The biological mechanisms underlying its negative association with muscle strength but its positive association with muscle mass warrants further investigation.
瘦素在调节脂肪和肌肉的能量平衡中起重要作用。血清瘦素水平与肌肉健康状况之间存在矛盾的发现。在此,我们旨在研究老年人血清瘦素水平与肌肉减少症或肌肉功能减退风险之间的关系。
在年度健康检查中招募社区中65岁及以上的成年人。检查身体成分、步速和握力。定义肌肉减少症和肌肉功能减退的肌肉质量和力量的临界值基于2019年亚洲肌肉减少症工作组的共识。通过免疫测定法测量血清瘦素水平。
共纳入460名参与者(55.65%为女性)。肌肉减少症和肌肉功能减退的发生率分别为16.08%和23.91%。较高的血清瘦素水平与肌肉和脂肪量呈正相关,但与男女的握力和步速呈负相关。在针对各种混杂因素进行调整的逻辑回归模型中,较高的血清瘦素水平与男性和女性参与者中肌肉功能减退风险增加及剂量反应效应相关(比值比[OR]=3.74,95%置信区间[CI]=0.99-14.17;OR=3.32,95%CI=1.03-10.74),且在两性中均存在正趋势(趋势p值分别为0.040和0.042)。相比之下,在多变量逻辑回归分析模型中,较高的瘦素水平与男女肌肉减少症风险降低及剂量反应趋势相关(OR=0.06,95%CI=0.01-0.48;OR=0.26,95%CI=0.06-1.17),且在两性中均存在负趋势(趋势p值分别为0.002和0.023)。
血清瘦素水平与肌肉功能减退风险之间存在正趋势,而在老年男性和女性中,血清瘦素水平与肌肉减少症风险呈负趋势。其与肌肉力量呈负相关但与肌肉量呈正相关的生物学机制值得进一步研究。