超声评估生物标志物和股四头肌肌构筑在射血分数保留的心力衰竭老年患者中的应用：一项横断面研究。
Biomarkers and the quadriceps femoris muscle architecture assessed by ultrasound in older adults with heart failure with preserved ejection fraction: a cross-sectional study.
机构信息
Grupo de Investigación Clinimetría CTS-631, Departamento de Fisioterapia, Universidad de Málaga, C/Arquitecto Peñalosa, 3, 29071, Málaga, Spain.
Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA, Plataforma Bionand, Málaga, Spain.
出版信息
Aging Clin Exp Res. 2022 Oct;34(10):2493-2504. doi: 10.1007/s40520-022-02189-7. Epub 2022 Aug 8.
BACKGROUND
Sarcopenia is an important comorbidity in patients with heart failure with preserved ejection fraction (HFpEF). The ultrasound (US) assessment has all the advantages of being used in primary care to assess muscle quantity and quality. Some biomarkers could be indicative of muscle mass loss.
AIMS
To describe the quantitative and qualitative characteristics of the quadriceps femoris assessed by US in older adults with HFpEF and to assess the relationship of the blood and urinary biomarkers, the polypharmacy and comorbidities with US outcomes in older adults with HFpEF.
METHODS
A cross-sectional study was conducted. 76 older adults with HFpEF were included. The quadriceps femoris muscle thickness (MT, cm), the subcutaneous fat tissue thickness (FT, cm), the muscle echo intensity (MEI) and the subcutaneous fat tissue echo intensity (FEI) were assessed by US in a non-contraction (non-con) and contraction (con) situations. Polypharmacy, comorbidities, blood and urine biomarkers were also collected.
RESULTS
The carbohydrate antigen 125 (CA-125), the folic acid and the urine creatinine shared the 86.6% variance in the non-con MT, adjusted by age, sex and body mass index (BMI). The folic acid shared the 38.5% of the variance in the con MT, adjusted by age, sex and BMI. The glycosylated haemoglobin explained the 39.6% variance in the non-con MEI, adjusted by age, sex and BMI. The chlorine (Cl) explained the 40.2% of the variance in the non-con FT, adjusted by age, sex and BMI. The polypharmacy and the folic acid explained the 37.9% of variance in the non-con FEI, while the polypharmacy and the thyrotropin (TSH) shared the 44.4% of variance in the con FEI, both adjusted by age, sex and BMI. No comorbidities, polypharmacy, or blood and urinary biomarkers could explain the con MEI and the con FT variance.
CONCLUSIONS
Blood and urinary biomarkers obtained in routine analyses could help clinicians detect US outcome changes in older adults with HFpEF and identify a worsening of sarcopenia.
TRIAL REGISTRATION
NCT03909919. April 10, 2019. Retrospectively registered.
背景
在射血分数保留的心力衰竭（HFpEF）患者中，肌肉减少症是一种重要的合并症。超声（US）评估具有在初级保健中用于评估肌肉量和质量的所有优势。一些生物标志物可能表明肌肉质量损失。
目的
描述超声评估老年 HFpEF 患者股四头肌的定量和定性特征，并评估血液和尿液生物标志物、多药治疗和合并症与老年 HFpEF 患者 US 结果的关系。
方法
进行了一项横断面研究。共纳入 76 例 HFpEF 老年患者。在非收缩（非 con）和收缩（con）情况下，通过 US 评估股四头肌肌肉厚度（MT，cm）、皮下脂肪组织厚度（FT，cm）、肌肉回声强度（MEI）和皮下脂肪组织回声强度（FEI）。还收集了多药治疗、合并症、血液和尿液生物标志物。
结果
碳水化合物抗原 125（CA-125）、叶酸和尿肌酐共同解释了非 con MT 中年龄、性别和体重指数（BMI）调整后的 86.6%方差，而叶酸共同解释了 con MT 中 38.5%的方差，经年龄、性别和 BMI 调整。糖化血红蛋白解释了非 con MEI 中 39.6%的方差，经年龄、性别和 BMI 调整。氯（Cl）解释了非 con FT 中 40.2%的方差，经年龄、性别和 BMI 调整。多药治疗和叶酸解释了非 con FEI 中 37.9%的方差，而多药治疗和促甲状腺激素（TSH）共同解释了 con FEI 中 44.4%的方差，均经年龄、性别和 BMI 调整。没有合并症、多药治疗或血液和尿液生物标志物可以解释 con MEI 和 con FT 的方差。
结论
常规分析中获得的血液和尿液生物标志物可帮助临床医生检测 HFpEF 老年患者的 US 结果变化，并识别肌肉减少症的恶化。
试验注册
NCT03909919。2019 年 4 月 10 日。回顾性注册。
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