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感染新型冠状病毒肺炎的老年人肌肉量、骨密度与血管钙化之间的关系

Relationship between Muscle Mass, Bone Density and Vascular Calcifications in Elderly People with SARS-CoV-2 Pneumonia.

作者信息

Del Toro Rossella, Palmese Francesco, Feletti Francesco, Zani Gianluca, Minguzzi Maria Teresa, Maddaloni Ernesto, Napoli Nicola, Bedogni Giorgio, Domenicali Marco

机构信息

Department of Primary Health Care, Internal Medicine Unit Addressed to Frailty and Aging, Santa Maria delle Croci Hospital, AUSL Romagna, 48121 Ravenna, Italy.

Department of Medical and Surgical Sciences, Alma Mater Studiorum University of Bologna, 40126 Bologna, Italy.

出版信息

J Clin Med. 2023 Mar 19;12(6):2372. doi: 10.3390/jcm12062372.

Abstract

BACKGROUND

Little is known about the changes in organs and tissues that may make elder patients more vulnerable to acute stressors such as SARS-CoV-2 infection.

METHODS

In 80 consecutive elderly patients with SARS-CoV-2 infection, we evaluated the association between the descending thoracic aorta calcium score, L1 bone density and T12 skeletal muscle density measured on the same scan by high-resolution computed tomography.

RESULTS

At median regression, the ln-transformed DTA calcium score was inversely associated with L1 bone density (-0.02, 95%CI -0.04 to -0.01 ln-Agatston units for an increase of 1 HU) and with T12 muscle density (-0.03, -0.06 to -0.001 ln-Agatston units for an increase of 1 HU). At penalized logistic regression, an increase of 1 ln-Agatston unit of DTA calcium score was associated with an OR of death of 1.480 (1.022 to 2.145), one of 1 HU of bone density with an OR of 0.981 (0.966 to 0.996) and one of 1 HU of muscle density with an OR of 0.973 (0.948 to 0.999). These relationships disappeared after correction for age and age was the stronger predictor of body composition and death.

CONCLUSIONS

Age has a big effect on the relationship between vascular calcifications, L1 bone density and T12 muscle density and on their relationship with the odds of dying.

摘要

背景

对于可能使老年患者更容易受到诸如SARS-CoV-2感染等急性应激源影响的器官和组织变化,我们知之甚少。

方法

在80例连续的SARS-CoV-2感染老年患者中,我们评估了通过高分辨率计算机断层扫描在同一扫描上测量的降主动脉钙评分、L1骨密度和T12骨骼肌密度之间的关联。

结果

在中位数回归分析中,经自然对数转换的降主动脉钙评分与L1骨密度呈负相关(每增加1 HU,为-0.02,95%置信区间为-0.04至-0.01 ln-阿加斯顿单位),与T12肌肉密度也呈负相关(每增加1 HU,为-0.03,-0.06至-0.001 ln-阿加斯顿单位)。在惩罚逻辑回归分析中,降主动脉钙评分每增加1个ln-阿加斯顿单位,死亡风险比为1.480(1.022至2.145),骨密度每增加1 HU,风险比为0.981(0.966至0.996),肌肉密度每增加1 HU,风险比为0.973(0.948至0.999)。在对年龄进行校正后,这些关系消失,且年龄是身体组成和死亡的更强预测因素。

结论

年龄对血管钙化、L1骨密度和T12肌肉密度之间的关系及其与死亡几率的关系有很大影响。

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