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[脊柱手术术前会诊中与肌肉力量相关的肌肉减少症和生物阻抗参数评估]

[Evaluation of sarcopenia and bioimpedance parameters related to muscle strength in the pre-operative consultation for spinal surgery].

作者信息

Moretti Dino, Fiorillo Pablo, Mogliani Marcelo, Buncuga Martín, Fain Humberto

机构信息

Centro de Nutrición y Metabolismo (CeNuMe). Unidad de Cuidados Intensivos. Hospital Escuela "Eva Perón".

Centro de Nutrición y Metabolismo (CeNuMe).

出版信息

Nutr Hosp. 2024 Feb 15;41(1):145-151. doi: 10.20960/nh.04660.

Abstract

Introduction: sarcopenia is characterized by loss of muscle mass and function. Spinal disorders are a risk factor for muscle deterioration. In turn, sarcopenia is associated with adverse outcomes in the postoperative period of spinal surgery. Objectives: to evaluate sarcopenia and the relationship of muscle strength with bioimpedance parameters in the preoperative consultation. Material and methods: cross-sectional observational study. Muscle strength (dynamometry) and body composition (bioimpedance spectroscopy) were measured as part of the functional assessment of nutritional status. Sarcopenia was defined according to the European Working Group on Sarcopenia in Older People 2019 (EGWSOP2) and dynapenia/myopenia in the case of low strength or isolated muscularity. The relationship between the dynamometry values and the bioimpedance variables was summarized with the Spearman's coefficient. Results: twenty-two patients were included. The median (IQR) age was 60 years (43-65) and 72 % were women. The most frequent diagnosis and surgical procedure was spondylolisthesis (45 %) and posterior fixation (50 %). The mean body mass index (BMI) was 28.3 (± 4.59) kg/m2. The presence of sarcopenia, dynapenia and myopenia was 18.2 %, 13.6 % and 22.7 %, respectively. Dynamometry was correlated with lean tissue index: 0.61 (p 0.002); body cell mass: 0.68 (p 0.000); appendicular skeletal muscle: 0.49 (p 0.021); phase angle: 0.46 (p 0.031); and resistance index 200/5 kHz: -0.47 (p 0.028). Conclusion: muscle strength is correlated with bioimpedance parameters. Sarcopenia, dynapenia and myopenia are frequent and objectifiable in the preoperative spinal surgery consultation.

摘要

引言

肌肉减少症的特征是肌肉质量和功能丧失。脊柱疾病是肌肉退化的危险因素。反过来,肌肉减少症与脊柱手术后的不良后果相关。目的:在术前咨询中评估肌肉减少症以及肌肉力量与生物电阻抗参数的关系。材料和方法:横断面观察性研究。作为营养状况功能评估的一部分,测量了肌肉力量(握力计测量)和身体成分(生物电阻抗光谱法)。根据2019年欧洲老年人肌肉减少症工作组(EGWSOP2)的标准定义肌肉减少症,对于力量低或单纯肌肉量减少的情况定义为肌力减退/肌少症。用Spearman系数总结握力计测量值与生物电阻抗变量之间的关系。结果:纳入22例患者。年龄中位数(四分位间距)为60岁(43 - 65岁),72%为女性。最常见的诊断和手术方式是腰椎滑脱(45%)和后路固定(50%)。平均体重指数(BMI)为28.3(±4.59)kg/m²。肌肉减少症、肌力减退和肌少症的发生率分别为18.2%、13.6%和22.7%。握力计测量与瘦组织指数相关:0.61(p < 0.002);体细胞质量:0.68(p < 0.000);四肢骨骼肌:0.49(p = 0.021);相位角:0.46(p = 0.031);以及电阻指数200/5 kHz:-0.47(p = 0.028)。结论:肌肉力量与生物电阻抗参数相关。在术前脊柱手术咨询中,肌肉减少症、肌力减退和肌少症很常见且可客观评估。

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