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中心血管代谢指数和肌肉减少症与中年和老年人中心血管代谢合并症的相关性:一项前瞻性研究。

Correlation of cardiometabolic index and sarcopenia with cardiometabolic multimorbidity in middle-aged and older adult: a prospective study.

机构信息

The Department of Geriatrics, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

The Department of Clinical Research Center, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China.

出版信息

Front Endocrinol (Lausanne). 2024 May 28;15:1387374. doi: 10.3389/fendo.2024.1387374. eCollection 2024.

Abstract

BACKGROUND

Research has demonstrated that sarcopenia and visceral obesity are significant risk factors for chronic disease in middle-aged and older adults. However, the relationship between sarcopenia, the cardiac metabolic index (CMI), a novel measure of visceral obesity, and cardiometabolic multimorbidity (CMM) remains unclear. In this study, data from the China Longitudinal Study of Health and Retirement (CHARLS) were analyzed to investigate the association between sarcopenia and CMI with CMM in the middle-aged and older adult population.

METHODS

The study included 4,959 participants aged 45 and over. Sarcopenia was defined using the criteria of the Asian Sarcopenia Working Group 2019. CMM is defined as having two or more of the following conditions: physician-diagnosed heart disease, diabetes, stroke, and/or hypertension. CMI was calculated using the formula: CMI = (TG/HDL-C) × WHtR. To explore the association between CMI and sarcopenia and CMM, cox proportional risk regression models were used.

RESULTS

The median age of all participants was 57 years, with 47.1% being male. Over the 8-year follow-up, 1,362 individuals developed CMM. The incidence of CMM was 8.7/1,000 person-years in the group without sarcopenia or high CMI, 17.37/1,000 person-years in those with high CMI, 14.22/1,000 person-years in the sarcopenia group, and 22.34/1,000 person-years in the group with both conditions. After adjusting for covariates, the group with both sarcopenia and high CMI had a significantly increased risk of CMM (HR 2.48, 95% CI 1.12-5.51) and heart disease (HR 2.04, 95% CI 1.05-3.98). Among those over 65 years, sarcopenia was discovered to be associated with an increased risk of CMM [HR (95% CI: 4.83 (1.22, 19.06)]. The risk of CMM was further increased to 7.31-fold (95% CI:1.72, 31.15) when combined with high CMI.

CONCLUSIONS

The combination of sarcopenia and high CMI is associated with an increased risk of developing CMM. Early identification and intervention of sarcopenia and CMI not only enable the development of targeted therapeutic strategies but also provide potential opportunities to reduce the morbidity and mortality of CMM.

摘要

背景

研究表明,肌少症和内脏肥胖是中年及以上成年人慢性疾病的重要危险因素。然而,肌少症、心脏代谢指数(CMI),一种新的内脏肥胖衡量指标,以及心脏代谢性多疾病(CMM)之间的关系仍不清楚。本研究利用中国健康与养老追踪调查(CHARLS)的数据,分析了中年及以上人群中肌少症与 CMI 和 CMM 的关系。

方法

本研究纳入了 4959 名 45 岁及以上的参与者。肌少症使用 2019 年亚洲肌少症工作组的标准进行定义。CMM 定义为存在以下两种或两种以上情况:医生诊断的心脏病、糖尿病、中风和/或高血压。CMI 通过公式计算得出:CMI = (TG/HDL-C) × WHtR。为了探讨 CMI 与肌少症和 CMM 之间的关系,使用 cox 比例风险回归模型进行分析。

结果

所有参与者的中位年龄为 57 岁,其中 47.1%为男性。在 8 年的随访期间,有 1362 人发生了 CMM。在无肌少症或高 CMI 的人群中,CMM 的发病率为 8.7/1000 人年;在高 CMI 的人群中,发病率为 17.37/1000 人年;在肌少症组中,发病率为 14.22/1000 人年;在同时存在两种情况的人群中,发病率为 22.34/1000 人年。调整了混杂因素后,同时存在肌少症和高 CMI 的组发生 CMM 的风险显著增加(HR 2.48,95%CI 1.12-5.51)和心脏病(HR 2.04,95%CI 1.05-3.98)。在年龄超过 65 岁的人群中,肌少症与 CMM 风险增加相关(HR(95%CI:4.83(1.22,19.06))。当与高 CMI 结合时,CMM 的风险进一步增加到 7.31 倍(95%CI:1.72,31.15)。

结论

肌少症和高 CMI 的结合与 CMM 发病风险增加有关。早期识别和干预肌少症和 CMI 不仅可以制定有针对性的治疗策略,还为降低 CMM 的发病率和死亡率提供了潜在机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3afd/11165091/4494cb98d043/fendo-15-1387374-g001.jpg

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