肌少症与吞咽困难患者尿功能障碍的关系。

Association between sarcopenia and urinary dysfunction in patients with dysphagia.

机构信息

Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan.

出版信息

Arch Gerontol Geriatr. 2024 Dec;127:105577. doi: 10.1016/j.archger.2024.105577. Epub 2024 Jul 19.

DOI:10.1016/j.archger.2024.105577

PMID:39032316

Abstract

INTRODUCTION

The objective was to determine the relationship between sarcopenia and urinary dysfunction in patients with dysphagia.

MATERIAL AND METHODS

A cross-sectional study was conducted on 460 Japanese Sarcopenic Dysphagia Database participants. Urinary dysfunction was defined as either urinary incontinence or urethral catheter use. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria. Univariate and multivariate analyses assessed the association between urinary dysfunction and sarcopenia, calf circumference (CC), handgrip strength (HGS), and Barthel Index (BI). Logistic regression analysis was performed for urinary dysfunction adjusted for age, sex, setting, and CCI in addition to BI and HGS or CC or sarcopenia (model 1) or FILS and BI (model 2).

RESULTS

The mean age was 80.8 ± 10.5 years and urinary dysfunction in 137 participants. Urinary dysfunction was not associated with sarcopenia (123 versus 281, p = 0.440) but was associated with CC (27.4 ± 4.2 versus 28.5 ± 3.9, p = 0.009), HGS (9.7 ± 7.9 versus 14.4 ± 9.3, p < 0.001), and BI (19.9 ± 0.3 versus 20.3 ± 0.2, p < 0.001). Logistic regression analysis showed urinary dysfunction was associated with HGS (OR: 0.968, CI: 0.938, 0.998) and BI (OR: 0.955, CI: 0.943, 0.966). The cutoff was 19 kg for men (sensitivity 0.786, specificity 0.56, Area Under Curve (AUC) 0.689) and 6.1 kg for women (sensitivity 0.493, specificity 0.774, AUC 0.639) in HGS and 27.5 points in BI (sensitivity 0.781, specificity 0.604, AUC 0.740).

CONCLUSION

Sarcopenia was not associated with urinary dysfunction. However, HGS and BI were related to urinary dysfunction.

摘要

简介

本研究旨在确定吞咽困难患者的肌肉减少症与尿功能障碍之间的关系。

材料和方法

对 460 名日本肌肉减少性吞咽障碍数据库参与者进行了横断面研究。尿功能障碍定义为尿失禁或尿道置管。根据 2019 年亚洲工作组的肌肉减少症标准诊断肌肉减少症。单变量和多变量分析评估了尿功能障碍与肌肉减少症、小腿围（CC）、握力（HGS）和巴氏指数（BI）之间的关系。除 BI 和 HGS 或 CC 或肌肉减少症（模型 1）或 FILS 和 BI（模型 2）外，还对年龄、性别、环境和 CCI 进行了调整，对尿功能障碍进行了逻辑回归分析。

结果

平均年龄为 80.8±10.5 岁，137 名参与者存在尿功能障碍。尿功能障碍与肌肉减少症无关（123 例与 281 例，p=0.440），但与 CC（27.4±4.2 与 28.5±3.9，p=0.009）、HGS（9.7±7.9 与 14.4±9.3，p<0.001）和 BI（19.9±0.3 与 20.3±0.2，p<0.001）有关。逻辑回归分析显示，尿功能障碍与 HGS（OR：0.968，CI：0.938，0.998）和 BI（OR：0.955，CI：0.943，0.966）有关。男性 HGS 的截断值为 19 kg（灵敏度 0.786，特异性 0.56，曲线下面积（AUC）0.689），女性为 6.1 kg（灵敏度 0.493，特异性 0.774，AUC 0.639），BI 为 27.5 分（灵敏度 0.781，特异性 0.604，AUC 0.740）。