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中国华东地区老年人肌少症与相关生物标志物的关系及其在强化生活方式干预后的变化。

The relationship between sarcopenia and related bioindicators and changes after intensive lifestyle intervention in elderly East-China populations.

机构信息

Department of Geriatric Medicine, The Affiliated Suzhou Hospital of Nanjing Medical University (Suzhou Municipal Hospital), Suzhou, Jiangsu, China.

出版信息

BMC Musculoskelet Disord. 2024 Sep 3;25(1):704. doi: 10.1186/s12891-024-07835-x.

Abstract

BACKGROUND

As populations live longer, there is a progressive increase in chronic degenerative diseases, particularly those related to the musculoskeletal system. Sarcopenia is characterized by loss of skeletal muscle mass, muscle strength, and loss of physical function. It is a common disease in older adults associated with various adverse health outcomes. There is a lack of bioindicators to screen for sarcopenia. Albumin and lymphocyte counts are commonly used to assess the degree of malnutrition, and blood routine, lipids, and thyroid function are relatively easy to obtain as part of a routine physical examination. Therefore, finding blood markers that can screen for sarcopenia is essential. Our primary aim was to explore whether the bioindicators of body composition, lymphocytes, albumin, lipids, and thyroid hormones are associated with sarcopenia, and a secondary aim was to investigate changes in these indicators after an intensive lifestyle intervention preliminarily.

METHODS

60 subjects were selected from Runda and Bailian community health centers in Suzhou, China. They underwent body composition analysis and tested lymphocyte, albumin, lipid, and thyroid hormone levels. The 30 sarcopenia subjects underwent a 3-month intensive lifestyle intervention program. At the end of the intervention, we rechecked the bioindicators. Statistical analyses were performed in IBM SPSS v26.0.

RESULTS

The blood indices of sarcopenia subjects were generally lower in albumin, non-high-density lipoprotein cholesterol (non-HDL-C), and free triiodothyronine (FT3). Body mass index (BMI)(r = 0.6266, p < 0.0001), fat-free mass (r = 0.8110, p < 0.0001), basal metabolism (r = 0.7782, p < 0.0001), and fat mass (r = 0.3916, p = 0.0020) were positively correlated with appendicular skeletal muscle index (ASMI). Higher BMI and FT3 were associated with lower odds of sarcopenia, while higher fat mass was associated with higher odds of sarcopenia. After a 3-month intensive intervention, sarcopenia subjects had a significant increase in BMI, ASMI, lymphocyte, and albumin levels, and an increase in FT3, but with a non-significant difference (p = 0.342).

CONCLUSIONS

Low BMI, FT3, and high fat mass were associated with sarcopenia. Intensive lifestyle intervention can significantly improve ASMI, BMI, lymphocytes, albumin, and FT3 in sarcopenia subjects, which is favorable for delaying the progression of sarcopenia.

TRIAL REGISTRATION

This study was retrospectively registered on ClinicalTrials.gov, registration number NCT06128577, date of registration: 07/11/2023.

摘要

背景

随着人口寿命的延长,慢性退行性疾病的发病率逐渐增加,尤其是与肌肉骨骼系统相关的疾病。肌少症的特征是骨骼肌质量、肌肉力量和身体功能下降。它是一种常见于老年人的疾病,与各种不良健康结局相关。目前缺乏筛查肌少症的生物标志物。白蛋白和淋巴细胞计数常用于评估营养不良程度,而血常规、血脂和甲状腺功能作为常规体检的一部分相对容易获得。因此,寻找可以筛查肌少症的血液标志物至关重要。我们的主要目的是探讨身体成分、淋巴细胞、白蛋白、血脂和甲状腺激素等生物标志物是否与肌少症相关,次要目的是初步探讨强化生活方式干预后这些指标的变化。

方法

在中国苏州润达和白莲社区卫生服务中心选取 60 名受试者,进行身体成分分析和淋巴细胞、白蛋白、血脂、甲状腺激素水平检测。30 名肌少症受试者接受了为期 3 个月的强化生活方式干预计划。干预结束后,我们重新检查了生物标志物。统计分析采用 IBM SPSS v26.0 进行。

结果

肌少症受试者的血液指标普遍较低,包括白蛋白、非高密度脂蛋白胆固醇(non-HDL-C)和游离三碘甲状腺原氨酸(FT3)。体质指数(BMI)(r=0.6266,p<0.0001)、去脂体重(r=0.8110,p<0.0001)、基础代谢率(r=0.7782,p<0.0001)和脂肪量(r=0.3916,p=0.0020)与四肢骨骼肌指数(ASMI)呈正相关。较高的 BMI 和 FT3 与较低的肌少症发生几率相关,而较高的脂肪量与较高的肌少症发生几率相关。经过 3 个月的强化干预,肌少症受试者的 BMI、ASMI、淋巴细胞和白蛋白水平显著升高,FT3 也有所升高,但差异无统计学意义(p=0.342)。

结论

低 BMI、FT3 和高脂肪量与肌少症相关。强化生活方式干预可显著改善肌少症受试者的 ASMI、BMI、淋巴细胞、白蛋白和 FT3,有利于延缓肌少症的进展。

试验注册

本研究于 2023 年 7 月 11 日在 ClinicalTrials.gov 上进行了回顾性注册,注册号为 NCT06128577。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8dc4/11370020/5274e3148dba/12891_2024_7835_Fig1_HTML.jpg

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