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肌肉减少症作为营养状况和合并症的预测因子:一项横断面和孟德尔随机化研究。

Sarcopenia as a predictor of nutritional status and comorbidities: a cross-sectional and mendelian randomization study.

机构信息

Department of Orthopedics, the Second Xiangya Hospital of Central South University, 139 Renmin Road, Changsha, Hunan , 410011, People's Republic of China.

Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha, 410011, People's Republic of China.

出版信息

BMC Geriatr. 2024 Sep 11;24(1):752. doi: 10.1186/s12877-024-05341-2.

Abstract

BACKGROUND

With the advancement of world population aging, age-related sarcopenia (SP) imposes enormous clinical burden on hospital. Clinical research of SP in non-geriatric wards has not been appreciated, necessitating further investigation. However, observational studies are susceptible to confounders. Mendelian randomization (MR) can effectively mitigate bias to assess causality.

OBJECTIVE

To investigate the correlation between SP and comorbidities in orthopedic wards, and subsequently infer the causality, providing a theoretical basis for developing strategies in SP prevention and treatment.

METHODS

Logistic regression models were employed to assess the correlation between SP and comorbidities. The MR analysis was mainly conducted with inverse variance weighted, utilizing data extracted from the UK and FinnGen biobank (Round 9).

RESULTS

In the cross-sectional analysis, SP exhibited significant associations with malnutrition (P = 0.013) and some comorbidities, including osteoporosis (P = 0.014), body mass index (BMI) (P = 0.021), Charlson Comorbidity Index (CCI) (P = 0.006). The MR result also provided supporting evidence for the causality between SP and hypertension, osteoporosis and BMI. These results also withstood multiple sensitivity analyses assessing the validity of MR assumptions.

CONCLUSION

The result indicated a significant association between SP and BMI, CCI, malnutrition, and osteoporosis. We highlighted that SP and comorbidities deserved more attention in non-geriatric wards, urging further comprehensive investigation.

摘要

背景

随着世界人口老龄化的发展,与年龄相关的肌肉减少症(SP)给医院带来了巨大的临床负担。非老年病房的 SP 临床研究尚未得到重视,需要进一步研究。然而,观察性研究容易受到混杂因素的影响。孟德尔随机化(MR)可以有效地减轻评估因果关系的偏差。

目的

调查骨科病房 SP 与合并症的相关性,并推断其因果关系,为制定 SP 预防和治疗策略提供理论依据。

方法

采用逻辑回归模型评估 SP 与合并症的相关性。MR 分析主要采用逆方差加权法,利用来自英国和 FinnGen 生物库的数据(第 9 轮)进行分析。

结果

在横断面分析中,SP 与营养不良(P=0.013)和一些合并症显著相关,包括骨质疏松症(P=0.014)、体重指数(BMI)(P=0.021)、Charlson 合并症指数(CCI)(P=0.006)。MR 结果也为 SP 与高血压、骨质疏松症和 BMI 之间的因果关系提供了证据。这些结果也通过了多种敏感性分析,评估了 MR 假设的有效性。

结论

结果表明 SP 与 BMI、CCI、营养不良和骨质疏松症之间存在显著关联。我们强调,非老年病房的 SP 和合并症值得更多关注,需要进一步进行全面调查。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e52f/11389292/207409e3e7ee/12877_2024_5341_Fig1_HTML.jpg

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