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中国老年人多种共病模式与肌肉减少症转化的关联。

Associations between multimorbidity patterns and sarcopenia transitions in Chinese older adults.

机构信息

Center for Aging and Health Research, School of Public Health, Xiamen University, Xiamen, China.

出版信息

Geriatr Gerontol Int. 2024 Nov;24(11):1137-1143. doi: 10.1111/ggi.14984. Epub 2024 Oct 7.

Abstract

AIM

Previous studies have shown that chronic diseases are strongly linked to the development of sarcopenia. Few studies have assessed the relationship between multimorbidity patterns and sarcopenia. This study aimed to investigate the impact of multimorbidity patterns on sarcopenia transitions in Chinese older adults.

METHODS

A total of 3842 older adults (aged 66.7 ± 6.2 years) with complete data at baseline and at least one follow-up record (2 years) were included from the China Health and Retirement Longitudinal Study. Multimorbidity patterns were identified using latent class analysis. Sarcopenia was determined by the Asian Working Group for Sarcopenia 2019 criteria. Multistage Markov modeling was used to explore the association of multimorbidity patterns with sarcopenia transitions after controlling for covariates in demographic features, health status and health-related behaviours.

RESULTS

Four multimorbidity patterns were identified at baseline: respiratory (17.73%), osteoarthritis-hypertension (22.23%), digestive-osteoarthritis (26.78) and cardiometabolic (33.27%). Participants with non-sarcopenia had 1-year transition probability of developing possible sarcopenia (10.1%) or sarcopenia (5.4%). Compared with the group without chronic diseases, the presence of cardiometabolic pattern increased the risk of progression from non-sarcopenia to possible sarcopenia (HR 1.43, 95% CI 1.05-2.95). The presence of the osteoarthritis-hypertension pattern (HR 1.55, 95% CI 1.00-2.41) and the digestive-osteoarthritis pattern (HR 1.78, 95% CI 1.20-2.66) were associated with the transition toward sarcopenia from non-sarcopenia.

CONCLUSIONS

Sarcopenia is a dynamic condition in older adults. To address sarcopenia in older adults, tailored interventions should be targeted at populations with different multimorbidity patterns. Geriatr Gerontol Int 2024; 24: 1137-1143.

摘要

目的

既往研究表明,慢性病与肌少症的发生发展密切相关。很少有研究评估多种疾病模式与肌少症之间的关系。本研究旨在探讨中国老年人多种疾病模式对肌少症转变的影响。

方法

本研究共纳入 3842 名年龄在 66.7±6.2 岁、基线时资料完整且至少有一次随访记录(2 年)的中国健康与养老追踪调查参与者。采用潜在类别分析确定多种疾病模式。采用 2019 年亚洲肌少症工作组标准确定肌少症。多阶段马尔可夫模型用于控制人口统计学特征、健康状况和健康相关行为等协变量后,探讨多种疾病模式与肌少症转变的关系。

结果

基线时确定了 4 种多种疾病模式:呼吸系统疾病(17.73%)、骨关节炎-高血压(22.23%)、消化系统疾病-骨关节炎(26.78%)和心血管代谢疾病(33.27%)。非肌少症患者发生可能肌少症(10.1%)或肌少症(5.4%)的 1 年转化率。与无慢性病组相比,心血管代谢疾病模式的存在增加了从非肌少症向可能肌少症进展的风险(HR 1.43,95%CI 1.05-2.95)。骨关节炎-高血压模式(HR 1.55,95%CI 1.00-2.41)和消化系统疾病-骨关节炎模式(HR 1.78,95%CI 1.20-2.66)与非肌少症向肌少症的转变相关。

结论

肌少症是老年人的一种动态状态。为了解决老年人的肌少症问题,应针对具有不同多种疾病模式的人群制定有针对性的干预措施。

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