Long Lu, Xiong Bingquan, Luo Zhidan, Yang Haiyan, She Qiang
Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Geriatrics, Chongqing General Hospital, Chongqing University, Chongqing, China.
J Clin Hypertens (Greenwich). 2025 Jan;27(1):e14944. doi: 10.1111/jch.14944. Epub 2024 Nov 17.
Sarcopenia worsens the prognosis in hypertensive patients, leading to complications such as proteinuria, osteoporosis, disability, and cognitive impairment. Early screening and intervention for sarcopenia in these patients may improve outcomes. This cross-sectional study utilized data from 9253 hypertensive patients in the 1999-2018 National Health and Nutrition Examination Survey (NHANES). We used logistic and linear regression models, restricted cubic splines (RCS), and subgroup analyses to evaluate the relationship between pan-immune-inflammation value (PIV) and sarcopenia. Patients were divided into quartiles based on PIV levels. After controlling for confounding factors, our study found that those in the highest PIV quartile faced a 36% greater risk of developing sarcopenia compared to those in the lowest quartile (OR = 1.36, 95% confidence interval [CI]: 1.04-1.77). The RCS analysis indicated a linear increase in sarcopenia risk as PIV levels rose (non-linear p = 0.130). Subgroup analysis demonstrated that diabetes synergistically increased sarcopenia risk (p for interaction = 0.007). Elevated PIV levels were identified as an independent risk factor for sarcopenia, with diabetes amplifying this risk. These findings highlight the importance of early identification and management of elevated PIV levels to improve outcomes for hypertensive patients at risk of sarcopenia.
肌肉减少症会使高血压患者的预后恶化，导致蛋白尿、骨质疏松、残疾和认知障碍等并发症。对这些患者进行肌肉减少症的早期筛查和干预可能会改善预后。这项横断面研究利用了1999 - 2018年国家健康和营养检查调查（NHANES）中9253名高血压患者的数据。我们使用逻辑回归和线性回归模型、限制性立方样条（RCS）以及亚组分析来评估全免疫炎症值（PIV）与肌肉减少症之间的关系。根据PIV水平将患者分为四分位数。在控制混杂因素后，我们的研究发现，PIV四分位数最高的患者发生肌肉减少症的风险比最低四分位数的患者高36%（比值比[OR]=1.36，95%置信区间[CI]：1.04 - 1.77）。RCS分析表明，随着PIV水平升高，肌肉减少症风险呈线性增加（非线性p = 0.130）。亚组分析表明，糖尿病会协同增加肌肉减少症风险（交互作用p = 0.007）。PIV水平升高被确定为肌肉减少症的独立危险因素，糖尿病会放大这种风险。这些发现凸显了早期识别和管理升高的PIV水平对于改善有肌肉减少症风险的高血压患者预后的重要性。
