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简单的临床实践措施能否作为肌少症性肥胖的替代指标并识别死亡风险?

Can simple measures from clinical practice serve as a proxy for sarcopenic obesity and identify mortality risk?

机构信息

Nutrition and Health Postgraduate Program, Federal University of Vitoria, Vitoria, Brazil.

Gerontology Postgraduate Program, Federal University of Sao Carlos, Sao Carlos, Brazil.

出版信息

Aging Clin Exp Res. 2024 Nov 19;36(1):222. doi: 10.1007/s40520-024-02866-9.

DOI:10.1007/s40520-024-02866-9
PMID:39557762
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11573834/
Abstract

BACKGROUND

Sarcopenic obesity is a condition where loss of muscle mass occurs alongside fat gain, and it is considered a risk factor for mortality. However, the use of various definitions for this condition has led to conflicting results.

AIM

To investigate whether the coexistence of low muscle mass and abdominal obesity, defined using two simple measures employed in clinical practice, is a risk factor for mortality in individuals aged 50 or older.

METHODS

A longitudinal study with a 14-year follow-up was conducted involving 5,440 participants of the English Longitudinal Study of Ageing. Abdominal obesity and low muscle mass were respectively defined based on high waist circumference and low skeletal muscle mass index (SMMI) determined by an equation. The sample was divided into four groups: non-low muscle mass/non-abdominal obesity (NLMM/NAO), non-low muscle mass/abdominal obesity (NLMM/AO), low muscle mass/non-abdominal obesity (LMM/NAO), and low muscle mass/abdominal obesity (LMM/AO). Cox regression models were used to estimate the mortality risk as a function of muscle mass and abdominal obesity status.

RESULTS

LMM/AO increased the risk of death by 83% (HR:1.83; 95%CI: 1.35-2.66) compared to those in the NLMM/NAO group. AO alone was not associated with a greater risk of mortality (HR:1.09; 95%CI: 0.93-1.27), whereas LMM alone increased the risk by 40% (HR:1.40; 95%CI:1.18-1.66).

CONCLUSIONS

Identifying LMM/AO in individuals aged 50 or older can be crucial for predicting the risk of mortality. Simple and easily applicable measures can serve as a proxy for sarcopenic obesity and aid in implementing the necessary interventions.

摘要

背景

肌少症性肥胖是一种肌肉质量下降同时脂肪增加的情况,被认为是死亡的危险因素。然而,由于对这种情况使用了各种定义,导致结果相互矛盾。

目的

研究使用两种简单的临床实践中使用的测量方法来定义的低肌肉量和腹型肥胖的共存是否是 50 岁及以上个体死亡的危险因素。

方法

对 5440 名英国老龄化纵向研究参与者进行了一项 14 年随访的纵向研究。腹型肥胖和低肌肉量分别根据高腰围和由公式确定的低骨骼肌质量指数(SMMI)来定义。将样本分为四组:非低肌肉量/非腹型肥胖(NLMM/NAO)、非低肌肉量/腹型肥胖(NLMM/AO)、低肌肉量/非腹型肥胖(LMM/NAO)和低肌肉量/腹型肥胖(LMM/AO)。使用 Cox 回归模型来估计肌肉量和腹型肥胖状况作为死亡风险的函数。

结果

与 NLMM/NAO 组相比,LMM/AO 使死亡风险增加了 83%(HR:1.83;95%CI:1.35-2.66)。单纯的 AO 与更高的死亡率无关(HR:1.09;95%CI:0.93-1.27),而单纯的 LMM 使风险增加了 40%(HR:1.40;95%CI:1.18-1.66)。

结论

在 50 岁及以上的个体中,识别 LMM/AO 对于预测死亡风险至关重要。简单且易于应用的测量方法可以作为肌少症性肥胖的替代指标,并有助于实施必要的干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38fa/11573834/b1f03347726c/40520_2024_2866_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38fa/11573834/b1f03347726c/40520_2024_2866_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/38fa/11573834/b1f03347726c/40520_2024_2866_Fig1_HTML.jpg

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本文引用的文献

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Dynapenic Abdominal Obesity as a Risk Factor for Metabolic Syndrome in Individual 50 Years of Age or Older: English Longitudinal Study of Ageing.动力性腹部肥胖是 50 岁及以上个体代谢综合征的一个危险因素:英国老龄化纵向研究。
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