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中风住院患者中肌肉减少症患病率及肌肉相关结局的性别差异。

Sex differences in sarcopenia prevalence and muscle-related outcomes among post-stroke inpatients.

作者信息

Yoshimura Yoshihiro, Wakabayashi Hidetaka, Nagano Fumihiko, Matsumoto Ayaka, Shimazu Sayuri, Shiraishi Ai, Kido Yoshifumi, Bise Takahiro, Hamada Takenori, Yoneda Kouki

机构信息

Center for Sarcopenia and Malnutrition Research, Kumamoto Rehabilitation Hospital, 760 Magate, Kikuyo-Town, Kikuchi-County, Kumamoto, 869-1106, Japan.

Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan.

出版信息

Eur Geriatr Med. 2025 Mar 23. doi: 10.1007/s41999-025-01186-z.

Abstract

BACKGROUND

Sex differences in sarcopenia prevalence and recovery patterns among post-stroke patients remain poorly understood. This study aimed to investigate sex differences in sarcopenia prevalence, improvement rates, and changes in muscle-related indices among post-stroke patients in rehabilitation settings.

METHODS

A retrospective cohort study was conducted at a post-acute rehabilitation hospital. Sarcopenia was diagnosed using the Asian Working Group for Sarcopenia 2019 criteria. The primary outcomes were sarcopenia status and muscle-related indices (handgrip strength and skeletal muscle mass index) at discharge. Propensity score-adjusted logistic regression analysis was performed to examine the association between sex and non-sarcopenia at discharge.

RESULTS

A total of 598 patients (274 women) with a mean age of 71.6 years were analyzed. Women showed higher sarcopenia prevalence at admission compared to men (47.4% vs 34.2%, p = 0.001). After adjusting for confounders, male sex was positively associated with non-sarcopenia at discharge (OR 1.046, 95% CI 1.009-1.104, p < 0.001) and greater improvements in handgrip strength (B = 1.93, p = 0.031) and skeletal muscle mass index (B = 0.322, p = 0.019).

CONCLUSION

This study revealed significant sex differences in sarcopenia among post-stroke rehabilitation patients. While women showed higher sarcopenia prevalence at admission, men demonstrated better improvements in muscle-related outcomes.

摘要

背景

中风后患者肌肉减少症的患病率及恢复模式中的性别差异仍未得到充分了解。本研究旨在调查康复环境中中风后患者在肌肉减少症患病率、改善率以及肌肉相关指标变化方面的性别差异。

方法

在一家急性后期康复医院进行了一项回顾性队列研究。采用2019年亚洲肌肉减少症工作组标准诊断肌肉减少症。主要结局指标为出院时的肌肉减少症状态及肌肉相关指标(握力和骨骼肌质量指数)。进行倾向评分调整后的逻辑回归分析,以检验性别与出院时非肌肉减少症之间的关联。

结果

共分析了598例患者(274例女性),平均年龄71.6岁。与男性相比,女性入院时肌肉减少症患病率更高(47.4%对34.2%,p = 0.001)。在调整混杂因素后,男性性别与出院时非肌肉减少症呈正相关(OR 1.046,95%CI 1.009 - 1.104,p < 0.001),并且握力(B = 1.93,p = 0.031)和骨骼肌质量指数(B = 0.322,p = 0.019)有更大改善。

结论

本研究揭示了中风后康复患者在肌肉减少症方面存在显著的性别差异。虽然女性入院时肌肉减少症患病率更高,但男性在肌肉相关结局方面表现出更好的改善。

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