肌肉减少症患者血清AMPK-αmRNA、SIRT1、GDF-8的水平及其临床意义

王琴; 林萍; 任谦; 冯莉; 谢晓枫; 张彬; 高康璐

doi:10.16766/j.cnki.issn.1674-4152.002545

肌肉减少症患者血清AMPK-αmRNA、SIRT1、GDF-8的水平及其临床意义

doi: 10.16766/j.cnki.issn.1674-4152.002545

杭州市第三人民医院老年科，浙江杭州 310009

基金项目:

浙江省医药卫生科技计划项目 2019KY502

杭州市卫生计生科技计划项目 2018A29

杭州市卫生计生科技计划项目 2018Z05

详细信息

通讯作者:
林萍, E-mail: linpingyj@sina.com

中图分类号: R685
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出版历程
- 收稿日期: 2021-04-14
- 网络出版日期: 2022-09-23

Serum AMPK-α mRNA, SIRT1 and GDF-8 levels in patients with sarcopenia

Department of the Geriatrics, Hangzhou Third People's Hospital, Hangzhou, Zhejiang 310009, China

摘要

摘要: 目的研究肌少症患者血清腺苷酸活化蛋白激酶-α微小RNA(AMPK-αmRNA)、血清沉默信息调节因子2相关酶1(SIRT1)及血清生长分化因子-8(GDF-8)的水平。方法选择2019年1月—2020年6月杭州市第三人民医院收治的老年患者81例，根据四肢肌肉质量指数、握力及步行速度将患者分为肌肉减少症组(41例)和非肌肉减少症组(40例)，检测血清AMPK-α mRNA、SIRT1及GDF-8等。采用Pearson、Spearman相关性分析相关性；采用ROC曲线分析GDF-8的诊断价值。结果肌少症组与非肌少症组患者各项指标[AMPK-α mRNA: 0.26(0.24，0.29)vs. 0.29(0.27, 0.32);SIRT1(ng/L): 582.68±35.92 vs. 646.50±39.08;GDF-8(μg/L): 20.97±5.10 vs. 14.76±1.59]比较差异均有统计学意义(均P＜0.001)。SIRT1、AMPK-α mRNA与GDF-8呈负相关(P＜0.001, P=0.001)。握力与AMPK-α mRNA及SIRT1呈正相关(P=0.028, P＜0.001)；握力与GDF-8呈负相关(P=0.001)。GDF-8诊断肌少症的临界值是17.25 μg/L，AUC值为0.884(P=0.040)。结论肌少症患者AMPK-α mRNA及SIRT1降低，GDF-8增高，GDF-8可作为肌少症诊断的辅助参考指标。
- 肌肉减少症 /
- 腺苷酸活化蛋白激酶-α微小RNA /
- 血清沉默信息调节因子2相关酶1 /
- 生长分化因子-8
Abstract: Objective To investigate the level of serum AMP-activated protein kinase-α mRNA (AMPK-α mRNA), silent mating type information regulation 2 homolog-1 (SIRT1) and growth differentiation factor-8 (GDF-8) in patients with sarcopenia. Methods A total of 81 elderly patients treated in Hangzhou Third People's Hospital from January 2019 to June 2020 were selected. According to appendicular skeletal mass index (ASMI), grip strength and walking speed, the patients were divided into sarcopenia group (41 cases) and non-sarcopenia group (40 cases). The level of AMPK-α mRNA, SIRT1 and GDF-8 in serum were detected. The correlation was analyzed by Pearson and Spearman correlation. The diagnostic value of GDF-8 was analyzed by ROC curve. Results The data of several indexes of patients in sarcopenia group and non sarcopenia group were as follows [AMPK-α mRNA: 0.26 (0.24, 0.29) vs. 0.29 (0.27, 0.32), SIRT1 (ng/L): 582.68±35.92 vs. 646.50±39.08, GDF-8 (μg/L): 20.97±5.10 vs. 14.76±1.59], the difference was statistically significant (all P < 0.01). SIRT1 and AMPK-α mRNA were negatively correlated with GDF-8 (P < 0.001, P=0.001). The grip strength was positively correlated with AMPK-α mRNA and SIRT1 (P=0.028, P < 0.001), and was negatively correlated with GDF-8 (P=0.001). The critical value of GDF-8 for the diagnosis of sarcopenia was 17.25 μg/L, and AUC was 0.884 (P=0.040). Conclusion AMPK-α mRNA and SIRT1 are decreased and GDF-8 is increased in sarcopenia group. GDF-8 can be used as an auxiliary reference index for the diagnosis of sarcopenia.
- Sarcopenia /
- AMP-activated protein kinase-α microRNA /
- Silent mating type information regulation 2 homolog-1 /
- Growth differentiation factor-8

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图 1 GDF-8诊断肌少症的ROC曲线

Figure 1. ROC curve of GDF-8 in diagnosis of sarcopenia

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表 1 2组老年患者一般情况比较

Table 1. The general conditions of the two groups

组别	例数	性别(男/女，例)	年龄(x±s，岁)	BMI (x±s)	高血压病(例)	冠心病(例)	糖尿病(例)	COPD (例)	CKD (例)	骨质疏松(例)
肌少症组	41	29/12	80.10±3.94	21.12±0.88	22	13	16	18	7	33
非肌少症组	40	27/13	79.38±3.10	21.26±0.69	23	10	18	14	5	34
统计量		0.099^a	0.915^b	-0.797^b	0.121^a	0.448^a	0.297^a	0.671^a	0.336^a	0.288^a
P值		0.753	0.363	0.428	0.728	0.503	0.586	0.413	0.562	0.591
注：^a为χ²值，^b为t值。

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表 2 2组老年患者SIRT1、AMPK-αmRNA、GDF-8、步行速度、ASMI、握力、睾酮、GDF-11和IGF-1比较

Table 2. Comparison of SIRT1, AMPK-αmRNA, GDF-8, walking speed, ASMI, grip strength, testosterone, GDF-11 and IGF-1 between two groups of elderly patients

组别	例数	GDF-11 (x±s, μg/L)	SIRT1 (x±s, ng/L)	AMPK-α mRNA [M(P₂₅, P₇₅)]	IGF-1 (x±s, μg/L)	GDF-8 (x±s, μg/L)
肌少症组	41	171.32±13.49	582.68±35.92	0.26(0.24，0.29)	144.63±10.99	20.97±5.10
非肌少症组	40	261.98±39.52	646.50±39.08	0.29(0.27, 0.32)	247.08±16.12	14.76±1.59
统计量		-13.749^a	-7.656^a	-3.433^b	-33.346^a	7.422^a
P值		＜0.001	＜0.001	0.001	＜0.001	＜0.001

组别	例数	步行速度[M(P₂₅, P₇₅), m/s]	ASMI [M(P₂₅, P₇₅), kg/m²]	握力[M(P₂₅, P₇₅), kg]		睾酮(x±s, nmol/L)
肌少症组	41	0.60(0.58, 0.64)	5.80(5.50, 6.10)	18.20(17.50, 18.65)		7.48±2.34
非肌少症组	40	0.82(0.81, 0.83)	7.20(7.03, 7.30)	26.50(26.30, 27.20)		15.98±2.90
统计量		-7.773^b	-7.765^b	-6.977^b		-14.508^a
P值		＜0.001	＜0.001	＜0.001		＜0.001
注：^a为t值，^b为Z值。

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表 3 SIRT1与GDF-8、GDF-11及IGF-1的相关性分析

Table 3. Correlation analysis of SIRT1 with GDF-8, GDF-11 and IGF-1

项目	r值	P值
GDF-8	-0.544	＜0.001
GDF-11	0.616	＜0.001
IGF-1	0.649	＜0.001

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表 4 AMPK-α mRNA与GDF-8、GDF-11及IGF-1的相关性分析

Table 4. Correlation analysis of AMPK-αmRNA with GDF-8, GDF-11 and IGF-1

项目	r值	P值
GDF-8	-0.359	0.001
GDF-11	0.331	0.001
IGF-1	0.355	0.003

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表 5 握力与ASMI、步行速度、IGF-1、AMPK、SIRT1及GDF-8的相关性分析

Table 5. Correlation analysis of grip strength with ASMI, walking speed, IGF-1, AMPK, SIRT1 and GDF-8

项目	r值	P值
GDF-8	-0.560	＜0.001
IGF-1	0.674	＜0.001
ASMI	0.819	＜0.001
步行速度	0.682	＜0.001
AMPK-α mRNA	0.244	0.028
SIRT1	0.565	＜0.001

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