肌少症性肥胖与老年高血压的相关性临床研究

赵旭冉; 高金娥; 娜日松; 海荣; 张鹏飞

doi:10.16766/j.cnki.issn.1674-4152.002724

肌少症性肥胖与老年高血压的相关性临床研究

doi: 10.16766/j.cnki.issn.1674-4152.002724

1.
内蒙古自治区人民医院老年医学中心，内蒙古呼和浩特 010010
2.
内蒙古自治区卫生健康委员会，内蒙古呼和浩特 010000
3.
内蒙古自治区人民医院运动医学中心

基金项目:

国家重点研发计划项目 2018YFC2002100

内蒙古自治区人民医院院内基金项目 2022YN20

详细信息

通讯作者:
张鹏飞, E-mail: 49732515@qq.com

中图分类号: R544.1 R589.2
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- 被引次数: 0
出版历程
- 收稿日期: 2021-12-28
- 网络出版日期: 2022-12-30

Clinical study on the correlation between sarcopenic obesity and hypertension in elderly subjects

1.
Geriatric Medicine Center, Inner Mongolia People's Hospital, Hohhot, Inner Mongolia 010010, China

摘要

摘要: 目的探讨老年人肌少症性肥胖与高血压的相关性，为临床防治老年高血压提供参考。方法选择2018年1月—2021年1月在内蒙古自治区人民医院老年医学中心住院的老年患者210例，其中高血压134例(63.81%)，非高血压76例(36.19%)，分别测定2组患者身高、体重、四肢骨骼肌肉量(ASM)、握力、血糖、血脂、肝肾功能，计算体重指数(BMI)及四肢骨骼肌质量指数(RSMI)，并进行比较分析。结果高血压组ASM、RSMI低于非高血压组[(14.90±3.38)kg vs. (19.41±1.56)kg, P＜0.001;(5.59±1.37)kg/m² vs. (7.11±0.84)kg/m², P＜0.001]。高血压组年龄和BMI高于非高血压组[(72.79±7.20)岁vs. (70.79±6.51)岁, P=0.046;25.66±3.48 vs. 24.46±2.81, P=0.011]。高血压组肌少症及肌少症性肥胖患病率均高于非高血压组(67.91% vs. 38.16%, P＜0.001；25.37% vs. 2.63%, P＜0.001)。多因素logistic回归分析显示，高龄、肌少症、肌少症性肥胖为老年高血压的危险因素。结论 ASM与老年高血压密切相关，高ASM是老年高血压的保护性因素，肌少症性肥胖、肌少症是老年高血压的重要危险因素。
- 高血压 /
- 肌少症 /
- 肌少症性肥胖 /
- 老年人
Abstract: Objective To explore the correlation between sarcopenic obesity and hypertension in the elderly, and to provide reference for clinical prevention and treatment of hypertension in the elderly. Methods Two hundred and ten elderly patients hospitalized in Geriatric Medicine Center of Inner Mongolia People's Hospital from January 2018 to January 2021 were selected. Among them, 134 (63.81%) were hypertensive and 76 (36.19%) were non-hypertensive. Height, body mass, appendicular skeletal muscle mass (ASM), grip strength, blood glucose, blood lipid, liver function and kidney function were measured. Body mass index (BMI) and relative skeletal muscle index (RSMI) were calculated and compared. Results ASM and RSMI in the hypertension group were lower than those in the non-hypertension group [(14.90±3.38) kg vs. (19.41±1.56) kg, P < 0.001; (5.59±1.37) kg/m² vs. (7.11 ±0.84) kg/m², P < 0.001]. The age and BMI of the hypertension group were higher than those of the non-hypertension group [(72.79±7.20) years vs. (70.79±6.51) years, P=0.046; 25.66±3.48 vs. 24.46±2.81, P=0.011]. The prevalence rate of sarcopenia and sarcopenic obesity in the hypertensive group was higher than those in the non-hypertensive group (67.91% vs. 38.16%, P < 0.001; 25.37% vs. 2.63%, P < 0.001). Multivariate logistic regression analysis showed that age, sarcopenia and sarcopenic obesity were the risk factors of hypertension in the elderly. Conclusion ASM is closely related to hypertension, and high ASM is a protective factor of hypertension in the elderly. Sarcopenic obesity and sarcopenia are important risk factors of hypertension in the elderly.
- Hypertension /
- Sarcopenia /
- Sarcopenic obesity /
- The aged

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表 1 2组老年患者一般特征比较

Table 1. Comparison of general characteristics between the two groups of elderly patients

项目	非高血压组(76例)	高血压组(134例)	统计量	P值
年龄(x±s，岁)	70.79±6.51	72.79±7.20	1.916^a	0.046
性别[例(%)]			3.434^b	0.064
女性	33(43.42)	76(56.72)
男性	43(56.58)	58(43.28)
BMI(x±s)	24.46±2.81	25.66±3.48	4.152^a	0.011
FPG(x±s，mmol/L)	5.27±0.78	5.17±0.62	1.335^a	0.335
TG[M(P₂₅, P₇₅)，mmol/L]	1.62(1.07, 2.14)	1.47(1.07, 2.10)	-0.826^c	0.409
TC(x±s，mmol/L)	4.52±0.98	4.61±1.08	0.779^a	0.566
LDL(x±s，mmol/L)	2.69±0.70	2.70±0.75	0.359^a	0.862
AST(x±s，U/L)	20.51±8.29	20.17±7.24	0.479^a	0.753
ALT[M(P₂₅, P₇₅)，U/L]	17.20(13.00，24.85)	16.40(13.15，22.10)	-0.545^c	0.586
Scr(x±s，μmol/L)	63.14±15.51	64.64±15.09	＜0.001^a	0.493
ASM(x±s，kg)	19.41±1.56	14.90±3.38	60.831^a	＜0.001
RSMI(x±s，kg/m²)	7.11±0.84	5.59±1.37	15.187^a	＜0.001
注：^a为t值，^b为χ²值，^c为Z值。

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表 2 老年高血压影响因素的多因素logistic回归分析

Table 2. Multiple logistic regression analysis

变量	B	SE	Wald χ²	P值	OR值	95% CI
常量	4.261	3.187	1.787	0.181	70.852
年龄	0.058	0.029	4.077	0.043	1.059	1.002~1.121
BMI	0.049	0.072	0.457	0.499	1.050	0.911~1.210
ASM	-0.561	0.087	41.540	＜0.001	0.571	0.481~0.677
肌少症性肥胖	2.069	0.959	4.652	0.031	7.918	1.208~51.912
肌少症	1.104	0.501	4.852	0.028	3.016	1.129~8.052

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参考文献(22)

[1]	李静, 范利, 华琦, 等. 中国老年高血压管理指南2019[J]. 中华高血压杂志, 2019, 27(2): 111-135. doi: 10.16439/j.cnki.1673-7245.2019.02.008 LI J, FAN L, HUA Q, et al. 2019 Chinese guidelines for the management of hypertension in the elderly[J]. Chinese Journal of Cardiovascular Medicine, 2019, 27(2): 111-135. doi: 10.16439/j.cnki.1673-7245.2019.02.008
[2]	吉彤, 汤哲, 李耘, 等. 老年人少肌性肥胖的诊断标准现况[J]. 实用老年医学, 2021, 35(1): 74-76. doi: 10.3969/j.issn.1003-9198.2021.01.020 JI T, TANG Z, LI Y, et al. Status of diagnostic criteria for sarcopenic obesity in the elderly[J]. Practical Geriatrics, 2021, 35(1): 74-76. doi: 10.3969/j.issn.1003-9198.2021.01.020
[3]	KREIDIEH D, ITANI L, El MASRI D, et al. Association between sarcopenic obesity, type 2 diabetes, and hypertension in overweight and obese treatment-seeking adult women[J]. J Cardiovasc Dev Dis, 2018, 5(4): 51-58. doi: 10.3390/jcdd5040051
[4]	CHEN L K, WOO J, ASSANTACHAI P, et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment[J]. J Am Med Dir Assoc, 2020, 21(3): 300-307. doi: 10.1016/j.jamda.2019.12.012
[5]	刘莹, 谭寅凤, 张金月, 等. 超重肥胖和正常体重人群肠道菌群的差异分析[J]. 中国临床研究, 2022, 35(1): 21-24. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK202201005.htm LIU Y, TAN Y F, ZHANG J Y, et al. Difference of gut microbiota in people with overweight/obese and normal weight[J]. Chinese Journal of Clinical Research, 2022, 35(1): 21-24. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGCK202201005.htm
[6]	DONINI L M, BUSETTO L, BAUER J M, et al. Critical appraisal of definitions and diagnostic criteria for sarcopenic obesity based on a systematic review[J]. Clin Nutr, 2020, 39(8): 2368-2388. doi: 10.1016/j.clnu.2019.11.024
[7]	PONTI F, SANTORO A, MERCATELLI D, et al. Aging and imaging assessment of body composition: From fat to facts[J]. Front Endocrinol(Lausanne), 2020, 10(1): 861-878.
[8]	ZHANG X, XIE X, DOU Q, et al. Association of sarcopenic obesity with the risk of all-cause mortality among adults over a broad range of different settings: A updated meta-analysis[J]. BMC Geriatr, 2019, 19(1): 183-197. doi: 10.1186/s12877-019-1195-y
[9]	HONG S H, CHOI K M. Sarcopenic obesity, insulin resistance, and their implications in cardiovascular and metabolic consequences[J]. Int J Mol Sci, 2020, 21(2): 494-511. doi: 10.3390/ijms21020494
[10]	POLYZOS S A, MARGIORIS A N. Sarcopenic obesity[J]. Hormones (Athens), 2018, 17(3): 321-331. doi: 10.1007/s42000-018-0049-x
[11]	ATKINS J L, WANNAMATHEE S G. Sarcopenic obesity in ageing: Cardiovascular outcomes and mortality[J]. Br J Nutr, 2020, 124(10): 1102-1113. doi: 10.1017/S0007114520002172
[12]	BAI T, FANG F, LI F, et al. Sarcopenia is associated with hypertension in older adults: A systematic review and meta-analysis[J]. BMC Geriatr, 2020, 20(1): 279-288. doi: 10.1186/s12877-020-01672-y
[13]	SASAKI K I, FUKUMOTO Y. Sarcopenia as a comorbidity of cardiovascular disease[J]. J Cardiol, 2022, 79(5): 596-604. doi: 10.1016/j.jjcc.2021.10.013
[14]	马璐瑶, 林萍, 王琴, 等. 老年慢性心力衰竭患者肌少症的筛查及干预研究[J]. 中华全科医学, 2022, 20(3): 419-423. doi: 10.16766/j.cnki.issn.1674-4152.002367 MA L Y, LIN P, WANG Q, et al. Screening and intervention of sarcopoenia in elderly patients with chronic heart failure[J]. Chinese Journal of General Practice, 2022, 20(3): 419-423. doi: 10.16766/j.cnki.issn.1674-4152.002367
[15]	PASDAR Y, DARBANDI M, REZAEIAN S, et al. Association of obesity, sarcopenia, and sarcopenic obesity with hypertension in adults: A cross-sectional study from Ravansar, Iran during 2014-2017[J]. Front Public Health, 2022, 9: 705055. DOI: 10.3389/fpubh.2021.705055.
[16]	ZAMBONI M, RUBELE S, ROSSI A P. Sarcopenia and obesity[J]. Curr Opin Clin Nutr Metab Care, 2019, 22(1): 13-19. doi: 10.1097/MCO.0000000000000519
[17]	LIVSHITS G, KALINKOVICH A. Inflammaging as a common ground for the development and maintenance of sarcopenia, obesity, cardiomyopathy and dysbiosis[J]. Ageing Res Rev, 2019, 56(8): 100980. DOI: 10.1016/j.arr.2019.100980.
[18]	GUARALDI G, MILIC J, SEBASTIANI G, et al. Sarcopenic obesity at the crossroad of pathogenesis of cardiometabolic diseases[J]. Atherosclerosis, 2021, 335(10): 84-86.
[19]	SUN T, MA Z, GAO L, et al. Correlation between sarcopenia and arteriosclerosis in elderly community dwellers: A multicenter study[J]. J Nutr Health Aging, 2021, 25(5): 692-697. doi: 10.1007/s12603-021-1624-4
[20]	TAKAHASHI F, HASHIMOTO Y, KAJI A, et al. Sarcopenic obesity is associated with macroalbuminuria in patients with type 2 diabetes: A cross-sectional study[J]. Endocr J, 2021, 68(7): 781-789. doi: 10.1507/endocrj.EJ20-0655
[21]	EVANS K, ABDELHAFIZ D, ABDELHAFIZ A H. Sarcopenic obesity as a determinant of cardiovascular disease risk in older people: A systematic review[J]. Postgrad Med, 2021, 133(8): 831-842. doi: 10.1080/00325481.2021.1942934
[22]	LIM H S, PARK Y H, SUH K, et al. Association between sarcopenia, sarcopenic obesity, and chronic disease in Korean elderly[J]. J Bone Metab, 2018, 25(3): 187-193. doi: 10.11005/jbm.2018.25.3.187