社区老年高血压与肌少症的相关性研究

吴小雪; 陈鸿桢; 郑坤; 余红梅; 夏丽

doi:10.16766/j.cnki.issn.1674-4152.003639

社区老年高血压与肌少症的相关性研究

doi: 10.16766/j.cnki.issn.1674-4152.003639

1.
重庆医科大学附属第一医院全科医学科，重庆 400016
2.
重庆医科大学附属第一医院老年病科

基金项目:

重庆市自然科学基金面上项目 CSTB2023NSCQ-MSX0119

详细信息

通讯作者:
夏丽，E-mail：13635441180@163.com

中图分类号: R544.1 R685
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出版历程
- 收稿日期: 2023-12-18
- 网络出版日期: 2024-11-19

Correlation between hypertension and sarcopenia in the community-dwelling older residents

1.
Department of General Practice, the First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China

摘要

摘要: 目的通过调查重庆市社区老年人肌少症患病现状，探讨肌少症和高血压的相关性，为社区老年群体肌少症的防治提供参考。方法选取2023年3—8月于重庆市社区卫生服务中心体检的615例老年人，通过问卷调查受试者的一般资料，并进行骨骼肌质量、步速、握力及血压的测量。根据亚洲肌少症工作组2019年诊断标准，将受试者分为肌少症组(80例)和非肌少症组(535例)，采用二元logistic回归分析探讨肌少症的影响因素，并通过Pearson相关性分析研究血压水平与肌少症各诊断关键指标之间的关系。结果本研究共纳入615例社区老年人，其中80例(13.0%)患有肌少症。肌少症组的年龄、高血压和糖尿病患病率均大于非肌少症组，而BMI小于非肌少症组(P＜0.05)。多因素分析结果显示，年龄增长(OR=1.140，95% CI：1.098~1.183)、患高血压病(OR=2.058，95% CI：1.195~3.545)是社区老年人患肌少症的危险因素(P＜0.05)。在合并高血压的老年人中，握力(r=-0.132，P=0.017)、四肢骨骼肌质量(r=-0.134，P=0.016)、骨骼肌质量指数(r=-0.121，P=0.030)与SBP存在一定的相关性。结论合并高血压病的社区老年人更易发生肌少症，SBP水平可以反映高血压老年人的肌肉质量和肌肉力量。因此，应尽早对社区老年人群进行肌少症筛查，严格控制血压以预防肌少症的发生。
- 肌少症 /
- 原发性高血压 /
- 老年人 /
- 社区
Abstract: Objective To investigate the correlation between sarcopenia and hypertension in community-dwelling older residents in Chongqing. Methods A total of 615 elderly who received medical check-ups at the community health center in Chongqing from March 2023 to August 2023 were selected. General information was collected by questionnaire and skeletal muscle mass, 6-meter walking speed, grip strength, and blood pressure were also measured. Subjects were divided into sarcopenia group and non-sarcopenia group according to the guidelines of Asian Working Group for Sarcopenia 2019. The factors influencing sarcopenia were determined by binary logistic regression analysis. The correlation between blood pressure and diagnostic indices of sarcopenia was performed by Pearson correlation analysis. Results Among the 615 elderly from Chongqing community, 80 elderly (13.0%) were diagnosed with sarcopenia. Compared with the non-sarcopenia group, the age, prevalence of hypertension and diabetes in the sarcopenia group were significantly higher, while the BMI was significantly lower (P < 0.05). Logistic regression analysis showed that older age (OR=1.140, 95% CI: 1.098-1.183), hypertension (OR=2.058, 95% CI: 1.195-3.545) were associated with increased risk of sarcopenia (P < 0.05). Pearson correlation analysis showed that grip strength (r=-0.132, P=0.017), appendicular skeletal muscle mass (r=-0.134, P=0.016), skeletal muscle mass index (r=-0.121, P=0.030) were negatively correlated with systolic blood pressure. Conclusion The risk of sarcopenia was increased with and hypertension in community-dwelling older residents. SBP can effectively reflect the muscle mass and strength of the elderly with hypertension. Therefore, screening for sarcopenia elderly in community-dwelling older residents should be done as early as possible, and sarcopenia should be prevented by effective blood pressure control.
- Sarcopenia /
- Essential hypertension /
- Older residents /
- Community

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表 1 2组社区老年人一般资料比较

Table 1. Comparison of general data between the two groups of community-dwelling elderly

项目	肌少症组 (n=80)	非肌少症组 (n=535)	统计量	P值
性别[例(%)]			0.001^a	0.975
男性	32(40.0)	215(40.2)
女性	48(60.0)	320(59.8)
年龄(x±s, 岁)	75.8±7.1	70.0±6.2	7.607^b	＜0.001
年龄[例(%)]			34.494^a	＜0.001
60~74岁	37(46.3)	414(77.4)
≥75岁	43(53.7)	121(22.6)
BMI(x±s)	22.6±3.3	24.9±3.0	6.272^b	＜0.001
BMI分类[例(%)]			-5.396^c	＜0.001
消瘦及正常	60(75.0)	214(40.0)
超重	14(17.5)	242(45.2)
肥胖	6(7.5)	79(14.8)
收入情况[例(%)]			1.039^a	0.308
可以承担日常生活	65(81.3)	458(85.6)
不能承担日常生活	15(18.7)	77(14.4)
文化程度[例(%)]			-1.097^c	0.273
文盲	18(22.5)	112(20.9)
小学	30(37.5)	167(31.2)
中学及以上	32(40.0)	256(47.9)
独居[例(%)]	12(15.0)	69(12.9)	0.269^a	0.604
吸烟史[例(%)]	24(30.0)	190(35.5)	0.933^a	0.334
饮酒史[例(%)]	11(13.8)	115(21.5)	2.563^a	0.109
疾病史[例(%)]
高血压	51(63.7)	274(51.2)	4.388^a	0.036
糖尿病	30(37.5)	138(25.8)	4.803^a	0.028
高脂血症	11(13.8)	64(12.0)	0.208^a	0.649
脂肪肝	11(13.8)	45(8.4)	2.397^a	0.122
冠心病	7(8.8)	40(7.5)	0.160^a	0.689
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组社区老年人血压、肌少症关键指标比较

Table 2. Comparison of key indicators of blood pressure and sarcopenia between the two groups of community-dwelling elderly

组别	例数	SBP (x±s, mmHg)	DBP (x±s, mmHg)	PP (x±s, mmHg)	上肢肌肉质量 [M(P₂₅, P₇₅), kg]	下肢肌肉质量 [M(P₂₅, P₇₅), kg]	SMI [M(P₂₅, P₇₅), kg/m²]	握力 [M(P₂₅, P₇₅), kg]	步速 [M(P₂₅, P₇₅), m/s]
肌少症组	80	131.5±9.4	78.2±7.5	53.3±7.2	3.1(2.6, 3.7)	10.5(9.2, 13.1)	5.6(5.4, 6.7)	19.7(16.0, 24.9)	0.9(0.8, 1.0)
非肌少症组	535	128.7±13.3	76.4±7.9	52.2±9.7	3.9(3.3, 4.8)	13.7(11.6, 16.1)	7.2(6.6, 8.1)	22.7(19.4, 29.7)	1.0(0.9, 1.2)
统计量		2.326^a	1.849^a	0.934^a	-7.903^b	-8.205^b	-10.986^b	-4.363^b	-6.223^b
P值		0.022	0.065	0.351	＜0.001	＜0.001	＜0.001	＜0.001	＜0.001
注：^a为t值，^b为Z值。

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表 3 社区老年人发生肌少症的影响因素分析

Table 3. Analysis of influencing factors of sarcopenia in community-dwelling elderly

变量	B	SE	Waldχ²	P值	OR值	95% CI
女性	0.008	0.245	0.001	0.975	1.008	0.624~1.628
年龄	0.131	0.019	46.344	＜0.001	1.140	1.098~1.183
BMI
超重	-1.578	0.311	25.705	＜0.001	0.206	0.112~0.380
肥胖	-1.306	0.448	8.501	0.004	0.271	0.113~0.652

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表 4 慢性病、血压水平对社区老年人发生肌少症的影响

Table 4. The influence of chronic diseases, blood pressure on the prevalence of sarcopenia in community-dwelling elderly

变量	B	SE	Waldχ²	P值	OR值	95% CI
高血压
校正前	0.516	0.248	4.323	0.038	1.675	1.030~2.724
校正后^a	0.722	0.277	6.763	0.009	2.058	1.195~3.545
糖尿病
校正前	0.546	0.251	4.722	0.030	1.726	1.055~2.824
校正后^a	0.441	0.277	2.534	0.111	1.554	0.903~2.675
SBP
校正前	0.016	0.009	3.265	0.071	1.016	0.999~1.034
校正后^a	0.020	0.010	4.002	0.045	1.020	1.000~1.041
校正后^b	0.010	0.011	0.702	0.402	1.010	0.987~1.033
DBP
校正前	0.027	0.015	3.384	0.066	1.027	0.998~1.057
校正后^a	0.035	0.017	4.540	0.033	1.036	1.003~1.070
校正后^b	0.022	0.018	1.457	0.227	1.022	0.987~1.059
注：^a校正年龄和BMI; ^b校正年龄、BMI和高血压。

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表 5 高血压老年人肌少症诊断指标与血压的相关性分析

Table 5. Correlation analysis between diagnostic indexes of sarcopenia and blood pressure in hypertensive elderly

项目	SBP		DBP		PP
项目	r值	P值	r值	P值	r值	P值
握力	-0.132	0.017	-0.079	0.155	-0.099	0.073
步速	0.034	0.543	-0.015	0.793	0.053	0.340
ASM	-0.134	0.016	-0.099	0.073	-0.086	0.123
SMI	-0.121	0.030	-0.073	0.189	-0.090	0.104

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