系统性炎症指标对下肢动脉硬化闭塞症患者发生肌少症的预测价值

Predictive value of systemic inflammatory markers for the onset of sarcopenia in patients with lower extremity arteriosclerosis obliterans

目的:评估全身免疫炎症指数(SII)、血小板/淋巴细胞比值(PLR)、中性粒细胞/淋巴细胞比值(NLR)、淋巴细胞/单核细胞比值(LMR)和C反应蛋白(CRP)等系统性炎症指标对下肢动脉硬化闭塞症(ASO)患者发生肌少症的预测价值。方法:本研究纳入江苏大学附属武进医院和南京医科大学附属常州第二人民医院的251例ASO患者。依据第三腰椎腰大肌指数(PMI)将患者分为肌少症组和非肌少症组。收集患者的一般资料和相关血液指标,并计算SII、PLR、NLR和LMR。通过二分类Logistic回归分析确定ASO患者发生肌少症的危险因素,并采用受试者工作特征(ROC)曲线评估相关指标的预测效果。结果:251例ASO患者中,肌少症组和非肌少症组患者数分别为98例(39.0%)和153例(61.0%)。与非肌少症组相比,肌少症组患者年龄明显增加(P<0.001),SII、PLR、NLR和CRP水平明显增高(P<0.01),而BMI和LMR水平明显降低(P<0.01)。多因素Logistic回归分析结果表明,高龄、BMI偏低、SII上升均为ASO患者发生肌少症的独立危险因素。ROC曲线结果显示,年龄、BMI、SII和3项指标联合预测肌少症发生的曲线下面积分别为0.674、0.678、0.644和0.746(P均<0.001)。结论:年龄、BMI及系统性炎症指标中的SII对ASO患者肌少症的发生有一定的预测价值。

Objective:To assess the predictive value of systemic inflammatory indicators,including systemic immune-inflammation index(SII),platelet to lymphocyte ratio(PLR),neutrophil to lymphocyte ratio(NLR),lymphocyte to monocyte ratio(LMR),and C-reactive protein(CRP),for the onset of sarcopenia in patients with lower extremity arteriosclerosis obliterans(ASO).Methods:A total of 251 ASO patients from the Wujin Hospital Affiliated with Jiangsu University and the Second People′s Hospital Affiliated with Nanjing Medical University were included in the study.Patients were classified into sarcopenia and non-sarcopenia groups based on the psoas muscle index(PMI)of the third lumbar vertebra.Relevant blood indicators of the patients were collected,and SII,PLR,NLR,and LMR were calculated.Binary Logistic regression analysis was used to identify the risk factors for sarcopenia,and the predictive performance of each indicator was assessed by using the receiver operating characteristic(ROC)curve.Results:Among the 251 ASO patients,there were 98(39.0%)in the sarcopenia group and 153(61.0%)in the non-sarcopenia group.Compared with the non-sarcopenia group,the age of patients in the sarcopenia group was significantly increased(P<0.001),and the levels of SII,PLR,NLR and CRP were significantly increased(P<0.01),and the levels of BMI and LMR were significantly decreased(P<0.01).Multivariate Logistic analysis revealed that advanced age,low BMI,elevated SII were independent risk factors for sarcopenia.The ROC curve further confirmed the predictive value of these indicators for sarcopenia,with the area under the curve(AUC)of age,BMI,SII,and combined prediction of 3 indicators for the onset of sarcopenia being 0.674,0.678,0.644,and 0.746 respectively(all P<0.001).Conclusion:Age,BMI,and systemic inflammatory indicators such as SII have predictive value for the onset of sarcopenia in ASO patients.