北京高龄老年男性骨骼肌含量减少与行走功能的相关性研究

Relationship between site-specific loss of body skeletal muscle mass and gait performance in very old men in Beijing

目的调查北京某社区80岁以上老年男性增龄性骨骼肌减少的患病率，探讨不同部位骨骼肌含量、体脂含量与行走功能改变的关系。方法2013年2月～2014年5月随机选取116名80岁以上在门诊体检的北京社区退休老年人和85名20～40岁的健康志愿者，使用双光能x线骨密度仪测量骨骼肌含量，检测6米步行速度及握力。结果80岁以上男性肌少症前期、肌少症、严重肌少症的检出率分别为12．1％、21．2％、20．2％；老年肌少症组体重、握力、步速、下肢骨骼肌含量、四肢骨骼肌含量、相对骨骼肌指数（RASM）均显著低于非肌少症组（P〈0．05），下肢脂肪含量、总体脂肪含量在两组之间无显著差异：步速与大腿骨骼肌含量（r=0．246，P=0．036）呈正相关，与年龄（r=-0．253，P=0．030）、上肢脂肪含量（r=-0．358，P=0．043）、大腿脂肪含量（r=-0．285，P=0．018）、躯干脂肪含量（r=-0．253，P=0．037）、全身脂肪含量（r=-0．281,P=0．015）、总体脂肪百分比（r=-0．345，P=0．002）呈负相关；多元线性回归分析显示，大腿骨骼肌含量（β=0．232，P=0．016）与步速呈正相关，年龄（β=-0．532，P=0．000）、总体脂肪含量（β=-0．217，P=0．002）与步速独立负相关。结论根据EWGSOP标准．北京地区高龄老年肌少症的患病率较高，大腿骨骼肌含量与步速正相关，年龄、总体脂肪含量与步速负相关。在高龄老年肌少症与机体功能的研究中，除了开展改善下肢骨骼肌肌力、肌量的研究，还应关注体脂含量对躯体功能影响的研究。

Objective To investigate the prevalence of sarcopenia and its associations with functional status among men age 80 years and over in Beijing. Methods A total of 85 young healthy volunteers and 116 older men aged 80 years and older participated in this study. Demographic characteristics,skeletal muscle mass measured by dual x-ray absorptiometry （DXA）, 6-meter walking speed ,and handgrip strength were collected, appendicular skeletal muscle mass （ASM） and relative appendicular skeletal muscle index （RASM） were obtained. Results The prevalence of presarcopenia,sarcopenia and severe sarcopenia was 12.1%, 21.2%,20.2%, respectively. The body weight, hand strength, gait speed,leg muscle mass （appendicular skeletal muscle mass） ASM, RASM was also remarkably lower in person of sarcopenia than that of no sarcopenia （P 〈 0.05）. Gait speed was positively correlate with leg muscle mass （r = 0.246,P = 0.036）,negatively correlate with age （r = - 0.253,P = 0.030）,upper limb fat mass （r = - 0.358 ,P = 0.043）,thigh fat mass （r = - 0.253 ,P = 0.037）,trunk fat mass （r = - 0.281 ,P = 0.015）,total fat mass （r = - 0.345,P = 0.002）. Multiple linear regression analyses revealed thigh skeletal muscle mass was positively eorrelated with gait speed indipendently （β = 0.232,P = 0.016）, total body fat （β= - 0.217,P = 0.002） and age （β = - 0.532, P = 0.000） were negatively correlated with gait speed indipendently. Conclusion Sareopenia is highly prevalent among older Chinese men age 80 years and older. Functional limitations are significantly associated with older age, high skeletal muscle mass, and total body fat.