老年男性住院患者各部位体成分随增龄的变化

Changes of body composition in various parts with aging in elderly male inpatients

目的探讨老年男性住院患者在多种慢性疾病共存的情况下,各部位人体成分随增龄的变化规律。方法选择2017年10月至2019年1月在复旦大学附属中山医院老年病科住院的65岁以上男性患者178例。收集基本信息、病史资料,测量身高、体重、腰围,计算体质量指数(body mass index,BMI)。采用双能X线骨密度扫描仪(dual X-ray absorptiometry,DXA)测量各部位人体成分。将BMI≥28 kg/m^2定义为肥胖;骨密度降低2.5标准差(standard deviation,SD)以上定义为骨质疏松;根据亚洲肌少症工作组(AWGS)诊断标准,将男性骨骼肌质量指数(skeletal muscle mass index,SMI)<7.0 kg/m^2定义为骨骼肌量减少。按每10岁为一组,分为65~74岁、75~84岁、≥85岁共3组,分析不同部位人体组分随年龄的变化趋势。结果该人群平均年龄(83.26±8.01)岁,平均BMI (24.20±3.28) kg/m^2,骨骼肌量减少、肥胖、骨质疏松的患病率分别为20.91%、28.18%、28.18%。总骨骼肌量随着年龄增长逐渐下降,其中四肢骨骼肌量下降明显,组间差异有统计学意义(P<0.05);总骨量逐渐减少,以骨盆、四肢骨量下降为主,骨密度与骨量的变化趋势一致;体脂百分比、各部位脂肪含量随年龄增长无显著变化。Pearson相关分析结果显示,SMI、总骨骼肌量、四肢骨骼肌量、总骨量、骨盆骨量、四肢骨量、骨盆骨密度均与年龄呈负相关(P<0.05)。回归分析结果显示,矫正BMI后,与65~74岁组相比,75~84岁组总骨骼肌量和总骨量分别减少了9.51%和6.84%,到85岁以后分别下降了11.75%和8.98%。结论随着年龄增长,老年男性住院患者各部位人体成分变化规律不一致,骨骼肌量及骨量消耗显著,脂肪含量无明显改变。

Objective To explore the variation tendency of body composition in various parts with aging in elderly male inpatients whom multiple chronic diseases coexist in.Methods We recruited 178 male elderly inpatients from the Geriatric Department of Zhongshan Hospital,Fudan University from October 2017 to January 2019.Anthropometric parameters included height,weight and waist circumference and disease history were collected.Dual X-ray absorptiometry(DXA) was used to measure body compositions.BMI ≥28 kg/m^2 was defined as obesity.Bone mineral density declining more than 2.5 standard deviation(SD) was defined as osteoporosis.Skeletal muscle mass index(SMI=appendicular lean mass/height2) <7.0 kg/m^2 in men was defined as skeletal muscle mass loss according to the Asian Working Group for sarcopenia(AWGS) criteria.The subjects were divided into three groups by every 10 years: 65-74 years,75-84 years and ≥85 years.The variation tendency of body composition in various parts with aging was analyzed.Results The average age of the subjects was(83.26±8.01) years old,and the average BMI was(24.20±3.28) kg/m^2.The prevalence of skeletal muscle mass loss,obesity and osteoporosis were 20.91%,28.18% and 28.18% respectively.The total skeletal muscle mass decreased with aging,while the limb skeletal muscle mass decreased significantly(P<0.05).The total bone mass decreased gradually,mainly in pelvis and limbs,which was consistent with the variation tendency of bone mineral density.The whole body fat mass percentage and fat mass in each part didn’t change significantly with aging.Pearson analysis showed that SMI,total skeletal muscle mass,total bone mass,pelvic bone mass,limb bone mass,and pelvic bone density were negatively correlated with age(P<0.05).Regression analysis showed that the total skeletal muscle mass and total bone mass in 75-84 years group decreased 9.51% and 6.84% respectively,and the total skeletal muscle mass and total bone mass in the ≥85 years group decreased 11.75% and 8.98% respectively when compared with 65-74 years group,after adjusted by BMI.Conclusion The skeletal muscle mass and bone mass but not fat mass decreased significantly with aging in the elderly male inpatients.