社区老年人肌少症与非酶糖基化水平和心血管疾病的相关性研究

Correlation between sarcopenia and non-enzymatic glycosylation and cardiovascular disease in the community elderly

目的探讨社区老年人群肌少症的发病特征及其与非酶糖基化水平、常见心血管疾病的相关性。方法纳入符合标准的入住江苏省老年公寓的老年人110例,根据亚洲肌少症工作组指南将其分为肌少症组(n=38)及非肌少症组(n=72)。比较2组人群的临床资料、心血管疾病(心力衰竭、冠心病、高血压)患病情况,采用多因素Logistic回归分析肌少症的危险因素。采用ELISA法进一步检测60例受试者的羧甲基赖氨酸(CML)、晚期糖基化终产物可溶性受体(sRAGE)水平,比较肌少症与非肌少症人群的CML、sRAGE水平及晚期糖基化终产物(AGEs)/sRAGE比值。结果肌少症组的年龄明显大于非肌少症组,而BMI、骨骼肌质量指数(SMI)、握力、4 m步速均显著小于非肌少症组,差异有统计学意义(P<0.01)。肌少症组的Hb、白蛋白水平显著低于非肌少症组,而CRP、HDL-C水平显著高于非肌少症组,差异均有统计学意义(P<0.05)。肌少症组合并心力衰竭及冠心病的比例较非肌少症组明显增多(均P<0.05),2组高血压患病率差异无统计学意义(P>0.05)。在校正性别、年龄、BMI、SMI、Hb、白蛋白、HDL-C、CRP等因素后,多因素Logistic回归分析结果显示,冠心病和心力衰竭并不是肌少症的独立影响因素(P>0.05)。老年肌少症人群的CML水平及AGEs/sRAGE比值较老年非肌少症人群明显升高(P<0.05),2组sRAGE水平差异无统计学意义(P=0.587)。结论老年肌少症人群CML水平及AGEs/sRAGE比值显著高于老年非肌少症人群。社区老年人群中合并冠心病、心力衰竭病人患肌少症的概率较大。

Objective To investigate the characteristics of sarcopenia in the community elderly and the correlation between sarcopenia and non-enzymatic glycosylation level and common cardiovascular diseases.Methods A total of 110 participants who lived in Jiangsu Province Elderly Apartment were selected,and they were divided into sarcopenia group(n=38)and non-sarcopenia group(n=72)according to the guidelines of Asian Working Group for Sarcopenia.The clinical data and the incidence rates of cardiovascular diseases(heart failure,coronary heart disease,hypertension)were compared between the two groups,and the risk factors of sarcopenia were evaluated by Logistic regression analysis.The levels of carboxymethyl lysine(CML)and soluble receptor for advanced glycation end products(sRAGE)in 60 subjects were detected by enzyme linked immunosorbent assay,and the levels of CML,sRAGE,advanced glycation end products(AGEs)/sRAGE in sarcopenia group and non-sarcopenia group were compared.Results Compared with non-sarcopenia group,the age,and the levels of C-reaction protein(CRP)and high density lipoprotein cholesterol(HDL-C)in sarcopenia group were significantly higher,while the levels of body mass index(BMI),skeletal muscle mass index(SMI),grip strength,4 m walking speed,hemoglobin and albumin were significantly lower(P<0.05 or P<0.01).The incidence rates of heart failure and coronary heart disease in sarcopenia group were significantly higher than those in non-sarcopenia group(P<0.05),but there was no difference in the incidence rate of hypertension between the two groups(P>0.05).After adjustment for gender,age,BMI,SMI,HDL-C and CRP,multivariate Logistic regression analysis showed that coronary heart disease and heart failure were not independent influencing factors for sarcopenia in the elderly.The levels of CML and AGEs/sRAGE in sarcopenia population were significantly higher than those in non-sarcopenia population(P<0.05),and there was no difference in sRAGE level between the two groups(P=0.587).Conclusions The levels of CML and AGEs/sRAGE in the sarcopenia population are significantly higher than those in the non-sarcopenia population.The community elderly with coronary heart disease and heart failure are more likely to suffer from carcopenia.