相位角与老年肌少症的关系研究

Association of phase angle with sarcopenia in elderly adults

目的:分析相位角与老年肌少症的相关性,并探讨相位角预测老年肌少症的可行性。方法:通过对泸州市某社区及医院439例老年人进行问卷调查,收集其一般人口学信息,并测量握力、步速,生物电阻抗仪器测量体成分以及相位角指标,采用2019年亚洲肌少症工作组诊断共识诊断肌少症;按性别分层比较肌少症组与非肌少症组间的相位角水平,Pearson相关分析相位角与肌少症诊断指标的相关性,多因素Logistic回归分析相位角水平与肌少症患病风险的关联性,ROC曲线确定相位角预测肌少症的最佳截断值。结果:男女肌少症病人的相位角平均水平均低于非肌少症病人(P <0.001),随着病情加重,相位角水平逐渐降低(P <0.001);相关分析显示相位角与骨骼肌质量(r=0.515,P <0.001)、SMI(r=0.586,P <0.001)、步速(r=0.286,P <0.001)、握力(r=0.555,P <0.001)均呈正相关;Logistic回归分析显示与相位角的最低四分位水平(Q1)相比,相位角Q2、Q3、Q4患病风险的OR值分别为0.380(95%CI:0.190-0.761)、0.285(95%CI:0.131-0.620)、0.197(95%CI:0.075-0.516);ROC曲线显示预测肌少症的男性相位角最佳截断点为4.9°,灵敏度和特异度分别为67.92%和67.12%,女性最佳截断值为4.3°,灵敏度和特异度分别为69.81%和73.15%。结论:相位角水平与肌少症的患病风险独立相关,相位角对早期肌少症病人具有一定的预测价值。

Objective: To analyze the relationship between phase angle and sarcopenia in elderly patients, and to investigate whether the phase angle can predict sarcopenia. Methods: Structured questionnaires were used to investigate 439 elderly persons in community or hospital in Luzhou City. The general demographics of the subjects were collected, All the subjects completed the measurement of phase angle, body composition analysis, grip strength test, 6-meter walk speed test. Diagnosis of sarcopenia based on the 2019 Consensus of Asian Working Group for Sarcopenia.The phase angle was compared between the sarcopenia and non-sarcopenia groups by gender. Multivariate logistic regression analysis was used to analyze the correlation between phase angle and risk of sarcopenia. The receiver operating characteristic(ROC) curve was adopted to analyze the predictive value of phase angle for sarcopenia.Results: PhA in the sarcopenia group was lower than that in the non-sarcopenia group in both genders(P < 0.001). As the sarcopenia progresses, the level of phase angle gradually decreases(P < 0.001). Correlation analysis showed that the phase angle was positively correlated with skeletal muscle mass(r = 0.515, P < 0.001), SMI(r = 0.586, P < 0.001), stride speed(r = 0.286, P < 0.001) and grip strength(r = 0.555, P < 0.001). Multivariate regression analysis showed that compared with the lowest quartile level(Q1) of the phase angle, Odds ratios(95%CI) of Q2、Q3、Q4 of phase angle were0.380(95%CI: 0.190 - 0.761), 0.285(95%CI: 0.131 - 0.620), 0.197(95%CI: 0.075 - 0.516), respectively. The ROC analysis indicated the cutoff value of the phase angle for men with sarcopenia at 4.9°, with the sensitivity and specificity67.92% and 67.12%, respectively;the cutoff value of the phase angle for women with sarcopenia at 4.3°, with the sensitivity and specificity 69.81% and 73.15%, respectively. Conclusions: The phase angle is an independent risk factor for sarcopenia in elderly patients, and the decreased phase angle has certain clinical significance for predicting sarcopenia.