上海部分社区老年人群肌少症与营养状况的相关性研究

Correlation between sarcopenia and nutritional status among elderly population in some communities of Shanghai

目的探讨社区老年人肌少症与营养状况的相关性。方法选取2021年2月至2022年1月符合条件的上海市社区老年人733名。记录受试者一般临床资料,微型营养评估(MNA),日常生活能力、认知功能、焦虑状态及血清学指标(如血红蛋白、白蛋白等),测量其体重指数(BMI)、骨骼肌质量指数(SMI)、握力和步速。根据亚洲肌少症工作组2019年的诊断标准,将研究对象分为肌少症组及非肌少症组;分析肌少症的影响因素;对研究对象进行营养评估,分析营养状况与肌少症相关性。结果受试者的肌少症发生率为19.37%,肌少症组与非肌少症组在年龄、体重、BMI、体脂量、文化程度、慢性病患病数目、日常生活能力、焦虑状态、血清白蛋白、血红蛋白、简易精神状态量表(MMSE)和MNA得分差异均有统计学意义;年龄、体脂量、患病数目是肌少症的危险影响因素,白蛋白、BMI、MMSE评分是肌少症的保护因素(P值均<0.05)。受试者营养不良风险和营养不良比例分别为17.33%和1.64%;营养不良、营养不良风险和营养正常老年人肌少症的发生率分别为66.67%、25.98%、17.00%。受试者营养状况从正常向不良发展,血红蛋白、血清白蛋白、血清前白蛋白、总胆固醇、三酰甘油以及BMI、SMI、握力、步速等指标逐步降低。相关性分析中体重、BMI、SMI、步速、握力、血红蛋白、血清白蛋白、血清前白蛋白、总胆固醇、三酰甘油与MNA得分存在正相关(P值均<0.05)。结论社区营养不良老年人的肌少症患病率较高,肌少症的发生与营养状况有一定的相关性。

Objective To explore the correlation between sarcopenia and nutritional status in elderly people in community.Methods From February 2021 to January 2022,a total of 733 eligible elderly persons in Shanghai community were enrolled.General clinical data, mini-nutritional assessment(MNA),daily living ability, cognitive function, anxiety status and serological indicators(such as hemoglobin, albumin, etc.) were recorded.Body mass index(BMI),skeletal muscle mass index(SMI),grip strength and walking speed were measured.According to the diagnostic criteria of the Asian Sarcopenia Working Group in 2019,subjects were divided into sarcopenia group and non-sarcopenia group.To analyze the influencing factors of sarcopenia;Nutritional assessment was conducted to analyze the correlation between nutritional status and sarcopenia.Results The subjects′ muscle disease prevalence was 19.37% less, less muscle disease with the less muscle disease group in age, weight, BMI,body fat mass, culture degree, the number of chronic illnesses, daily life ability, anxious state, albumin, hemoglobin, simple mental state scale(MMSE) and MNA score difference had statistical significance;Age, body fat and number of patients were the risk factors of sarcopenia.Serum albumin, BMI and MMSE are protective factors for sarcopenia(P<0.05).The risk and rate of malnutrition were 17.33% and 1.64%,respectively.The prevalence of malnutrition, risk of malnutrition and sarcopenia in the elderly with normal nutrition were 66.67%,25.98% and 17.00%,respectively.The nutritional status of the subjects developed from normal to poor, and hemoglobin, serum albumin, serum prealbumin, total cholesterol, triglyceride, BMI,SMI,grip strength, walking speed and other indicators gradually decreased.In correlation analysis, body weight, BMI,SMI,walking speed, grip strength, hemoglobin, serum albumin, serum prealbumin, total cholesterol, triglyceride were positively correlated with MNA(P<0.05).Conclusions The prevalence of sarcopenia in the elderly with malnutrition in community is higher, and there is a certain correlation between sarcopenia and nutritional status.