肌少症性肥胖与老年高血压的相关性临床研究

Clinical study on the correlation between sarcopenic obesity and hypertension in elderly subjects

目的探讨老年人肌少症性肥胖与高血压的相关性,为临床防治老年高血压提供参考。方法选择2018年1月—2021年1月在内蒙古自治区人民医院老年医学中心住院的老年患者210例,其中高血压134例(63.81%),非高血压76例(36.19%),分别测定2组患者身高、体重、四肢骨骼肌肉量(ASM)、握力、血糖、血脂、肝肾功能,计算体重指数(BMI)及四肢骨骼肌质量指数(RSMI),并进行比较分析。结果高血压组ASM、RSMI低于非高血压组[(14.90±3.38)kg vs.(19.41±1.56)kg,P<0.001;(5.59±1.37)kg/m^(2)vs.(7.11±0.84)kg/m^(2),P<0.001]。高血压组年龄和BMI高于非高血压组[(72.79±7.20)岁vs.(70.79±6.51)岁,P=0.046;25.66±3.48 vs.24.46±2.81,P=0.011]。高血压组肌少症及肌少症性肥胖患病率均高于非高血压组(67.91%vs.38.16%,P<0.001;25.37%vs.2.63%,P<0.001)。多因素logistic回归分析显示,高龄、肌少症、肌少症性肥胖为老年高血压的危险因素。结论ASM与老年高血压密切相关,高ASM是老年高血压的保护性因素,肌少症性肥胖、肌少症是老年高血压的重要危险因素。

Objective To explore the correlation between sarcopenic obesity and hypertension in the elderly,and to provide reference for clinical prevention and treatment of hypertension in the elderly.Methods Two hundred and ten elderly patients hospitalized in Geriatric Medicine Center of Inner Mongolia People's Hospital from January 2018 to January 2021 were selected.Among them,134(63.81%)were hypertensive and 76(36.19%)were non-hypertensive.Height,body mass,appendicular skeletal muscle mass(ASM),grip strength,blood glucose,blood lipid,liver function and kidney function were measured.Body mass index(BMI)and relative skeletal muscle index(RSMI)were calculated and compared.Results ASM and RSMI in the hypertension group were lower than those in the non-hypertension group[(14.90±3.38)kg vs.(19.41±1.56)kg,P<0.001;(5.59±1.37)kg/m^(2) vs.(7.11±0.84)kg/m^(2),P<0.001].The age and BMI of the hypertension group were higher than those of the non-hypertension group[(72.79±7.20)years vs.(70.79±6.51)years,P=0.046;25.66±3.48 vs.24.46±2.81,P=0.011].The prevalence rate of sarcopenia and sarcopenic obesity in the hypertensive group was higher than those in the non-hypertensive group(67.91%vs.38.16%,P<0.001;25.37%vs.2.63%,P<0.001).Multivariate logistic regression analysis showed that age,sarcopenia and sarcopenic obesity were the risk factors of hypertension in the elderly.Conclusion ASM is closely related to hypertension,and high ASM is a protective factor of hypertension in the elderly.Sarcopenic obesity and sarcopenia are important risk factors of hypertension in the elderly.