肿瘤相关性肌肉减少症的发病危险因素分析——一项基于NHANES数据库的研究

Analysis of risk factors for tumor-associated sarcopenia:a study based on the NHANES database

目的通过使用美国国家健康与营养调查(NHANES)数据库,探究肿瘤相关性肌肉减少症(以下简称肌少症)的发病危险因素。方法纳入来自于2011—2018年的NHANES数据库中的410例肿瘤病人。使用四肢肌肉质量指数(ASMI)判定肌少症,分析病人临床特征。采用Logistic回归模型分析肿瘤相关性肌少症的相关危险因素。结果单因素分析结果显示,在NHANES数据库内433个变量中,1周内是否完成≥10 min的高强度运动是男性病人唯一一个有统计学意义的影响因素(P<0.1)。在女性病人中,血钙、血钾、血磷、血清白蛋白,是否被告知超重、1周内是否完成≥10 min的高强度体力工作,有无减重意愿,过去1年是否曾尝试减重,是否存在非运动状态漏尿症状、血清高密度脂蛋白、总胆红素、自我体重认知为差异有统计学意义的影响因素(P均<0.1)。多因素分析结果显示,多因素分析结果显示,1周内高强度运动<10 min是男性病人患肌少症的独立危险因素。血钾、非运动状态存在漏尿症状、高密度脂蛋白、自我认为体重过低为女性病人患肌少症的独立危险因素(P均<0.05)。结论不同性别肿瘤病人肌少症的发病危险因素不同,男性主要与高强度运动不足有关,女性主要与血生化的营养相关指标、漏尿以及自我认知有关。

Objective To explore the risk factors of tumor-associated sarcopenia by using the National Health And Nutrition Examination Survey(NHANES)database,Methods The data of 410 cancer patients in the NHANES database from 2011 to 2018 were analyzed.Appendicular skeleton muscle index(ASMI)was used of diagnose sarcopenia.Clinical features of these patients were analyzed for risk factors for sarcopenia.Results Uni-variate analysis revealed that high-tension physical activity of less than 10 minutes per week was a risk factor for sarcopenia in male cancer patients(P<0.1).While,blood calcium,blood potassium,blood phosphate,and plasma albumin,be informed whether to be overweight or not,high-tension physical work less than 10 minutes per week,be willing to lose weight or not,attempted to lose weight in the past year or not,urine leakage in non-physical activities,high-density lipoprotein-cholesterol,total bilirubin,self-recognition of body weight were factors with statistical significance(All P<0.1).Multi-variate analysis revealed that high-tension physical activity of less than 10 minutes per week was a risk factor for sarcopenia in male cancer patients,while,serum potassium,urine leakage in non-physical activities,high-density lipoprotein--cholesterol,recognized low weight were risk factors in female cancer patients(All P<0.05).Conclusion The risk factors for tumor-associated sarcopenia were distinct because of gender.In male cancer patients,insufficient exercise was the main cause.In female cancer patients,serum biochemical nutrition-related indexes,urine leakage,and questionnaire self-cognition were the main reasons.It is essential to provide a reference for future screening and diagnosis of tumor-associated sarcopenia patients.