绝经后女性肌少症与颈动脉斑块发生风险的关系

Relationship between sarcopenia and carotid plaque risk in post⁃menopausal women

目的:探讨绝经后女性肌少症与颈动脉斑块发生风险的相关性。方法:采用整群抽样法,选取2022年3月—10月在华东疗养院体检中心进行健康体检的绝经后女性527例为研究对象。采用人体成分分析仪(InBody720)检测人体四肢骨骼肌质量,计算四肢骨骼肌指数(ASMI)并测量握力与步速。收集一般资料及实验室指标,采用多因素Logistic回归分析探讨绝经后女性肌少症与颈动脉斑块发生风险的关系,并采用受试者工作特征(ROC)曲线探讨ASMI对颈动脉斑块发生的预测价值。结果:527例绝经后女性中,172例发生颈动脉斑块,发生率为32.6%。绝经后女性颈动脉斑块组ASMI低于非颈动脉斑块组[5.42(4.88,6.09)kg/m^(2)与6.63(5.73,7.78)kg/m^(2),P<0.001],同时颈动脉斑块组肌少症发生率显著高于非颈动脉斑块组(45.30%与18.00%,P<0.001)。绝经后女性ASMI越小,颈动脉斑块发生风险越高(Pfor trend<0.001)。多因素Logistic回归分析显示,肌少症增加绝经后女性颈动脉斑块发生风险[OR=3.486,95%CI(2.237,5.432)]。ROC分析显示,相比于腰围及体质指数,ASMI对颈动脉斑块有更高的预测价值(ROC曲线下面积=0.756)。结论:绝经后女性肌少症增加其颈动脉斑块发生风险,ASMI可作为预测其颈动脉斑块发生的简易指标。

Objective:To investigate the relationship between sarcopenia and the risk of carotid plaque in postmenopausal women.Methods:A total of 527 postmenopausal women who underwent physical examination in the health examination center of Huadong Sanatorium from March to October 2022 were selected as the research objects by random cluster sampling.The body composition analyzer(InBody720)was used to calculate the skeletal muscle mass of human limbs,appendicular skeletal muscle index(ASMI)was calculated and handgrip and walking speed were measured.Clinical data were collected,univariate combined with multivariate regression analysis was used to explore the relationship between sarcopenia and the risk of carotid plaque in postmenopausal women,and receiver operating characteristic(ROC)curve was used to explore the diagnostic value of ASMI in the occurrence of carotid plaque in postmenopausal women.Results:Among 527 postmenopausal women,172(32.6%)had carotid plaque.In postmenopausal women,ASMI in the carotid plaque group was significantly lower than that in the non-carotid plate group[5.42(4.88,6.09)kg/m^(2)vs 6.63(5.73,7.78)kg/m^(2),P<0.001].The incidence of sarcopenia in the carotid plaque group was significantly higher than that in the non-carotid plaque group(45.3%vs 18.0%,P<0.001).The lower the ASMI value in postmenopausal women,the higher the risk of carotid plaque(Pfor trend<0.001).Multivariate logistic regression analysis showed that postmenopausal women with sarcopenia significantly increased the risk of carotid plaque(OR=3.486,95%CI 2.237-5.432).ROC showed that ASMI had a higher predictive value for carotid plaque than waist circumference and body mass index(AUC=0.756).Conclusions:Sarcopenia significantly increases the risk of carotid artery plaque in postmenopausal women,and ASMI can be used as a simple predictor of carotid artery plaque.