中国老年人慢性病共病模式与肌少症发生风险的关联性研究

Association of chronic comorbidity modes with risk of sarcopenia in elderly in China

目的探讨中国老年人慢性病共病模式与肌少症发生风险的关联,为肌少症的预防与控制提供科学依据。方法数据来源于中国健康与养老追踪调查(China Health and Retirement Longitudinal Study,CHARLS),选取在2011年及2013年参与初次调查的2569名≥60岁老年人作为研究对象,对其进行问卷调查和体格检查。以2015年为观测终点,2013—2015年新发肌少症为观测结局。采用SPSS 25.0软件进行t检验、方差分析、χ^(2)检验,采用Cox回归分析不同共病模式与肌少症发病风险的关联。应用Mplus 7.4进行潜在类别分析(LCA)识别老年人共病模式。结果中国老年人慢性病共病的患病率为52.90%,随访期间共发生287例肌少症,肌少症的发病密度为34.0/1000人年。LCA识别出3组慢性病共病模式,分别为呼吸系统疾病组、代谢系统疾病组、关节炎-消化系统疾病组。调整混杂因素后,多因素Cox回归分析结果显示,与未患慢性病组相比,关节炎-消化系统疾病组肌少症的发病风险显著上升(HR=1.606,95%CI:1.176~2.193,P<0.05)。结论关节炎-消化系统疾病模式与肌少症的发生风险密切相关,肌少症的监控应重点关注该人群。

Objective To explore the association between chronic comorbidity modes with the risk of sarcopenia in Chinese elderly,and provide the scientific basis for the prevention and control of sarcopenia.Methods The data were from the China Health and Retirement Longitudinal Study(CHARLS);total 2569 elderly(≥60 years old)who participated in the initial survey in 2011 and 2013 were selected as the subjects.The investigation was performed with questionnaire and physical examination.Year 2015 was used as the observation end point,new sarcopenia in 2013-2015 was the observed outcome.The t test,analysis of variance andχ2 test were used to analyze the data.COX regression analysis was used to explore the association of different comorbidity modes with the risk of sarcopenia.The used software was SPSS 25.0.Mplus 7.4 was applied to perform latent class analysis(LCA)to identify comorbidity modes in elderly.Results The morbidity of chronic disease comorbidity in Chinese elderly was 52.90%,and 287 cases of sarcopenia occurred during the follow-up period,the incidence density of sarcopenia was 34.0/103 person-years.The LCA identified 3 comorbidity modes,namely,respiratory disease group,metabolic disease group,and arthritisdigestive system disease group.After adjusting the confounders,multifactorial Cox regression analysis showed that as compared with the group without chronic disease,the risk of sarcopenia in the arthritis-digestive system disease group significantly increased(HR=1.606,95%CI:1.176-2.193,P<0.05).Conclusion The arthritis-digestive disease pattern is strongly associated with the risk of sarcopenia,and surveillance of sarcopenia should focus on those population.