[1]陈新宇,周军良,李婷婷,等.相位角与老年肌少症的关系研究[J].肠外与肠内营养杂志,2021,(05):275-280.[doi:10.16151/j.1007-810x.2021.05.004]
 CHEN Xin-yu,ZHOU Jun-liang,LI Ting-ting,et al.Association of phase angle with sarcopenia in elderly adults[J].PARENTERAL & ENTERAL NUTRITION,2021,(05):275-280.[doi:10.16151/j.1007-810x.2021.05.004]
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相位角与老年肌少症的关系研究
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《肠外与肠内营养》杂志[ISSN:1007-810X/CN:32-1477/R]

卷:
期数:
2021年05期
页码:
275-280
栏目:
论著
出版日期:
2021-09-10

文章信息/Info

Title:
Association of phase angle with sarcopenia in elderly adults
作者:
陈新宇1周军良1李婷婷1宋 雨1汪 敏2贾 红1
1.西南医科大学公共卫生学院;2.西南医科大学附属医院营养科,四川泸州 646000
Author(s):
CHEN Xin-yu1 ZHOU Jun-liang1 LI Ting-ting1 SONG Yu1 WANG Min2 JIA Hong1
1.School of Public Health, Southwest Medical University;2.Department of Nutrition, The Affiliated Hospital of Southwest Medical University, Luzhou 646000, Sichuan, China
关键词:
相位角 肌少症 老年人
Keywords:
Phase angle Sarcopenia Older adults
分类号:
R443+.8,R592
DOI:
10.16151/j.1007-810x.2021.05.004
文献标志码:
A
摘要:
目的:分析相位角与老年肌少症的相关性,并探讨相位角预测老年肌少症的可行性。 方法:通过对泸州市某社区及医院 439例老年人进行问卷调查,收集其一般人口学信息,并测量握力、步速,生物电阻抗仪器测量体成分以及相位角指标,采用 2019 年亚洲肌少症工作组诊断共识诊断肌少症;按性别分层比较肌少症组与非肌少症组间的相位角水平,Pearson相关分析相位角与肌少症诊断指标的相关性,多因素 Logistic 回归分析相位角水平与肌少症患病风险的关联性,ROC曲线确定相位角预测肌少症的最佳截断值。 结果:男女肌少症病人的相位角平均水平均低于非肌少症病人(P < 0.001),随着病情加重,相位角水平逐渐降低(P < 0.001);相关分析显示相位角与骨骼肌质量(r = 0.515,P < 0.001)、SMI(r = 0.586,P < 0.001)、步速(r = 0.286,P < 0.001)、握力(r = 0.555,P < 0.001)均呈正相关;Logistic回归分析显示与相位角的最低四分位水平(Q1) 相比,相位角 Q2、Q3、Q4患病风险的 OR值分别为 0.380(95%CI:0.190 ~ 0.761)、0.285(95%CI:0.131 ~ 0.620)、0.197(95%CI:0.075 ~ 0.516);ROC曲线显示预测肌少症的男性相位角最佳截断点为 4.9°,灵敏度和特异度分别为 67.92%和 67.12%,女性最佳截断值为 4.3°,灵敏度和特异度分别为 69.81%和 73.15%。 结论:相位角水平与肌少症的患病风险独立相关,相位角对早期肌少症病人具有一定的预测价值。
Abstract:
Objective: To analyze the relationship between phase angle and sarcopenia in elderly patients, and to investigate whether the phase angle can predict sarcopenia. Methods: Structured questionnaires were used to investigate 439 elderly persons in community or hospital in Luzhou City. The general demographics of the subjects were collected, All the subjects completed the measurement of phase angle, body composition analysis, grip strength test, 6- meter walk speed test. Diagnosis of sarcopenia based on the 2019 Consensus of Asian Working Group for Sarcopenia. The phase angle was compared between the sarcopenia and non-sarcopenia groups by gender. Multivariate logistic regression analysis was used to analyze the correlation between phase angle and risk of sarcopenia. The receiver operating characteristic (ROC) curve was adopted to analyze the predictive value of phase angle for sarcopenia. Results: PhA in the sarcopenia group was lower than that in the non-sarcopenia group in both genders (P < 0.001). As the sarcopenia progresses, the level of phase angle gradually decreases (P < 0.001). Correlation analysis showed that the phase angle was positively correlated with skeletal muscle mass (r = 0.515, P < 0.001), SMI (r = 0.586, P < 0.001), stride speed (r = 0.286, P < 0.001) and grip strength (r = 0.555, P < 0.001). Multivariate regression analysis showed that compared with the lowest quartile level (Q1) of the phase angle, Odds ratios (95%CI) of Q2、Q3、Q4 of phase angle were 0.380 (95%CI: 0.190 ~ 0.761), 0.285(95%CI: 0.131 ~ 0.620), 0.197(95%CI: 0.075 ~ 0.516), respectively. The ROC analysis indicated the cutoff value of the phase angle for men with sarcopenia at 4.9°, with the sensitivity and specificity 67.92% and 67.12%, respectively; the cutoff value of the phase angle for women with sarcopenia at 4.3° , with the sensitivity and specificity 69.81% and 73.15%, respectively. Conclusions: The phase angle is an independent risk factor for sarcopenia in elderly patients, and the decreased phase angle has certain clinical significance for predicting sarcopenia.

参考文献/References:


[1] Chen LK, Liu LK, Woo J, et al. Sarcopenia in Asia: consensus report of the Asian Working Group for Sarcopenia. J Am Med Dir Assoc, 2014, 15(2): 95-101.
[2] Von Haehling S. The wasting continuum in heart failure: from sarcopenia to cachexia. Proc Nutr Soc, 2015, 74(4): 367-377.
[3] Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age and ageing,2019, 48(1): 16-31.
[4] Dhillon R J, Hasni S. Pathogenesis and Management of Sarcopenia. Clinics in geriatric medicine, 2017, 33(1): 17-26.
[5] 宁华英,赵崇法,齐玉梅,等 .相位角预测手术病人营养风险及住院时间 .肠外与肠内营养,2017,24(5):296-300.
[6] Mattar JA. Application of total body bioimpedance to the critically ill patient. Brazilian Group for Bioimpedance Study. New horiz, 1996, 4(4): 493-503.
[7] 王艳莉,辛晓伟,周秀耕,等 .食管癌手术病人相位角与营养状况的相关性研究 .肠外与肠内营养,2019,26(2):65-69.
[8] 肖慧娟, 张 明, 齐玉梅,等 . 相位角与肝硬化病人营养状况及临床结局的关系研究 . 肠外与肠内营养, 2019,26(3): 145-149.
[9] Baumgartner RN, Chumlea WC, Roche AF. Bioelectric impedance phase angle and body composition. Am J Clin Nutr,1988, 48(1): 16-23.
[10] Miura T, Matsumoto Y, Kawaguchi T, et al. Low Phase Angle Is Correlated With Worse General Condition in Patients with Advanced Cancer. Nutrition and cancer, 2019, 71(1): 83-88.
[11] Basile C, Della-Morte D, Cacciatore F, et al. Phase angle as bioelectrical marker to identify elderly patients at risk of sarcopenia. Exp Gerontol, 2014, 58: 43-46.
[12] Espirito Santo Silva DD, Waitzberg DL, Passos De Jesus R, et al.Phase angle as a marker for sarcopenia in cirrhosis. Clin Nutr ESPEN, 2019, 32: 56-60.
[13] Kilic MK, Kizilarslanoglu MC, Arik G, et al. Association of Bioelectrical Impedance Analysis-Derived Phase Angle and Sarcopenia in Older Adults. Nutr Clin Pract, 2017, 32(1):103-109.
[14] Dos Reis AS, Santos HO, Limirio LS, et al. Phase Angle Is Associated With Handgrip Strength but Not With Sarcopenia in Kidney Transplantation Patients. J Ren Nutr, 2019, 29(3):196-204.
[15] Mendes J, Amaral TF, Borges N, et al. Handgrip strength values of Portuguese older adults: a population based study. BMC geriatrics, 2017, 17(1): 191.
[16] 王拥军,潘华山 .运动医学 .北京:人民卫生出版社,2018,9.
[17] Ozturk ZA, Turkbeyler iH , Abiyev A, et al. Health-related quality of life and fall risk associated with age-related body composition changes; sarcopenia, obesity and sarcopenic obesity.Intern Med J, 2018, 48(8): 973-981.
[18] Chen LK, Woo J, Assantachai P, et al. Asian Working Group for Sarcopenia: 2019 Consensus Update on Sarcopenia Diagnosis and Treatment. J Am Med Dir Assoc, 2020, 21(3): 300-307.
[19] Cruz-Jentoft A J, Sayer A A. Sarcopenia. Lancet, 2019, 393 (10191): 2636-2646.
[20] Yeung SSY, Reijnierse EM, Pham VK, et al. Sarcopenia and its association with falls and fractures in older adults: A systematic review and meta-analysis. J Cachexia Sarcopenia Muscle, 2019,10(3): 485-500.
[21] Martone AM, Bianchi L, Abete P, et al. The incidence of sarcopenia among hospitalized older patients: results from the Glisten study. J Cachexia Sarcopenia Muscle, 2017, 8(6): 907-914.
[22] Sergi G, De Rui M, Stubbs B, et al. Measurement of lean body mass using bioelectrical impedance analysis: a consideration of the pros and cons. Aging Clin Exp Res, 2017, 29(4): 591-597.
[23] Beyer I, Mets T, Bautmans I. Chronic low-grade inflammation and age-related sarcopenia. Curr Opin Clin Nutr Metab Care, 2012, 15(1): 12-22.
[24] Li CW, Yu K, Shyh-Chang N, et al. Circulating factors associated with sarcopenia during ageing and after intensive lifestyle intervention. J Cachexia Sarcopenia Muscle, 2019, 10(3):586-600.
[25] Gonzalez MC, Barbosa-Silva TG, Bielemann RM, et al. Phase angle and its determinants in healthy subjects: influence of body composition. Am J Clin Nutr, 2016, 103(3): 712-716.
[26] Ott M, Fischer H, Polat H, et al. Bioelectrical impedance analysis as a predictor of survival in patients with human immunodeficiency virus infection. J Acquir Immune Defic Syndr Hum Retrovirol, 1995, 9(1): 20-25.
[27] Gupta D, Lammersfeld CA, Vashi PG, et al. Bioelectrical impedance phase angle in clinical practice: implications for prognosis in stage IIIB and IV non-small cell lung cancer. BMC cancer, 2009, 9:37.
[28] Matias CN, Cavaco-Silva J, Reis M, et al. Phase Angle as a Marker of Muscular Strength in Breast Cancer Survivors. Int J Environ Res Public Health, 2020, 17(12): 4452.
[29] Marini E, Buffa R, Saragat B, et al. The potential of classic and specific bioelectrical impedance vector analysis for the assessment of sarcopenia and sarcopenic obesity. Clin Interv Aging, 2012, 7:585-591.
[30] Norman K, Wirth R, Neubauer M, et al. The bioimpedance phase angle predicts low muscle strength, impaired quality of life, and increased mortality in old patients with cancer. J Am Med Dir Assoc, 2015, 16(2): 173.e17-e22.
[31] Santana NM, Pinho CPS, Da Silva CP, et al. Phase Angle as a Sarcopenia Marker in Hospitalized Elderly Patients. Nutr Clin Pract, 2018, 33(2): 232-237.
[32] Yamada M, Kimura Y, Ishiyama D, et al. Phase Angle Is a Useful indicator for Muscle Function in Older Adults. J Nutr Health Aging, 2019, 23(3): 251-255.

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备注/Memo

备注/Memo:
基金项目 :达能营养中心膳食营养研究与宣教基金(DIC2019-10) 作者简介 :陈新宇,初级医师,医学硕士,主要从事流行病学与卫生统计学工作。E-mail:371636843@qq.com 通讯作者 :贾 红,E-mail: jhong_lz@163.com
更新日期/Last Update: 1900-01-01