| 鸢尾素与不同性别老年高同型半胱氨酸血症患者并发肌少症风险的关系研究 |
| 投稿时间：2025-03-15 修订日期：2025-09-11 点此下载全文 |
| 引用本文：黄荣荣,汤朝毅,乔露,李维辛.鸢尾素与不同性别老年高同型半胱氨酸血症患者并发肌少症风险的关系研究[J].医学研究杂志,2025,54(10):58-63, 104 |
| DOI：
10.11969/j.issn.1673-548X.2025.10.011 |
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| 基金项目:甘肃省自然科学基金资助项目(22JR5RA925) |
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| 中文摘要:目的 研究血清鸢尾素与不同性别的老年高同型半胱氨酸血症(hyperhomocysteinemia,HHcy)患者并发肌少症风险的关系。方法 回顾性选取2021年1月～2023年1月就诊于兰州大学第一医院老年病科的180例老年HHcy患者为研究对象。根据《2019年肌少症诊断与治疗共识更新》[1]诊断标准将研究对象分为男性肌少症组(n=43)和男性非肌少症组(n=57),女性肌少症组(n=44)和女性非肌少症组(n=36)。采用酶联免疫吸附试验检测血清鸢尾素水平,比较不同性别下肌少症组和非肌少症组患者的临床资料。将血清鸢尾素浓度进行四分位分组,运用ANOVA分析或Kruskal-Wallis检验,对肌少症相关指标[四肢骨骼肌质量指数(appendicular skeletal muscle mass index, ASMI)、握力、步速]在4组间的差异进行统计学评估。采用多因素Logistic回归分析评估不同性别老年HHcy患者并发肌少症的影响因素。结果 老年男性中,肌少症组与非肌少症组的年龄、血清鸢尾素、血红蛋白、总蛋白、白蛋白、甘油三酯、高密度脂蛋白胆固醇、ASMI、体脂百分数比较,差异均有统计学意义(P<0.05)。老年女性中,肌少症组与非肌少症组的血清鸢尾素、C反应蛋白、血小板计数、尿酸、ASMI、体脂百分数比较,差异均有统计学意义(P<0.05)。ASMI在老年男性HHcy患者的血清鸢尾素四分位组别间比较,差异有统计学意义(P<0.001)；握力、步速在老年女性HHcy患者的血清鸢尾素四分位组别间比较,差异有统计学意义(P=0.016、0.020)。多因素Logistic回归分析结果显示,血清鸢尾素(OR=0.951,95%CI:0.905~0.999)、体脂百分数(OR=0.741,95%CI:0.641~0.857)是老年男性HHcy患者并发肌少症的独立影响因素(P<0.05)；血清鸢尾素(OR=0.942,95%CI:0.892~0.994)、体脂百分数(OR=0.698,95%CI:0.576~0.846)、血小板计数(OR=1.013,95%CI:1.002~1.024)是老年女性HHcy患者并发肌少症的独立影响因素(P<0.05)。结论 血清鸢尾素、体脂百分数升高是老年男性及女性HHcy患者并发肌少症的独立保护因素；PLT升高为老年女性HHcy患者并发肌少症的独立危险因素。 |
| 中文关键词:高同型半胱氨酸血症 肌少症 鸢尾素 老年人 |
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| Relationship between Irisin and the Risk of Sarcopenia in Elderly Patients with Hyperhomocysteinemia of Different Genders. |
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| Abstract:Objective To study the relationship between irisin and the risk of sarcopenia in elderly patients with hyperhomocysteinemia of different genders. Methods A retrospective study was conducted on 180 elderly patients with hyperhomocysteinemia who were admitted to the Geriatrics Department of the First Hospital of Lanzhou University between January 2021 and January 2023. The study participants were categorized into the male sarcopenia group (n=43) and the male non-sarcopenia group (n=57), the female sarcopenia group (n=44), and the female non- sarcopenia group (n=36) according to the《2019 Consensus Update on the Diagnosis and Treatment of Sarcopenia》. Serum irisin levels were measured by enzyme-linked immunosorbent assay, and the clinical data of patients in sarcopenia and non-sarcopenia groups were compared under different genders. Serum irisin concentrations were grouped into quartiles, and the differences in the indicators related to sarcopenia [appendicular skeletal muscle mass index (ASMI), grip strength, and step speed] were statistically assessed among the four groups using analysis of ANOVA or the Kruskal-Wallis test. Multifactorial Logistic regression analysis was used to evaluate the influencing factors of sarcopenia in elderly patients with hyperhomocysteinemia of different genders. Results Among elderly male patients, there were statistically significant differences in age, irisin, hemoglobin, total protein, albumin, triglycerides, High-density lipoprotein cholesterol, ASMI and percent body fat between the sarcopenia group and the non-sarcopenia group (P<0.05). Among elderly female patients, there were statistically significant differences in irisin, C-reactive protein, platelets count, uric acid, ASMI and percent body fat between the sarcopenia group and the non-sarcopenia group (P<0.05). After statistical analysis, it was found that the ASMI was significantly different between the irisin quartile groups of elderly male patients with hyperhomocysteinemia (P<0.001); grip strength and step speed were significantly different between the irisin quartile groups of elderly female patients with hyperhomocysteinemia (P=0.016,0.020). Multiple Logistic regression analysis showed that serum irisin (OR=0.951,95% CI:0.905-0.999) and percent body fat (OR=0.741,95% CI:0.641-0.857) were independent influences on the development of sarcopenia in elderly male patients with hyperhomocysteinemia (P<0.05). Serum irisin (OR=0.942,95% CI:0.892-0.994), percent body fat (OR=0.698,95% CI:0.576-0.846), and platelet count (OR=1.013,95% CI:1.002-1.024) were independent influencing factors for sarcopenia in the elderly female patients with hyperhomocysteinemia(P<0.05). Conclusion Elevated serum irisin and body fat percentage are independent protective factors against sarcopenia in elderly male and female patients with hyperhomocysteinemia; elevated platelet count is an independent risk factor for sarcopenia in elderly female patients with hyperhomocysteinemia. |
| keywords:Hyperhomocysteinemia Sarcopenia Irisin Older adults |
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