社区中老年人骨骼肌质量与代谢综合征的关联研究

陈思敏; 努尔比亚木·艾合提; 沈静; 晏师康; 开地日艳·库日班江; 彭星; 阿卜杜乃比·吾普尔; 戴江红; 杨蕾

doi:10.19428/j.cnki.sjpm.2024.23241

摘要:

目的探讨新疆乌鲁木齐市社区中老年人骨骼肌质量与代谢综合征（MS）患病风险的相关性，为了解社区中老年居民骨骼肌质量与MS的关系提供理论依据。

方法以2018年7月—2019年1月新疆多民族自然人群队列乌鲁木齐市1 438名≥50岁社区居民为研究对象，使用问卷调查、体格检查、生物电阻抗分析（BIA）、实验室检测等方式收集数据。骨骼肌质量使用经体重校正的四肢骨骼肌质量指数（SMI）评估；MS的定义为至少存在以下之中的3项：腹部肥胖、高血压、高血糖、高三酰甘油和高低高密度脂蛋白胆固醇。将SMI分为Q₁~Q₄等4个四分位数组。应用趋势χ²检验探讨SMI分级水平与MS之间的相关性；应用多因素logistic回归模型，分析较高SMI组（Q₂、Q₃、Q₄）与参照组Q₁的MS患病风险的差异。

结果共检出MS患者560人、患病率38.94%，其中男性代谢综合征患病率39.16%、女性患病率38.80%。男性SMI分级水平增加与MS患病率不相关（趋势性P>0.05）；调整混杂因素后（模型4），SMI增加与MS患病率仍不相关（P_趋势=0.995），MS发生风险在SMI最低四分位数Q₁组和最高四分位数组Q₄（OR=1.01，95%CI：0.69~1.78）间不存在统计学差异。女性MS患病率随着SMI分级水平的增加逐渐下降（P_趋势<0.001）；调整混杂因素后（模型4），SMI增加与MS患病率仍存在相关关系（P_趋势=0.005），且以SMI最低四分位数Q₁为参照组，Q₂（OR=0.63，95%CI：0.40~1.00）、Q₃（OR=0.56，95%CI：0.34~0.94）、Q₄（OR=0.42，95%CI：0.23~0.76）发生MS的风险均下降。

结论骨骼肌质量增加可能有益于预防MS，尤其是女性中老年居民。考虑到我国老龄化加剧及MS与相关合并症的密切关系，管理骨骼肌质量可能有助于预防MS及潜在合并症。

Abstract:

Objective To explore the correlation between skeletal muscle mass and metabolic syndrome （MS） disease risk among middle-aged and elderly community residents in Urumqi， and to provide a theoretical basis for understanding the relationship between skeletal muscle mass and MS among middle-aged and elderly community residents in China.

Methods A total of 1 438 community residents ≥ 50 years old were selected as the research subjects from July 2018 to January 2019 in Urumqi. They were selected from a multi-ethnic natural population cohort in Xinjiang. Data were collected through questionnaires， physical examination， bioelectrical impedance analysis （BIA）， laboratory tests， etc. Skeletal muscle mass was evaluated using the limb skeletal muscle mass index （SMI） corrected for body weight； MS was defined as it at least includes three of the following： abdominal obesity， hypertension， hyperglycemia， high triglycerides and low high-density lipoprotein cholesterol. SMI was divided into four quantile arrays of Q₁‒Q₄. Trend χ² test was applied to explore whether there was a correlation between SMI changes and MS. A multivariate logistic regression model was used to analyze whether there is a difference in the risk of MS between the higher SMI group （Q₂， Q₃， Q₄） and the reference group Q₁.

Result A total of 560 MS patients were detected in this study， with a prevalence rate of 38.94%. Among them， the prevalence rate of MS was 39.16% in males and 38.80% in females. The increase in male SMI grading level is not correlated with the prevalence of MS （trend P>0.05）； After adjusting for confounding factors （model 4）， the increase in SMI was still not related to the prevalence of MS （P_trend=0.995）. There was no statistical difference in the risk of MS between the lowest quartile group Q₁ and the highest quartile group Q₄ （OR=1.01， 95%CI： 0.69‒1.78）. The prevalence of MS in women gradually decreased with the increase of SMI grading level （P_trend<0.001）； After adjusting for confounding factors （model 4）， there was still a correlation between the increase of SMI and the prevalence of MS （P_trend=0.005）. With the lowest quartile of SMI Q₁ as the reference group， the risk of MS in Q₂ （OR=0.63， 95%CI： 0.40‒1.00）， Q₃ （OR=0.56， 95%CI： 0.34‒0.94）， Q₄ （OR=0.42， 95%CI： 0.23‒0.76） decreased.

Conclusion An increase in skeletal muscle mass may be beneficial for preventing MS， especially among middle-aged and elderly female residents. Considering the intensification of aging in China and the close relationship between MS and related comorbidities， managing skeletal muscle mass may contribute to potential MS prevention.

社区中老年人骨骼肌质量与代谢综合征的关联研究

Association between skeletal muscle mass and metabolic syndrome in middle-aged and elderly community residents