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| 血细胞炎性指数与肌少症严重程度之间的相关性研究 |
| Association of blood cell countderived inflammation indices with the severity of sarcopenia |
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| DOI：10.3969/j.issn.1006-7108.2023.12.008 |
| 中文关键词: 肌少症 炎性指数 生物标志物 老年人 |
| 英文关键词:sarcopenia inflammation indices biomarker elderly |
| 基金项目:北京大学人民医院研究与发展基金（RDJ2022-16）；2021年北京大学医学部大健康国际研究院项目
；2020年国家临床重点专科能力建设项目 |
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| 中文摘要: |
| 目的 探讨血细胞炎性指数与肌少症的相关性。方法 回顾性分析2018年8月至2022年1月于北京大学人民医院老年科就诊的≥60岁患者351例，根据AWGS2019诊断标准分为非肌少症组284例，肌少症组26例和严重肌少症组41例。根据血常规化验结果计算中性粒细胞与淋巴细胞比值（neutrophil-to-lymphocyte, NLR）、血小板与淋巴细胞比值（platelet-to-lymphocyte ratio, PLR）、淋巴细胞与单核细胞比值（lymphocyte-to-monocyte ratio, LMR）、血小板与白细胞比值（platelet-to-white blood cell ratio, PWR）、全身免疫炎性指数（systemic immune-inflammation index, SII）、全身炎性反应指数（systemic inflammation response index, SIRI）和综合炎性指数（aggregate inflammation systemic index, AISI）。采用ANOVA分析和回归分析探究炎性指数与肌少症及其诊断要件的关系。包括步速、握力、简易躯体能力测试试验（short physical performance battery, SPPB）评分、四肢骨骼肌质量指数（appendicular skeletal muscle mass index, ASMI）、去脂体质量指数 (fat free mass index, FFMI)和脂肪指数(fat mass index, FMI)。结果 与非肌少症组相比，肌少症和严重肌少症组年龄更大，HDL-C显著更高，TG、LDL-C显著更低（P＜0.05）。与非肌少症和肌少症组相比，严重肌少症组的PLR、NLR、SII、SIRI和AISI显著更高，LMR显著更低，PWR在三组间无显著差异。多因素分析结果显示：NLR、SII和AISI与严重肌少症发生风险增加显著相关，NLR、SII和AISI值每增加1，严重肌少症的发生风险分别增加2.851倍(1.024~7.941)、1.531倍(1.531~9.156)、2.644倍(1.240~5.639)。且SII (P=0.039)和AISI (P=0.039)与SPPB得分下降显著相关。结论 血细胞炎性指数客观、廉价、简单，NLR、SII和AISI的升高与老年人严重肌少症发生风险增加有关，SII和AISI的升高与SPPB得分下降相关，可能作为肌少症筛查和管理的标志物。 |
| 英文摘要: |
| Objective Chronic inflammation is one of the important mechanisms of sarcopenia. Blood cell count derived inflammation indices can be used as a marker of systemic inflammation. The purpose of this study was to explore the association of these inflammation indices with sarcopenia. Methods 351 patients aged≥60 years who visited the Department of Geriatrics, Peking University People's Hospital from August 2018 to January 2022 were included in this retrospective analysis. Sarcopenia was diagnosed according to the 2019 Asian Working Group for Sarcopenia criteria.The value of inflammation indices was based on full blood count measurements. Multiple regression analysis was used to explore the association between inflammation indices and sarcopenia. Results Platelet-to-lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI) and aggregate inflammation systemic index (AISI) were significantly higher and lymphocyte-to-monocyte ratio (LMR) was significantly lower in the severe sarcopenia group than in the non-sarcopenia and sarcopenia groups, and there was no significant difference in platelet-to-white blood cell ratio (PWR) between three groups. After adjusting forcovariates, NLR [odds ratio (OR) 2.851, 95 % confidence interval (CI) 1.024-7.941, P=0.045], SII (OR 1.531, 95% CI: 1.531-9.156, P=0.004) and AISI (OR 2.644, 95% CI: 1.240-5.639,P=0.012) were significantly associated with increased risk of severe sarcopenia, and SII (B value=0.551, P=0.039) and AISI (B value=0.657, P=0.039) were significantly associated with decreased Short Physical Performance Battery (SPPB) scores. Conclusion Higher NLR, SII and AISI are associated with an increased risk of severe sarcopenia in the elderly. Higher SII and AISI were associated with decreased SPPB scores. Blood cell count derived inflammation index may be used as a biomarker for screening and management of sarcopenia for the advantage of being objective, inexpensive and simple. |
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