摘要
目的探讨老年人非甲状腺疾病综合征(NTIS)与肌少症前期的相关性。方法回顾性分析2018年4月至2021年3月在南京医科大学附属逸夫医院老年医学科就诊老年患者219例,年龄60~85岁。其中NTIS患者60例,非NTIS患者159例,同时收集患者的病例资料、实验室检查结果及人体成分指标结果。应用Logistic回归、Pearson相关系数、受试者工作特征曲线(ROC)分析甲状腺激素水平与肌少症前期的关系。结果通过人体成分测定诊断肌少症前期患者54例。男性中肌少症前期占30.3%(36/119),女性占18.0%(18/100);NTIS组男性和女性患者年龄高于非NTIS组(均P<0.01),体质指数、三碘甲状腺原氨酸(T3)、游离三碘甲状原氨酸(FT3)、血红蛋白、白蛋白低于非NTIS组(均P<0.05),NTIS组女性患者肌少症前期发病率高于非NTIS组[58.8%(10/17)比9.6%(8/83),χ^(2)=9.564,P<0.01]。多因素Logistic回归分析结果显示,NTIS患者肌少症前期发病风险增加。FT3与四肢骨骼肌质量指数、去脂体重、相位角呈正相关(r值分别为0.28、0.24、0.49,均P<0.01),与内脏脂肪面积呈负相关(r=-0.17,P<0.05);游离四碘甲状原氨酸(FT4)与四肢骨骼肌质量指数(r=-0.21)、去脂体重(r=-0.16)、相位角(r=-0.2)呈负相关(P<0.01或P<0.05),与体脂百分比、内脏脂肪面积呈正相关(r值分别为0.20、0.22,均P<0.01)。FT3预测肌少症前期的ROC下面积为0.768(95%CI:0.691~0.844)。结论NTIS与老年人肌少症前期相关,低水平FT3对肌少症前期有一定的预测价值。
Objective To explore the association between non-thyroid illness syndrome(NTIS)and pre-sarcopenia in the elderly.Methods In the retrospective study,a total of 219 patients aged 60-85 years in Department of Geriatrics,Sir Run Run Hospital,Nanjing Medical University from April 2018 to March 2021,included 60 patients with NTIS and 159 patients without NTIS.Clinical data,laboratory results and body composition data were collected.Pre-sarcopenia was diagnosed based on human composition determination data and diagnostic criteria of pre-sarcopenia.Logistic regression analysis,Pearson's correlation analysis and the area under receiver operator characteristic curve(ROC)were used to explore the correlation between serum thyroid hormone levels and diagnostic data level of pre-sarcopenia.Results Of 54 pre-sarcopenia patients,30.3%(36/119)were male,18.0%(18/100)were female with statistically significantly differences(P<0.01).Mean age was higher in both male and female patients in the NTIS group than in the non-NTIS group(P<0.01).The body mass index,levels of triiodothyronine(T3),free triiodothyronine(FT3),hemoglobin,and albumin were lower in NTIS group than in non-NTIS group(P<0.05).The prevalence of presarcopenia in female patients was higher in the NTIS group than in the non-NTIS group[42.9%(10/17)vs.10.6%(8/83),χ^(2)=9.564,P<0.01].Multivariate logistic regression analysis showed that the risk of pre-morbidity of sarcopenia was significantly higher in NTIS patients than in non-NTIS patients.FT3 was positively correlated with skeletal muscle mass index,fat-free body weight,and phase angle,and negatively correlated with visceral fat area(r=-0.17,P<0.05).While,free thyroxine(FT4)was negatively correlated with skeletal muscle mass index(r=-0.21),fat-free body weight(r=-0.16)and phase Angle(r=-0.2,P<0.01 or P<0.05),and was positively correlated with body fat percentage and visceral fat area(r=0.20 and 0.22,respectively,P<0.01).The use of area under ROC curve(AUC)of FT3 predicting sarcopenia stage showed that the AUC was 0.768(95%CI:0.691~0.844).Conclusions In elderly patients,NTIS is correlated with the pre-sarcopenia in the elderly,and FT3 and FT4 are related to muscle mass.The low level of FT3 can predict the pre-validation of pre-sarcopenia.
作者
林玉双
赵璨
何慧薇
高伟
鲁翔
Lin Yushuang;Zhao Can;He Huiwei;Gao Wei;Lu Xiang(Department of Geriatrics,Sir Run Run Hospital,Nanjing Medical University,Nanjing 211166,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2022年第7期817-821,共5页
Chinese Journal of Geriatrics
基金
科技部国家重点研发计划(2020YFC2008500)
江苏省老年医学学会科技发展基金(JGS2019ZXYY06)
医学学会科技发展基金(JGS2019ZXYY06)。
