高龄男性肌少症患者的活动能力与下肢肌肉质量和肌力的相关性研究

Correlation of functional activities and muscle mass with lower limb muscle strength in aged sarcopenic men

摘要:

目的 探讨高龄（＞85岁）男性肌少症患者的活动能力与其下肢肌肉质量和下肢肌力的相关性。方法 根据亚洲肌少症工作组（AWGS）纳入和排除标准，入选2014年6月至2015年2月于解放军总医院门诊部查体的87名高龄肌少症男性患者，年龄（89.5±4.4）岁，平均相对骨骼肌肉质量指数（RASMMI）为（6.04±0.62）kg/m2。分别对研究对象进行身体成分测试、握力测试、下肢肌力测试（分别测试髂腰肌、股四头肌、胫前肌及腘绳肌的最大等长肌力），并研究上述指标与活动能力测试如步速（6min最大步行速度测试）、计时“起立?行走”时间测试（TUGT）、5次起坐时间测试（FTSST）和闭目单腿站立测试的相关性。结果 步速、TUGT、FTSST、闭目单腿站立时间主要与年龄（r＝?0.567，P＝0.018；r＝0.742，P＝0.001；r＝0.632，P＝0.007；r＝?0.489，P＝0.047）、下肢肌肉质量（r＝0.489，P＝0.045；r＝?0.579，P＝0.012；r＝?0.641，P＝0.003；r＝0.476，P＝0.048）和下肢脂肪含量（r＝?0.517，P＝0.032；r＝0.513，P＝0.031；r＝0.528，P＝0.015；r＝?0.533，P＝0.012）相关。步速、TUGT、FTSST、闭目单腿站立时间与髂腰肌肌力（r＝0.313，P＝0.000；r＝?0.887，P＝0.000；r＝?0.666，P＝0.003；r＝0.515，P＝0.035）和与股四头肌肌力（r＝0.251，P＝0.017；r＝?0.775，P＝0.000；r＝?0.612，P＝0.013；r＝0.671，P＝0.002）相关。结论 高龄肌少症老人的活动能力与身体成分及下肢肌力相关程度较高。脂肪含量高而下肢肌肉质量低的老年人活动能力相对差；下肢肌力高的老年人活动能力较好，尤其以股四头肌、髂腰肌肌力为代表。

Abstract:

Objective To investigate the correlation of functional activities and lower limb muscle mass with muscle strength in the aged sarcopenic men. Methods According to the inclusion and exclusion criteria of Asian Working Group for Sarcopenia (AWGS), 87 men at an average age of (89.5±4.4) years were diagnosed as sarcopenia from those who took physical examination in Outpatient Department of our hospital from June 2014 to February 2015. Their average relative appendicular skeletal muscle mass index (RASMMI) was (6.04±0.62)kg/m2. Physical composition was measured by dual X-ray absorptiometry (DXA), grip strength by a dynamometer named JAMAR, and maximum isometric strength of iliopsoas, quadriceps femoris, tibialis anterior and hamstrings by a dynamometer named FET3. Physical composition, lower limb strength test, 6-min walking test, timed up and go test (TUGT), five times sit-to-stand test (FTSST), and one-legged stance test with eyes closed were performed respectively to investigate the correlations of above indices with the test results. Results The walking speed, TUGT, FTSST, and time for one-legged stance were correlated with age (r＝?0.567, P＝0.018; r＝0.742, P＝0.001; r＝0.632, P＝0.007; r＝?0.489, P＝0.047), muscle mass (r＝0.489, P＝0.045; r＝?0.579, P＝0.012; r＝?0.641, P＝0.003; r＝0.476, P＝0.048) and fat mass (r＝?0.517, P＝0.032; r＝0.513, P＝0.031; r＝0.528, P＝0.015; r＝?0.533, P＝0.012). In addition, the indices of walking speed, TUGT, FTSST, and time for one-legged stance showed correlation with maximum isometric strength of iliopsoas (r＝0.313, P＝0.000; r＝?0.887, P＝0.000; r＝?0.666, P＝0.003; r＝0.515, P＝0.035) and maximum isometric strength of quadriceps femoris (r＝0.251, P＝0.017; r＝?0.775, P＝0.000; r＝?0.612, P＝0.013; r＝0.671, P＝0.002). Conclusion There exists a high correlation of functional activities and physical composition with lower limb muscle strength in aged sarcopenic men. The elderly with high fat content and low muscle mass have relatively poor physical activity, and those with high lower limb muscle strength have good physical activity, especially for iliopsoas and quadriceps femoris muscle strength.