腹型肥胖对体质量指数正常的中老年男性骨骼肌的影响

Effect of abdominal obesity on skeletal muscle in middle-aged and elderly males with normal body mass index

摘要:

目的 观察腹型肥胖对正常体质量指数(BMI)的中老年男性骨骼肌质量及功能的影响。方法 选取2019年3月至2020年7月内蒙古包钢医院老年科住院的96例中老年男性(≥45岁)为研究对象,根据有无腹型肥胖分为腹型肥胖组和非腹型肥胖组。测定2组患者的生化指标、炎症指标、内脏脂肪面积(VFA)、骨骼肌肌肉质量与力量及躯体功能。采用SPSS 19.0统计软件进行数据分析。根据数据类型,分别采用t检验或χ²检验进行组间比较。以多元线性回归分析腹型肥胖与四肢骨骼肌量指数(ASMI)的独立相关性。结果 AO(+)组肌少症患病率、BMI、VFA、肿瘤坏死因子α(TNF-α)、白介素-6(IL-6)、C反应蛋白(CRP)、空腹胰岛素(FINS)、胰岛素抵抗指数(HOMA-IR)、总胆固醇(TC) 及低密度脂蛋白胆固醇(LDL-C)均高于 AO(-)组(均 P＜0.05)；双下肢肌量、ASMI及6m步数(6MWS)低于 AO(-)组(均 P＜0.05)。相关性分析显示,VFA 与 BMI、TC、LDL-C 、IL-6、CRP、FINS 及HOMA-IR均呈正相关(r= 0.526~0.886,均 P＜0.05)；与双下肢肌量、ASMI及6MWS呈负相关(r=-0.640,-0.727,-0.622；均P＜0.05)。多元线性回归分析提示,ASMI的独立影响因素为腹型肥胖(β=0.124,P＜0.001)和HOMA-IR(β=0.013,P=0.092)。结论 VFA与中老年男性ASMI呈正相关,腹型肥胖是BMI正常的中老年男性ASMI的独立影响因素。

Abstract:

Objective To determine the effect of abdominal obesity on skeletal muscle mass and function in the middle-aged and elderly males with normal body mass index (BMI). Methods A total of 96 inpatients (≥45 years old) admitted in our department from March 2019 to July 2020 were enrolled as subjects. According to having abdominal obesity or not, they were divided into abdominal obesity group[AO(+) group, n=46] and non-abdominal obesity group [AO(-) group, n=50]. Biochemical indexes, inflammatory indexes, visceral fat area (VFA), mass and strength of skeletal muscle, and physical function were measured and compared between the two groups. SPSS statistics 19.0 was used for data analysis. According to data types, student′s t test or Chi-square test was employed for comparison between groups. The independent correlation between abdominal obesity and appendicular skeletal muscle index (ASMI) was analyzed by multiple linear regression analysis. Results The prevalence of sarcopenia, BMI, VFA, and serum levels of tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), C-reactive protein (CRP), fasting insulin (FINS), homeostatic model assessment for insulin resistance index (HOMA-IR), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C) were significantly higher, and lower limb muscle mass, ASMI and 6-meter walking speed (6MWS) were obviously lower in AO(+) group than in AO(-) group (all P<0.05). Correlation analysis showed that VFA was positively correlated with BMI, TC, LDL-C, IL-6, CRP, FINS and HOMA-IR (r= 0.526-0.886, all P<0.05), and negatively with lower extremity muscle mass, ASMI and 6MWS (r=-0.640, -0.727, -0.622, all P<0.05). Multiple linear regression analysis indicated that abdominal obesity (β=0.124, P<0.001) and HOMA-IR (β=0.013, P=0.092) were independent factors for ASMI. Conclusion VFA is positively correlated with ASMI in middle-aged and elderly males, and abdominal obesity is an independent factor affecting ASMI in those with normal BMI.