社区老年男性居民肌肉减少与代谢相关脂肪性肝病的相关性

肝脏 ›› 2022, Vol. 27 ›› Issue (11): 1206-1212.

社区老年男性居民肌肉减少与代谢相关脂肪性肝病的相关性

张爽, 刘晓慧, 王罡, 张丽, 吴剑, 张晶

100069 首都医科大学附属北京佑安医院脂肪性肝病诊疗中心(张爽,刘晓慧,张晶);北京京煤集团总医院门矿医院(王罡,张丽);首都体育学院(吴剑)

收稿日期:2021-12-30 出版日期:2022-11-30 发布日期:2023-01-31
通讯作者: 张晶,Email:zjyouan@ccmu.edu.cn;吴剑,Email:wujian@cupes.edu.cn
作者简介:刘晓慧,Email:lxhui123456@126.com
基金资助:
北京慢性病防治与健康教育研究会科研基金(BJMB0012021025002),首都医科大学附属北京佑安医院青年人才孵育项目(YNKTQN2021015)。

Muscle loss in elder male residents of the community is associated with the severity of metabolic associated fatty liver disease

ZHANG Shuang¹, LIU Xiao-hui¹, WANG Gang², ZHANG Li², WU Jian³, ZHANG Jing¹

1. Fatty Liver Disease Treatment Center, Beijing Youan Hospital, Capital Medical University, Beijing 100069, China;
2. Menkuang Hospital, Beijing Jingmei Group General Hospital, Beijing 102399, China;
3. Capital University Of Physical Education And Sports, Beijing 100191, China

Received:2021-12-30 Online:2022-11-30 Published:2023-01-31
Contact: ZHANG Jing, Email: zjyouan@ccmu.edu.cn; WU Jian, Email: wujian@cupes.edu.cn

摘要/Abstract

摘要： 目的探讨社区老年男性居民肌肉减少与代谢相关脂肪性肝病(metabolic associated fatty liver disease, MAFLD)的相关性。方法本研究对北京某社区65岁以上232名老年男性居民进行横断面调查。所有受试者均收集人口学数据、病史、体格检查和实验室检查结果,使用身体成分测试仪检测体成分,使用FibroScan进行肝脏脂肪含量和肝脏弹性检测。肌肉减少的定义为经体质量校正的四肢骨骼肌质量(appendicular skeletal muscle mass %, ASM%)小于29.1。比较少肌组和非少肌组代谢相关指标、MAFLD比例和严重程度的差异,四分位数组间差异的比较采用卡方检验、单因素方差分析和Kruskal-Wallis秩和检验。结果在全部患者中,少肌组ASM%(27.41±1.17)的年龄、BMI、体脂率、内脏脂肪面积、超敏C反应蛋白及糖代谢指标均显著高于非少肌组ASM%(31.47±1.86),且ALT[24.0(18.0, 33.0)vs. 20.0(16.0, 26.0)]、肝脏脂肪含量[(290.4±60.4)vs.(256.4±53.6)]及肝脏硬度值[(5.30(4.20, 6.80)vs. 4.45(3.80, 5.90))]均高于非少肌组,基础代谢率、HDL-C低于非少肌组(均P<0.05)。低ASM%四分位组的患者比高ASM%四分位组的患者具有更显著代谢紊乱和严重的肝脏脂肪变。少肌组MAFLD患者占76.9%,非少肌组MAFLD患者占50.3%(χ²=13.593, P<0.001)。MAFLD合并肌肉减少的患者BMI、腰围、臀围、腰臀比、上臂围度、体脂率、内脏脂肪面积、肝脏脂肪含量高于非少肌组(均P<0.05)。结论在老年男性中,肌肉减少伴随着更严重的代谢异常和肝脏脂肪变,提示要重视老年人肌肉减少及MAFLD的筛查,为及时诊断早期干预奠定基础。

关键词: 代谢相关脂肪性肝病, 肌少症, 社区, 横断面研究

Abstract: Objective To investigate the relationship between metabolic associated fatty liver disease (MAFLD) and muscle loss in elder male residents of the community.Methods A cross-sectional survey was conducted among 232 elderly male residents over 65 years old in a community in Beijing. Demographic data, medical history, physical examination and laboratory examination Results were collected for all subjects. Body composition was detected with body composition tester. Liver fat content and liver elasticity were examined by FibroScan. Muscle loss was defined as the ratio of skeletal muscle mass and weight (ASM%) less than 29.1. The patients were divided into a muscle loss group and a non-muscle loss group, and the differences in metabolic indicators, proportion and severity of MAFLD between the two groups were compared. The differences between the quartiles were compared using Chi-square test, one-way ANOVA analysis, and Kruskal-Wallis test.Results In all patients, age, BMI, body fat percentage, visceral fat area, hypersensitive C-reactive protein and glucose metabolism indexes in muscle loss group [ASM% (27.41±1.17)] were significantly higher than those in non-muscle loss group [ASM% (31.47±1.86)], ALT [24.0 (18.0, 33.0) vs. 20.0 (16.0, 26.0)], liver fat content [(290.4±60.4) vs. (256.4±53.6)], liver stiffness scores [(5.30 (4.20, 6.80) vs. 4.45 (3.80, 5.90)], basal metabolic rate, and HDL-C were lower than those in non-muscle loss group (all P<0.05). Patients in the lower ASM% quartile group had more significant metabolic disturbances and severe hepatic fatty changes than those in the higher ASM% quartile group. 76.9% of patients with MAFLD were in the muscle loss group and 50.3% in the non-muscle loss group (χ²=13.593, P<0.001). BMI, waist circumference, hip circumference, waist-hip ratio, upper arm circumference, body fat percentage, visceral fat area and controlled attenuation parameters (CAP) in patients with MAFLD combined with muscle loss were higher than those in the non-muscle loss group (all P<0.05).Conclusion In elder men, muscle loss is accompanied by more severe metabolic abnormalities and hepatic steatosis, suggesting that attention should be paid for the screening of elderly muscle loss and MAFLD to lay the foundation of timely diagnosis and early intervention.

Key words: Metabolic associated fatty liver disease, Sarcopenia, Community, Cross-sectional studies

张爽, 刘晓慧, 王罡, 张丽, 吴剑, 张晶. 社区老年男性居民肌肉减少与代谢相关脂肪性肝病的相关性[J]. 肝脏, 2022, 27(11): 1206-1212.

ZHANG Shuang, LIU Xiao-hui, WANG Gang, ZHANG Li, WU Jian, ZHANG Jing. Muscle loss in elder male residents of the community is associated with the severity of metabolic associated fatty liver disease[J]. Chinese Hepatolgy, 2022, 27(11): 1206-1212.

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