生物电阻抗衍生相位角与老年男性衰弱状态进展的相关性研究

Study on correlation between bioelectrical impedance-derived phase angle and progression of frailty in elderly men

中文关键词: 老年  相位角  衰弱  进展

英文关键词: elderly  phase angle  frailty  progression

中文摘要:

      目的　探究相位角（ＰｈＡ）与老年男性衰弱状态进展的相关性。 方法　２０２１年４月—２０２３年６月，选取２４２例中国人民解放军总医院体检的６０岁及以上老年男性。 收集受试者的年龄、身高、体重和共病等基线资料，通过Ｆｒｉｅｄ衰弱表型量表评估衰弱。 测量体质量指数、骨矿物质含量（ＢＭＣ）、内脏脂肪面积、骨骼肌质量指数（ＳＭＩ）、总蛋白质、ＰｈＡ和 无机盐等体成分。 根据随访期间受试者衰弱状态的转变，将受试者分为稳定组（ｎ＝１８２）、进展组（ｎ＝４７）及改善组（ｎ＝１３）。 受试者操作特征曲线分析ＰｈＡ对衰弱进展的预测价值；二元Ｌｏｇｉｓｔｉｃ向前逐步回归法探索衰弱状态进展的相关因素。 结果　２４２例老年男性中稳定组１８２例（７５．２１％）、进展组４７例（１９．４１％）、改善组１３例（５．３８％）。 与进展组相比，稳定组年龄较小，糖尿病构成比较低，ＢＭＣ、ＳＭＩ、总蛋白质、无机盐和简易体能状况量表评分较高，ＰｈＡ与握力较大，步速较快，差异有统计学意义（Ｐ＜０．０５）。 当ＰｈＡ临界值为４．９５°时，曲线下面积为０．７２８（９５％ＣＩ： ０．６５２～０.８０４），灵敏度为７６．６０％（３６／４７），特异度为６２．６４％（１１４／１８２）。 多因素 Ｌｏｇｉｓｔｉｃ 向前逐步回归法分析，高龄、存在共病以及低 ＰｈＡ是衰弱状态进展的独立风险因素。 结论　低ＰｈＡ老年男性发生衰弱状态进展的风险一定程度上更大。

英文摘要:

      Objective To investigate the correlation between the phase angle (PhA) and the progression of frailty in elderly men. Methods From April 2021 to June 2023, 242 elderly males aged 60 and above were selected for physical examination in General Hospital of Chinese PLA. Their baseline data such as age, height, weight and comorbidities were collected. Their frailty was assessed with the Fried Frailty Phenotype scale. Their body mass index, bone mineral content ( BMC), visceral fat area, skeletal muscle mass index ( SMI), total protein, PhA, inorganic salts and other body compositions were measured. According to the changes in the frailty status during the follow-up period, they were divided into stable group (n = 182 ) progressive group (n=47) and improvement group (n=13). The receiver operator characteristic curve was used to analyze the predictive value of PhA for the progression of frailty. Binary Logistic forward stepwise regression method was used to explore the related factors of the progression of frailty. Results Among 242 elderly males, there were 182 cases in the stable group (75.21% ), 47 ones in the progressive group ( 19.41% ), and 13 ones in the improvement group (5.38% ). Compared with the progressive group, the stable group had a younger age, a lower proportion of diabetes, and higher levels of BMC, SMI, total protein and inorganic salts, and higher score of Short Physical Performance Battery ( P <0.05). The PhA and grip strength of the stable group were greater, and the walking speed was faster ( P < 0. 05). When the PhA cut-off value was4.95°, the area under the curve was 0.728 (95% C1. 0. 652-0. 804). the sensitivity was76.60% (36/47). and the specificity was 62. 64% (114/182). Multivariate Logistic forward stepwise regression analysis showed that advanced age, comorbidity and low PhA were independent risk factors for the progression of frailty. Conclusion Elderly men with low PhA have a somewhat greater risk of developing the progression of frailty.