社区老年人肌少症患病率及影响因素的meta分析

摘要/Abstract

摘要： 目的分析社区老年人肌肉减少症（肌少症）的患病率及影响因素。方法检索PubMed、Embase、The Cochrane Library、Web Of Science、CINAHL、维普数据库、中国知网、万方数据库、中国生物医学文献服务系统等数据库从建库至2021年7月关于社区老年人肌少症患病率及影响因素的相关文献,采用RevMan 5.3软件对社区老年人肌少症患病率及影响因素进行meta分析。结果共纳入19篇横断面研究,老年肌少症人数合计3 883例,社区老年人肌肉减少症总患病率为16%[95%CI（10%~22%）],亚组分析显示,南美洲、城市地区老年人肌少症患病率更高;年龄70~<80岁（OR=3.42,95%CI：1.84~6.43）、年龄≥80岁（OR=11.42,95%CI：6.89~18.92）、吸烟（OR=2.66,95%CI：1.76~4.02）、糖尿病（OR=1.93,95%CI：1.06~3.52）、体质量指数增加（OR=0.71,95%CI：0.67~0.75）、营养不良（OR=3.96,95%CI：2.88~5.44）、女性（OR=2.55,95%CI：1.84~3.53）是社区老年肌少症的影响因素。结论社区老年人肌少症患病率较高,高龄、吸烟、糖尿病、营养不良、女性是社区老年人发生肌少症的危险因素,体质量指数增加是社区老年人发生肌少症的保护因素。社区医护人员应针对以上干预因素,对高危老人加以防护,以降低肌少症的发生率,改善患者不良结局。

关键词: 老年人, 肌肉减少症, 患病率, 影响因素

Abstract: Objective To analyze the prevalence and influencing factors of sarcopenia in the community-dwelling older adults. Methods The PubMed,Embase,the Cochrane Library,Web Of Science,CINAHL,VIP,CNKI,Wanfang Data and CBM databases were searched to retrieve the relevant literature on the prevalence and influencing factors of sarcopenia among the elderly in the community from the establishment of the database to July 2021. The meta-analysis on the prevalence and influencing factors of sarcopenia among the elderly in the community was conducted by RevMan 5.3 software. Results A total of 19 cross-sectional studies were included. There were 3 883 cases of senile sarcopenia,the prevalence of sarcopenia among the elderly in the community was 16%[95%CI（10%-22%）]. The subgroup analysis showed that the prevalence of sarcopenia among the elderly in South America and urban areas was higher,while aged 70-<80 years old（OR=3.42,95%CI：1.84-6.43）,aged ≥80 years old（OR=11.42,95%CI：6.89-18.92）,smoking（OR=2.66,95%CI：1.76-4.02）,diabetes mellitus（OR=1.93,95%CI：1.06-3.52）,increased BMI（OR=0.71,95%CI：0.67-0.75）,malnutrition（OR=3.96,95%CI：2.88-5.44） and female（OR=2.55,95%CI：1.84-3.53） were the influencing factors of sarcopenia among the elderly in the community. Conclusions The prevalence of sarcopenia is high among the elderly in the community. Elderly,smoking,diabetes,malnutrition and female are risk factors for sarcopenia among the elderly in the community,increased BMI is a protective factor for the occurrence of sarcopenia among the elderly in the community. The community medical staff should protect the high-risk elderly according to the above intervention factors,so as to reduce the incidence of sarcopenia and improve the adverse outcomes of patients.

Key words: The elderly, Sarcopenia, Prevalence, Influencing factor

中图分类号:

R181.2

周洋, 高慧婷, 曲桂玉, 方晓风. 社区老年人肌少症患病率及影响因素的meta分析. [J]职业与健康, 2023, 39(11): 1539-1544.

ZHOU Yang, GAO Hui-ting, QU Gui-yu, FANG Xiao-feng. Prevalence and influencing factors of sarcopenia among community-dwelling older adults：A meta-analysis. [J]OCCUPATION AND HEALTH, 2023, 39(11): 1539-1544.

参考文献

[1] SANTILLI V,BERNETTI A,MANGONE M,et al.Clinical definition of sarcopenia[J].Clin Cases Miner Bone Metab,2014,11(3):177-180.
[2] XU J,WAN C S,KTORIS K,et al.Sarcopenia is associated with mortality in adults:A systematic review and meta-analysis[J].Gerontology,2022,68(4):361-376.
[3] YEUNG S,REIJNIERSE E M,PHAM V K,et al.Sarcopenia and its association with falls and fractures in older adults:A systematic review and meta-analysis[J].J Cachexia Sarcopenia Muscle,2019,10(3):485-500.
[4] XIA L,ZHAO R,WAN Q,et al.Sarcopenia and adverse health-related outcomes:An umbrella review of meta-analyses of observational studies[J].Cancer Med,2020,9(21):7964-7978.
[5] 刘海霞,周萍,张一娜.肌少症的诊断与治疗[J].中华骨质疏松和骨矿盐疾病杂志,2021,14(4):434-440.
[6] 中华医学会骨质疏松和骨矿盐疾病分会.肌少症共识[J].中华骨质疏松和骨矿盐疾病杂志,2016,9(3):215-227.
[7] MALAFARINA V,URIZ O,INIESTA R,et al.Sarcopenia in the elderly:diagnosis,physiopathology and treatment[J].Maturitas,2012,71(2):109-114.
[8] 曾宪涛,刘慧,陈曦,等.Meta分析系列之四:观察性研究的质量评价工具[J].中国循证心血管医学杂志,2012,4(4):297-299.
[9] WU C H,CHEN K T,HOU M T,et al.Prevalence and associated factors of sarcopenia and severe sarcopenia in older Taiwanese living in rural community:The Tianliao old people study 04[J].Geriatr Gerontol Int,2014,14(1):69-75.
[10] ALEXANDRE T S,DUARTE Y A,SANTOS J L,et al.Prevalence and associated factors of sarcopenia among elderly in Brazil:Findings from the SABE study[J].J Nutr Health Aging,2014,18(3):284-290.
[11] VOLPATO S,BIANCHI L,CHERUBINI A,et al.Prevalence and clinical correlates of sarcopenia in community-dwelling older people:Application of the EWGSOP definition and diagnostic algorithm[J].J Gerontol A Biol Sci Med Sci,2014,69(4):438-446.
[12] GAO L,JIANG J,YANG M,et al.Prevalence of sarcopenia and associated factors in chinese community-dwelling elderly:Comparison between rural and urban areas[J].J Am Med Dir Assoc,2015,16(11):1001-1003.
[13] KHONGSRI N,TONGSUNTUD S,LIMAMPAI P,et al.The prevalence of sarcopenia and related factors in a community-dwelling elders Thai population[J].Osteoporos Sarcopenia,2016,2(2):110-115.
[14] TRAMONTANO A,VERONESE N,SERGI G,et al.Prevalence of sarcopenia and associated factors in the healthy older adults of the Peruvian Andes[J].Arch Gerontol Geriatr,2017,1(68):49-54.
[15] 张艳,谈玉婷,黄夕夏,等.上海市社区老年人肌少症患病率及相关危险因素分析[J].老年医学与保健,2018,24(6):608-613.
[16] SIMSEK H,MESERI R,SAHIN S,et al.Prevalence of sarcopenia and related factors in community-dwelling elderly individuals[J].Saudi Med J,2019,40(6):568-574.
[17] SU Y,HIRAYAMA K,HAN T F,et al.Sarcopenia prevalence and risk factors among japanese community dwelling older adults living in a snow-covered city according to EWGSOP2[J].J Clin Med,2019,8(3):291.
[18] 王慧,海珊,刘颖,等.成都市社区老人肌少症患病率及相关因素研究[J].四川大学学报(医学版),2019,50(2):224-228.
[19] MOREIRA V G,PEREZ M,LOURENCO R A.Prevalence of sarcopenia and its associated factors:The impact of muscle mass,gait speed,and handgrip strength reference values on reported frequencies[J].Clinics (Sao Paulo),2019,8(74):477.
[20] NAKAMURA K,YOSHIDA D,HONDA T,ET al.Prevalence and mortality of sarcopenia in a community-dwelling older Japanese population:The Hisayama Study[J].J Epidemiol,2020,31(5):320-327.
[21] KUROSE S,NISHIKAWA S,NAGAOKA T,et al.Prevalence and risk factors of sarcopenia in community-dwelling older adults visiting regional medical institutions from the Kadoma Sarcopenia Study[J].Sci Rep,2020,10(1):19129.
[22] 王光辉,蔡文玮,沈晓君,等.欧洲肌少症共识在上海部分社区老年人群肌少症筛查中的应用[J].中国临床保健杂志,2020,23(3):325-330.
[23] 陈姝,俞静,狄文娟,等.南京市社区老年肌少症流行病学调查及其影响因素分析[J].实用老年医学,2020,34(8):793-796.
[24] PEREZ-SOUSA M A,POZO-CRUZ J D,CANO-GUTIERREZ C A,et al.High prevalence of probable sarcopenia in a representative sample from colombia:Implications for geriatrics in Latin America[J].J Am Med Dir Assoc,2020,22(4):859-864.
[25] 李博.内蒙古某社区老年人群肌肉衰减综合征流行病学调查和相关影响因素分析[D].呼和浩特:内蒙古医科大学,2020.
[26] 孟欣宇.老年人罹患肌少症现状及影响因素分析[D].新乡:新乡医学院,2020.
[27] WU L C,KAO H H,CHEN H J,et al.Preliminary screening for sarcopenia and related risk factors among the elderly[J].Medicine(Baltimore),2021,100(19):25946.
[28] YANJIAO S,JING C,XIAOYAN C,et al.Prevalence and associated factors of sarcopenia in nursing home residents:A systematic review and meta-analysis[J].J Am Med Dir Assoc,2019,20(1):5-13.
[29] 梁艳虹,薛磊,高媛媛,等.老年住院患者肌少症情况及其影响因素分析[J].中华老年医学杂志,2020,39(9):1042-1045.
[30] SENIOR H E,HENWOOD T R,BELLER E M,et al.Prevalence and risk factors of sarcopenia among adults living in nursing homes[J].Maturitas,2015,82(4):418-423.
[31] BUCKINX F,REGINSTER J Y,BRUNOIS T,et al.Prevalence of sarcopenia in a population of nursing home residents according to their frailty status:Results of the SENIOR cohort[J].J Musculoskelet Neuronal Interact,2017,17(3):209-217.
[32] MARTONE A M,BIANCHI L,ABETE P,et al.The incidence of sarcopenia among hospitalized older patients:Results from the Glisten study[J].J Cachexia Sarcopenia Muscle,2017,8(6):907-914.
[33] SHAFIEE G,KESHTKAR A,SOLTANI A,et al.Prevalence of sarcopenia in the world:A systematic review and meta- analysis of general population studies[J].J Diabetes Metab Disord,2017,16(1):21.
[34] LIU X,HAO Q,YUE J,et al.Sarcopenia,obesity and sarcopenia obesity in comparison:Prevalence,metabolic profile,and key differences:Results from WCHAT Study[J].J Nutr Health Aging,2020,24(4):429-437.
[35] AUYEUNG T W,LEE S W,LEUNG J,et al.Age-associated decline of muscle mass,grip strength and gait speed:A 4-year longitudinal study of 3018 community-dwelling older Chinese[J].Geriatr Gerontol Int,2014,14(1):76-84.
[36] MONTES D O M,LOEB E,TORRES S H,et al.Peripheral muscle alterations in non-COPD smokers[J].Chest,2008,133(1):13-18.
[37] DEGENS H,GAYAN-RAMIREZ G,VAN HEES H W.Smoking-induced skeletal muscle dysfunction:From evidence to mechanisms[J].Am J Respir Crit Care Med,2015,191(6):620-625.
[38] SIDDALL A,BILZON J,THOMPSON D,et al.Smoking and biochemical,performance,and muscle adaptation to military training[J].Med Sci Sports Exerc,2020,52(5):1201-1209.
[39] PETERSEN A M,MAGKOS F,ATHERTON P,et al.Smoking impairs muscle protein synthesis and increases the expression of myostatin and MAFbx in muscle[J].Am J Physiol Endocrinol Metab,2007,293(3):843-848.
[40] DARABSEH M Z,MADEN-WILKINSON T M,Welbourne G,et al.Fourteen days of smoking cessation improves muscle fatigue resistance and reverses markers of systemic inflammation[J].Sci Rep,2021,11(1):12286.
[41] ANAGNOSTIS P,GKEKAS N K,ACHILLA C,et al.Type 2 diabetes mellitus is associated with increased risk of sarcopenia:A systematic review and meta-analysis[J].Calcif Tissue Int,2020,107(5):453-463.
[42] NOMURA T,KAWAE T,KATAOKA H,et al.Assessment of lower extremity muscle mass,muscle strength,and exercise therapy in elderly patients with diabetes mellitus[J].Environ Health Prev Med,2018,23(1):20.
[43] MESINOVIC J,ZENGIN A,DE COURTEN B,et al.Sarcopenia and type 2 diabetes mellitus:A bidirectional relationship[J].Diabetes Metab Syndr Obes,2019,8(12):1057-1072.
[44] 张慧,牟绍玉,谭人福.重庆地区老年住院患者营养风险、营养不良发生率及营养支持现状调查[J].激光杂志,2012,33(6):87-88.
[45] VERREIJEN A M,VERLAAN S,ENGBERINK M F,et al.A high whey protein-,leucine-,and vitamin D-enriched supplement preserves muscle mass during intentional weight loss in obese older adults:a double-blind randomized controlled trial[J].Am J Clin Nutr,2015,101(2):279-286.
[46] ZHU L Y,CHAN R,KWOK T,et al.Effects of exercise and nutrition supplementation in community-dwelling older Chinese people with sarcopenia:A randomized controlled trial[J].Age Ageing,2019,48(2):220-228.
[47] HANSEN M.Female hormones:Do they influence muscle and tendon protein metabolism?[J].Proc Nutr Soc,2018,77(1):32-41.
[48] 马悦,卞爱琳,王小飞,等.天津地区不同性别与年龄老年人肌肉减少症患病率的差异研究[J].中国全科医学,2017,20(26):3267-3271.
[49] YAP S F,BOO N Y,PRAMOD D S,et al.Risk factors associated with sarcopenia among independently mobile,institutionalised older people in the klang valley of malaysia:A cross-sectional study[J].Malays J Med Sci,2020,27(2):120-128.
[50] 车雅洁,杨璇璇,张可,等.乌鲁木齐市社区老年人肌少症患病现状及相关因素[J].中华骨质疏松和骨矿盐疾病杂志,2020,13(4):304-310.