山东大学学报 (医学版) ›› 2025, Vol. 63 ›› Issue (4): 26-35.doi: 10.6040/j.issn.1671-7554.0.2024.1040
• 营养、肠道微生态及相关疾病 • 上一篇
陈瑛翼1,游倩1,王意1,张帆2,李凤2,季舒铭3,徐浩源4,饶志勇1
CHEN Yingyi1, YOU Qian1, WANG Yi1, ZHANG Fan2, LI Feng2, JI Shuming3, XU Haoyuan4, RAO Zhiyong1
摘要: 目的 调查分析办公室职员肌肉质量减少发生率及影响因素,构建并验证风险预测模型,为制定干预方案提供参考。 方法 选取2023年3月至2023年12月在四川大学华西医院健康管理中心体检的事业单位、机关单位办公室职员和退休者286人,采用食物频率调查问卷、运动情况调查问卷、体格检查、人体成分分析、实验室检查等进行分析。使用R语言(R Studio,版本4.4.1)分析肌肉质量影响因素,建立风险预测模型并进行验证。 结果 肌肉质量减少发生率26.22%;高血糖、低体质量指数(body mass index, BMI)为肌肉质量减少的危险因素,高血尿素/血肌酐(blood urea nitrogen to serum creatinine, BUN/Cr)、每天实际摄入能量/每日推荐摄入能量比、高新鲜水果、高握力评分、超重是肌肉质量减少的保护因素,并构建模型;验证该模型的ROC曲线下面积为0.83,Youden指数为0.52,最佳风险阈值取14.40%。Hosmer-Lemeshow检验和校准曲线评估模型拟合度较高(χ2=11.98,P=0.152),预测模型的阈值概率值在0.07~0.93。 结论 本研究预测模型具有较好的预测效果和拟合程度,利于医技护人员评估发生肌肉质量减少的风险,有助于为办公室职员肌肉质量减少高危人群提供参考尽早预防。
中图分类号:
| [1] Lim WS, Cheong CY, Lim JP, et al. Singapore clinical practice guidelines for sarcopenia: screening, diagnosis, management and prevention[J]. J Frailty Aging, 2022, 11(4): 348-369. [2] Chen LK, Woo J, Assantachai P, et al. Asian working group for sarcopenia: 2019 consensus update on sarcopenia diagnosis and treatment[J]. J Am Med Dir Assoc, 2020, 21(3): 300-307. [3] Xin CH, Sun X, Lu L, et al. Prevalence of sarcopenia in older Chinese adults: a systematic review and meta-analysis[J]. BMJ Open, 2021, 11(8): e041879. doi:10.1136/bmjopen-2020-041879 [4] Lexell J, Taylor CC, Sjöström M. What is the cause of the ageing atrophy? Total number, size and proportion of different fiber types studied in whole vastus lateralis muscle from 15- to 83-year-old men[J]. J Neurol Sci, 1988, 84(2/3): 275-294. [5] Jing Y, Zuo YS, Yu Y, et al. Single-nucleus profiling unveils a geroprotective role of the FOXO3 in primate skeletal muscle aging[J]. Protein Cell, 2023, 14(7): 497-512. [6] Daily JW, Park S. Sarcopenia is a cause and consequence of metabolic dysregulation in aging humans: effects of gut dysbiosis, glucose dysregulation, diet and lifestyle[J]. Cells, 2022, 11(3): 338. doi:10.3390/cells11030338 [7] 崔华, 王朝晖, 吴剑卿, 等. 老年人肌少症防控干预中国专家共识(2023)[J]. 中华老年医学杂志, 2023, 42(2): 144-153. CUI Hua, WANG Zhaohui, WU Jianqing, et al. Chinese expert consensus on prevention and intervention for elderly with sarcopenia(2023)[J]. Chinese Journal of Geriatrics, 2023, 42(2): 144-153. [8] 于普林, 高超, 周白瑜, 等. 预防老年人肌少症核心信息中国专家共识(2021)[J]. 中华老年医学杂志, 2021, 40(8): 953-954. YU Pulin, GAO Chao, ZHOU Baiyu, et al. Chinese expert consensus on core information for sarcopenia prevention in the elderly[J]. Chinese Journal of Geriatrics, 2021, 40(8): 953-954. [9] 赵启迪, 王凯, 赵小刚, 等. 基于SEER数据库构建并验证IIIB期非小细胞肺癌患者预后模型[J]. 山东大学学报(医学版), 2023, 61(10): 23-37. ZHAO Qidi, WANG Kai, ZHAO Xiaogang, et al. Constructing and validating a prognostic model for patients with stage IIIB non-small cell lung cancer based on SEER database[J]. Journal of Shandong University(Health Sciences), 2023, 61(10): 23-37. [10] 宋峻, 臧嘉捷, 汤红梅, 等. 食物频率问卷法评估人群膳食营养素摄入量的相对效度研究[J]. 卫生研究, 2016, 45(5): 743-748. SONG Jun, ZANG Jiajie, TANG Hongmei, et al. Relative validity of food frequency questionnaire for estimating dietary nutrients intake[J]. Journal of Hygiene Research, 2016, 45(5): 743-748. [11] 中国营养学会. 中国高龄老年人体质指数适宜范围与体重管理指南(T/CNSS 021—2023)[J]. 中华流行病学杂志, 2023, 44(9): 1335-1337. Chinese Nutrition Society.Appropriate range of body mass index and body weight management guidelines for Chinese oldest old(T/CNSS 021-2023)[J]. Chinese Journal of Epidemiology, 2023, 44(9): 1335-1337. [12] 中国营养学会.中国居民膳食指南 2022 版[M].北京:人民卫生出版社,2022. [13] Hou J, Liu XT, Tu RQ, et al. Long-term exposure to ambient air pollution attenuated the association of physical activity with metabolic syndrome in rural Chinese adults: a cross-sectional study[J]. Environ Int, 2020, 136: 105459. doi:10.1016/j.envint.2020.105459 [14] 袁帆, 陈征, 张妍, 等. 我国职业人群身体活动现状调查[J]. 中国公共卫生, 2018, 34(10): 1327-1330. YUAN Fan, CHEN Zheng, ZHANG Yan, et al. Status of physical activity among occupational populations in China: a cross-sectional study[J]. Chinese Journal of Public Health, 2018, 34(10): 1327-1330. [15] Bischoff-Ferrari HA, Orav JE, Kanis JA, et al. Comparative performance of current definitions of sarcopenia against the prospective incidence of falls among community-dwelling seniors age 65 and older[J]. Osteoporos Int, 2015, 26(12): 2793-2802. [16] Yuan S, Larsson SC. Epidemiology of sarcopenia: prevalence, risk factors, and consequences[J]. Metabolism, 2023, 144: 155533. doi:10.1016/j.metabol.2023.155533 [17] Lao MX, Zhang KC, Zhang M, et al. Clinical features and co-infections in invasive pulmonary aspergillosis in elderly patients[J]. Infect Drug Resist, 2020, 13: 3525-3534. doi:10.2147/IDR.S273946 [18] Marasco G, Dajti E, Serenari M, et al. Sarcopenia predicts major complications after resection for primary hepatocellular carcinoma in compensated cirrhosis[J]. Cancers, 2022, 14(8): 1935. doi:10.3390/cancers14081935 [19] Li C, Kang BX, Zhang T, et al. High visceral fat area attenuated the negative association between high body mass index and sarcopenia in community-dwelling older Chinese people[J]. Healthcare, 2020, 8(4): 479. doi:10.3390/healthcare8040479 [20] Weiss EP, Jordan RC, Frese EM, et al. Effects of weight loss on lean mass, strength, bone, and aerobic capacity[J]. Med Sci Sports Exerc, 2017, 49(1): 206-217. [21] Sartori R, Romanello V, Sandri M. Mechanisms of muscle atrophy and hypertrophy: implications in health and disease[J]. Nat Commun, 2021, 12(1): 330. doi:10.1038/s41467-020-20123-1 [22] Talpur AS, Kavanoor Sridhar K, Shabbir K, et al. Restrictive pulmonary disease in diabetes mellitus type II patients[J]. Cureus, 2022, 14(4): e23820. doi:10.7759/cureus.23820 [23] Qaisar R, Karim A, Muhammad T, et al. Prediction of sarcopenia using a battery of circulating biomarkers[J]. Sci Rep, 2021, 11(1): 8632. doi:10.1038/s41598-021-87974-6 [24] Kameda M, Teruya T, Yanagida M, et al. Reduced uremic metabolites are prominent feature of sarcopenia, distinct from antioxidative markers for frailty[J]. Aging, 2021, 13(17): 20915-20934. [25] Vaishya R, Misra A, Vaish A, et al. Hand grip strength as a proposed new vital sign of health: a narrative review of evidences[J]. J Health Popul Nutr, 2024, 43(1): 7. [26] 《中国人群身体活动指南》编写委员会. 中国人群身体活动指南(2021)[J]. 中华流行病学杂志, 2022, 43(1): 5-6. Composing and Editorial Board of Physical Activity Guidelines for Chinese.Physical activity guidelines for Chinese(2021)[J]. Chinese Journal of Epidemiology, 2022, 43(1): 5-6. [27] 刘娟, 丁清清, 周白瑜, 等. 中国老年人肌少症诊疗专家共识(2021)[J]. 中华老年医学杂志, 2021, 40(8): 943-952. LIU Juan, DING Qingqing, ZHOU Baiyu, et al. Chinese expert consensus on diagnosis and treatment for elderly with sarcopenia(2021)[J]. Chinese Journal of Geriatrics, 2021, 40(8): 943-952. [28] Aytekin N, Mileva KN, Cunliffe AD. Selected B vitamins and their possible link to the aetiology of age-related sarcopenia: relevance of UK dietary recommendations[J]. Nutr Res Rev, 2018, 31(2): 204-224. [29] Koyanagi A, Veronese N, Solmi M, et al. Fruit and vegetable consumption and sarcopenia among older adults in low- and middle-income countries[J]. Nutrients, 2020, 12(3): 706. doi:10.3390/nu12030706 [30] Liu YT, Wang QH, Zhang ZF, et al. Magnesium supplementation enhances mTOR signalling to facilitate myogenic differentiation and improve aged muscle performance[J]. Bone, 2021, 146: 115886. doi:10.1016/j.bone.2021.115886 [31] Khor SC, Abdul Karim N, Ngah WZW, et al. Vitamin E in sarcopenia: current evidences on its role in prevention and treatment[J]. Oxid Med Cell Longev, 2014, 2014: 914853. doi:10.1155/2014/914853 [32] Ganapathy A, Nieves JW. Nutrition and sarcopenia-what do we know?[J]. Nutrients, 2020, 12(6): 1755. doi:10.3390/nu12061755 |
| [1] | 刘国伟,翟艳,王薇,吕军城. 潍坊市某城区65岁及以上老年人社会适应能力现状及其影响因素[J]. 山东大学学报 (医学版), 2025, 63(2): 104-110. |
| [2] | 李永,崔书君,杨飞,张凡,殷晓霞. 基于增强MRI的亚区域影像组学模型可预测乳腺癌患者新辅助化疗后的病理完全反应[J]. 山东大学学报 (医学版), 2025, 63(1): 81-89. |
| [3] | 孙丽娜,白红艳,牛宗格,张福帅,曲仪庆. 基于SII构建及评价预测ARDS住院死亡率的在线临床风险模型[J]. 山东大学学报 (医学版), 2024, 62(7): 10-20. |
| [4] | 郭振江,王宁,赵光远,杜立强,崔朝勃,刘防震. 基于机器学习建立术前预测近端胃癌食管切缘阳性模型[J]. 山东大学学报 (医学版), 2024, 62(7): 78-83. |
| [5] | 刘峰,马彩霞,李春燕,程海英,靳乐雨,刘仲,李学文. 2023年11月流感高峰期济南市大学生流感样病例发生情况及影响因素[J]. 山东大学学报 (医学版), 2024, 62(7): 91-97. |
| [6] | 刁玉洁,林琳,李文瑄,王洲洋,江蓓,胡迎迎,刘广义. NPR预测ANCA相关血管炎不良肾脏预后及其协同多因素优化模型[J]. 山东大学学报 (医学版), 2024, 62(2): 60-68. |
| [7] | 景睿,张文茜,董卉,董怡然,于胜男,段勇,闫芹,赵传禄,李秀君,汪卫兵. 济南市大一新生结核病防治知信行现状及行为影响因素[J]. 山东大学学报 (医学版), 2024, 62(2): 101-107. |
| [8] | 冯绪强,高萍,孙超,陶琳,闫根全,冷冰. 替加环素治疗感染性疾病临床疗效及影响因素[J]. 山东大学学报 (医学版), 2024, 62(12): 11-20. |
| [9] | 于菲萍,李鑫,司明舒,张丹,苏永刚. 医学生医养结合认知程度与养老就业意愿[J]. 山东大学学报 (医学版), 2024, 62(11): 105-114. |
| [10] | 刘凤祺,高峰,薛彩彩,乔秀梅,王金红. 高糖诱导PC12细胞损伤的影响因素及梓醇的保护作用[J]. 山东大学学报 (医学版), 2023, 61(7): 34-39. |
| [11] | 钟璐,薛付忠. 基于贝叶斯网络不确定性推理的肺癌风险预测模型[J]. 山东大学学报 (医学版), 2023, 61(4): 86-94. |
| [12] | 程传龙,韩闯,房启迪,刘盈,杨淑霞,崔峰,刘靖靖,李秀君. 基于时空地理加权回归模型探索肺癌发病的环境影响因素[J]. 山东大学学报 (医学版), 2023, 61(4): 95-102. |
| [13] | 韩璐怿,田雪莹,高琦,佘凯丽,曹云贤,魏淑淑,丁淑军,李秀君. 基于MaxEnt的山东省SFTS影响因素评估及风险区域预测[J]. 山东大学学报 (医学版), 2023, 61(4): 103-110. |
| [14] | 王建华,孙淑青,张效东,杨筱筱,王友健,卢金宝,李赞武. ICU机械通气患者撤机风险预测模型的构建[J]. 山东大学学报 (医学版), 2023, 61(12): 86-93. |
| [15] | 张明慧,王丽云,王芸,张新月,沙凯辉. 髋部骨折患者术后恐动症风险的列线图分析[J]. 山东大学学报 (医学版), 2023, 61(11): 74-81. |
|
||