关键词: 肌少症, 老年人, 慢性病, 患病率, 影响因素分析

Abstract: Background　Sarcopenia，an age-related progressive decline in total body skeletal muscle mass and/or decreased muscle strength or decreased muscle physiological function，is associated with health problems，and high social and medical expenditure.Objective　To investigate the prevalence and associated factors of sarcopenia in elderly hospitalized patients with chronic diseases，facilitating early detection and prevention of sarcopenia.Methods　236 inpatients（≥60 years old） with chronic diseases from Department of Geriatrics，Peking University People's Hospital were enrolled during November 2017 to November 2018.Their demographic data and clinical data including prevalence of chronic disease，medication in the past 3 months，laboratory parameters，and prevalence of depression assessed by the 30-item Geriatric Depression Scale（GDS-30），and nutrition status assessed by Mini-Nutritional Assessment Scale-Short Form（MNA-SF） were collected，and were compared between those who were diagnosed with sarcopenia（n=63） and those without sarcopenia（n=173） by the guidelines by Asian Working Group for Sarcopenia.Multivariate Logistic regression analysis was performed to identify the factors associated with sarcopenia.Results Patients with sarcopenia ands those without showed significant differences in sex ratio，mean age，BMI，osteoporosis incidence，mean levels of hemoglobin，albumin，urea nitrogen，total cholesterol，triglyceride（TG） / high-density lipoprotein cholesterol（HDL-C） ratio，estimated glomerular filtration rate，prevalence and risk factors of malnutrition，appendicular skeletal muscle mass index（ASMI），grip strength，and gait speed（P<0.05）.Multivariate Logistic regression analysis showed that，age 〔OR=1.052，95%CI（1.007，1.099）〕，BMI 〔OR=0.885，95%CI（0.793，0.988）〕，osteoporosis 〔OR=2.217，95%CI（1.100，4.467）〕，hemoglobin 〔OR=0.936，95%CI（0.909，0.964）〕，TG/HDL-C ratio 〔OR=1.501，95%CI（1.074，2.099）〕 were independently associated with sarcopenia（P<0.05）.The incidence of sarcopenia differed significantly across BMI quartile groups（P<0.05）.In particular，the prevalence of sarcopenia in BMI 24.7-27.0 kg/m2 group was significantly lower than that in BMI ≤ 22.4 kg/m2 group（χ2=12.844，P<0.001）.There was no significant difference in the prevalence of sarcopenia across TG/HDL-C ratio quartile groups（P>0.05）.Conclusion　Older age，osteoporosis，decreased hemoglobin and increased TG/HDL ratio are associated with an increased risk of sarcopenia.The relationship between BMI level and sarcopenia tends to be U-shaped.

Key words: Sarcopenia, Aged, Chronic disease, Prevalence, Root cause analysis