老年肌少症患者骨骼肌质量指数与肥胖、骨质疏松及肠道菌群的相关性研究

目的探讨老年肌少症患者骨骼肌质量指数（SMI）与肥胖、骨质疏松的相关性，并分析不同SMI老年肌少症患者肠道菌群分布情况。 方法将103例老年肌少症患者根据入选者SMI的均值（男5.1 kg / m²，女4.3 kg /m²）分为低SMI组（男38例，女11例）与极低SMI组（男43例，女11例）。对不同性别两组肌少症患者SMI、体质量指数（BMI）、全身脂肪百分比、髋关节密度及股骨颈密度进行比较，并采用Pearson检验分析SMI与上述指标间的相关性。同时，采用PCR技术检测患者肠道菌群的含量。 结果在老年男性患者中，极低SMI组的SMI[（4.4 ± 0.5）kg / m² vs.（5.8 ± 0.5）kg / m²]与BMI[（21.6 ± 2.9）kg / m² vs.（24.8 ± 3.1）kg / m²]显著低于低SMI组（t = 12.062，P < 0.001；t = 4.740，P < 0.001）。在老年女性中，极低SMI组的SMI显著低于低SMI组[（3.8 ± 0.3）kg / m² vs.（4.8 ± 0.8）kg / m²，t = 7.065，P < 0.001]。同时，在老年男性中，SMI与BMI成正相关（r = 0.521，P < 0.001），普拉梭菌[2.87（0.42，10.86）× 10⁶拷贝数/ g vs. 9.57（1.33，36.04）× 10⁶拷贝数/ g]、梭菌属Ⅰ族[3.03（0.39，20.47）× 10⁴拷贝数/ g vs. 15.94（3.57，48.88）× 10⁴拷贝数/ g]在极低SMI组的含量均显著少于低SMI组（Z = 1.987，P = 0.047；Z = 2.943，P = 0.003）。在老年女性中，SMI与全身脂肪百分比成负相关（r = -0.447，P = 0.029）；与低SMI组比较，极低SMI组患者肠球菌含量显著减少[2.56（0.20，54.82）× 10⁴拷贝数/ g vs. 0.28（0.01，1.55）× 10⁴拷贝数/ g，Z = 2.068，P = 0.040]，梭菌属Ⅰ族含量显著增加[1.18（0.37，11.73）× 10⁴拷贝数/ g vs. 16.88（5.22，66.79）× 10⁴拷贝数/ g，Z = 2.134，P = 0.034]。 结论老年肌少症患者SMI与BMI及全身脂肪百分比显著相关，且肠道菌群在不同程度的SMI间有所差异。

Correlation between skeletal muscle index and obesity,osteoporosis, intestinal microflora in aged patients with sarcopenia

ObjectiveTo investigate the correlation of skeletal muscle index (SMI) with obesity and osteoporosis, and to explore the changes of intestinal microflora in different SMI aged patients with sarcopenia. MethodsTotally 103 aged patients with sarcopenia were divided into the low SMI group (38 males, 11 females) and very low SMI group (43 males, 11 females) according to the mean SMI (male: 5.1 kg / m², female: 4.3 kg / m²). The SMI, body mass index (BMI), total body fat percentage, hip density and femoral neck density were measured, and the correlation between SMI and above indicators was analyzed by the Pearson test. Mean-while, the intestinal microflora was detected by PCR. ResultsIn aged male patients, the levels of SMI[(4.4 ± 0.5) kg / m² vs. (5.8 ± 0.5) kg / m²] and BMI [(21.6 ± 2.9) kg / m² vs. (24.8 ± 3.1) kg / m²] in the very low SMI group were much lower than those in the low SMI group (t = 12.062, P < 0.001; t = 4.740, P < 0.001). In aged female patients, only the SMI level in the very low SMI group was much lower than that in the low SMI group [(3.8 ± 0.3) kg / m² vs. (4.8 ± 0.8) kg / m², t = 7.065, P < 0.001]. Meanwhile, in aged male patients, the SMI was positively correlated with BMI (r = 0.521, P < 0.001), and the contents of Faecali-bacterium prausnitzii [2.87 (0.42, 10.86) × 10⁶ copies / g vs. 9.57 (1.33, 36.04) × 10⁶ copies / g] and Clostridium cluster I [3.03 (0.39, 20.47) × 10⁴ copies / g vs. 15.94 (3.57, 48.88) × 10⁴ copies / g] in the very low SMI group were much lower than those in the low SMI group (Z = 1.987, P = 0.047; Z = 2.943, P = 0.003). In aged female patients, the SMI was negatively correlated with total body fat percentage (r = -0.447, P = 0.029), and compared with the low SMI group, the content of Enterococcus decreased [2.56 (0.20, 54.82) × 10⁴ copies / g vs. 0.28 (0.01, 1.55) × 10⁴ copies / g, Z = 2.068, P = 0.040], and the content of Clostridium cluster I increased significantly [1.18 (0.37, 11.73) × 10⁴ copies / g vs. 16.88 (5.22, 66.79) × 10⁴ copies / g, Z = 2.134, P = 0.034]. ConclusionThe SMI is related to the BMI and total body fat percentage in elderly patients with sarcopenia, and the content of intestinal microflora varies with different SMI degrees.