The ClinicianThe ClinicianКлиницист1818-83382412-8775Publishing House ABV Press49610.17650/1818-8338-2022-16-2-K661ORIGINAL INVESTIGATIONSОРИГИНАЛЬНОЕ ИССЛЕДОВАНИЕFrequency and risk factors of sarcopenia in the elderly peopleЧастота и факторы риска саркопении у людей старших возрастных группhttps://orcid.org/0000-0003-2923-9712SafonovaYu. A.СафоноваЮ. А.
Russian Federation

Yulia Alexandrovna Safonova

41 Kirochnaya St., St.­Petersburg 191015

34 А Kashirskoye Shosse, Moscow 115522

Юлия Александровна Сафонова 

191015 Санкт­Петербург, ул. Кирочная, 41

115522 Москва, Каширское шоссе, 34А

jula_safonova@mail.ruhttps://orcid.org/0000-0003-4739-4302ToroptsovaN.  V.ТоропцоваН. В.
Russian Federation

34 А Kashirskoye Shosse, Moscow 115522

115522 Москва, Каширское шоссе, 34А

North-Western State Medical University named after I. I. MechnikovФГБОУ ВО «Северо-Западный государственный медицинский университет им. И. И. Мечникова» Минздрава РоссииV.A. Nasonova Research Institute of RheumatologyФГБНУ «Научно-исследовательский институт ревматологии им. В. А. Насоновой»V.A. Nasonova Research Institute of RheumatologyФГБНУ «Научно-­исследовательский институт ревматологии им. В. А. Насоновой»1504202216240471010202210102022Copyright ©; 2022, Safonova Y.A., Toroptsova N.V.Copyright ©; 2022, Сафонова Ю.А., Торопцова Н.В.2022Safonova Y.A., Toroptsova N.V.Сафонова Ю.А., Торопцова Н.В.https://creativecommons.org/licenses/by/4.0https://klinitsist.abvpress.ru/Klin/article/view/496

Aim. To determine the frequency and assess the risk factors of sarcopenia (SP) in elderly people living at home.

Materials and methods. The study included 230 people aged 65 years and older who lived at home and were observed in outpatient clinic. To detect SP, grip strength was measured and muscle mass was determined using dual-energy absorptiometry (DXA). Severe SP was diagnosed based on the results of Short physical performance battery (SPPB) and the “Up and Go” test. The diagnosis of SP was made according to the criteria of EWGSOP2 (2018). The laboratory examination included clinical and biochemical blood analysis, determination of the level of 25 (OH) D.

Results. Probable SP was found in 64.8 %, confirmed SP – in 28.7 %, and severe SP – in 21.3 % of older people. The frequency of SP increased with age from 19.6 % in 65–74 years to 52.9 % in 85 years and older (p <0.05). The results of multivariate analysis showed that the probability of SP increased with a BMI of less than 25 kg / m2 (OR 5,459; 95 % CI: 1,939–15,369; p = 0.0013), severe comorbidity calculated by the Charlson index (OR 5,178; 95 % CI: 1,597–14,128; p = 0.0030) and the presence of such laboratory indicators like level 25 (OH) D less than 20 ng / ml (OR 4,989; 95 % CI: 1,321–12,626; p = 0.0420), total protein less than 64 g / l (OR 8,567; 95 % CI: 2,658–27,617; p = 0.00032), CRP more than 5 mg / l (OR 14,279; 95 % CI: 3,511–58,071; p = 0.00020) and moderately reduced renal function (GFR <60 ml / min / 1.73 m (OR 12,108; 95 % CI: 3,944–37,170; p = 0.00001).

Conclusions. Among elderly people, a high frequency (28.7 %) of SP was detected, which increased with age. A BMI of less than 25 kg / m2, a deficiency of 25(OH)D, total protein level of less than 64 g / l and CRP of more than 5 mg / l, a decrease in GFR of less than 60 ml / min were associated with the presence of SP.

Цель исследования – определить частоту и оценить факторы риска саркопении у пожилых людей, проживающих в домашних условиях.

Материалы и методы. В исследование включены 230 пациентов в возрасте 65 лет и старше, проживающих в домашних условиях и наблюдавшихся амбулаторно. Для выявления саркопении выполняли измерение силы мышц кистей и определение мышечной массы с помощью двухэнергетической абсорбциометрии, а для диагностики тяжелой саркопении проводили комплекс тестов физической работоспособности и тест «Встань и иди». Диагноз саркопении ставился по критериям EWGSOP2 (2018). Лабораторное обследование включало клинический и биохимический анализы крови, определение уровня 25 (ОН) D.

Результаты. Вероятная саркопения установлена у 64,8 % людей пожилого и старческого возраста, подтвержденная – у 28,7 %, тяжелая – у 21,3 %. Частота саркопении увеличивалась с возрастом с 19,6 % в 65–74 года до 52,9 % в 85 лет и старше (р <0,05). Результаты многофакторного анализа показали, что вероятность саркопении повышалась при индексе массы тела менее 25 кг / м2 (отношение шансов (ОШ) 5,459; 95 % доверительный интервал (ДИ) 1,939– 15,369; р = 0,0013), тяжелой коморбидности, рассчитанной по индексу Charlson (ОШ 5,178; 95 % ДИ 1,597–14,128; р = 0,0030), и наличии таких лабораторных показателей, как уровень 25(OH)D <20 нг / мл (ОШ 4,989; 95 % ДИ 1,321–12,626; р = 0,0420), общий белок <64 г / л (ОШ 8,567; 95 % ДИ 2,658–27,617; р = 0,00032), С-реактивный белок >5 мг / л (ОШ 14,279; 95 % ДИ 3,511–58,071; р = 0,00020) и умеренно сниженной функции почек (скорость клубочковой фильтрации <60 мл / мин / 1,73 м2) (ОШ 12,108; 95 % ДИ 3,944–37,170; р = 0,00001).

Заключение. Среди людей пожилого возраста выявлена высокая частота саркопении (28,7 %), растущая с увеличением возраста. Индекс массы тела менее 25 кг / м2, дефицит 25 (OH) D, уровни общего белка <64 г / л и С-реактивный белок >5 мг / л, снижение скорости клубочковой фильтрации <60 мл / мин ассоциировались с наличием саркопении у лиц пожилого и старческого возраста.

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