Study on the relationship between comorbidities of chronic diseases, phase angle, and muscle mass decline related to sarcopenia in the elderly

doi:10.3969/j.issn.1674-8115.2024.02.005

Abstract

Abstract:

Objective ·To explore the correlation between comorbidities of chronic non-communicable diseases (chronic diseases), phase angle (PhA), and muscle mass decline associated with sarcopenia in the elderly, and the predictive value of chronic disease comorbidities and PhA in muscle mass decline in the elderly. Methods ·By retrospectively screening inpatients aged ≥60 years who were admitted to the Department of Geriatrics, Renji Hospital, Shanghai Jiao Tong University School of Medicine from August 1, 2018 to July 31, 2019, basic information and medical history of the patients (gender, age, number of medications used, number of comorbidities, presence of osteoporosis, smoking history, etc.) were collected, as well as laboratory examination indicators (hemoglobin, albumin, serum creatinine, serum uric acid, ferritin, vitamin D, triacylglycerol, total cholesterol, high-density lipoprotein, low-density lipoprotein, etc.). The age-adjusted Charlson comorbidity index (aCCI) was calculated. The InBody S10 bioelectrical impedance body composition detector was used to test the body composition. Body mass index (BMI), skeletal muscle mass index (SMI), and PhA were collected. Some patients underwent measurement of grip strength. Muscle mass decline was diagnosed by using the SMI values recommended by the 2019 Asian Working Group for Sarcopenia (AWGS) (≤7.0 kg/m² for males and ≤5.7 kg/m² for females). According to the measured SMI values, patients were divided into a group with normal muscle mass and a group with muscle mass decline. Univariate and multivariate Logistic analyses were employed to investigate the risk factors associated with muscle mass decline related to sarcopenia in the elderly. Additionally, the receiver operator characteristic (ROC) curve and the area under the curve were utilized to predict the significance of these factors in muscle mass decline. Results ·A total of 359 chronic disease patients were enrolled, including 226 males and 133 females. There were 241 cases in the normal muscle mass group and 118 cases in the muscle mass decline group. The incidence of muscle mass decline related to sarcopenia in the elderly was 32.9%. The univariate Logistic regression analysis showed that age (OR=1.036, 95%CI 1.013?1.060), comorbidities (OR=1.117, 95%CI 1.025?1.217), aCCI (OR=1.123, 95%CI 1.031?1.222), and high-density lipoprotein (OR=3.688, 95%CI 2.065?6.622) were positively correlated with the risk of muscle mass decline in the elderly. BMI (OR=0.514, 95%CI 0.443?0.597), PhA (OR=0.195, 95%CI 0.126?0.303), hemoglobin (OR=0.984, 95%CI 0.972?0.996) and triacylglycerol (OR=0.606, 95%CI 0.424?0.866) were negatively correlated with the risk of muscle mass decline in the elderly. Multivariate Logistic regression model indicated that PhA (OR=0.338, 95%CI 0.119?0.959) and BMI (OR=0.634, 95%CI 0.476?0.844) were negatively correlated with the risk of muscle mass decline in elderly. The area under the ROC curve for predicting muscle mass decline related to sarcopenia in elderly by using BMI and PhA was 0.893 (95%CI 0.855?0.931) and 0.786 (95%CI 0.736?0.837), respectively. The sensitivity was 0.724 and 0.676, respectively. The specificity was 0.916 and 0.762, respectively. When BMI combined with PhA predicted muscle mass decline in the elderly, the area under the ROC curve was 0.917 (95%CI 0.883?0.951). The sensitivity was 0.867, and the specificity was 0.860. Conclusion ·aCCI is correlated with muscle mass decline associated with sarcopenia in the elderly. As BMI and PhA decrease, the risk of muscle mass decline in the elderly increases. The combination of BMI and PhA has a high predictive value in muscle mass decline in the elderly.No predictive value of chronic diseases comorbidities in muscle mass decline related to sarcopenia in the elderly is found.

Key words: muscle mass, sarcopenia, multiple chronic condition, age-adjusted Chalson's comorbidities index (aCCI), phase angle (PhA), the elderly

CLC Number:

R592

WANG Junlin, HAO Mingxiu, TANG Yinhan, WU Yunyun, JIN Yuhua, HU Yaomin. Study on the relationship between comorbidities of chronic diseases, phase angle, and muscle mass decline related to sarcopenia in the elderly[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(2): 196-203.

Figures/Tables 7

TrendMD

References 22

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Item	Muscle mass decline group (n=118)	Normal muscle mass group (n=241)	P value
Age/year	75.59±10.26	72.23±9.29	0.030
Gender/n(%)			0.090
Male	67 (56.78)	159 (65.98)
Female	51 (43.22)	82 (34.02)
BMI/(kg·m^-2)	20.00±2.81	24.89±2.94	0.005
Number of medications used/n	4 (0, 10)	3 (0, 9)	0.371
Number of comorbidities/n	9 (8, 10)	7 (6, 8)	0.033
aCCI	10 (6, 14)	9 (5, 13)	0.017
PhA/°	4.07±0.63	4.82±0.71	0.005
Hb/(g·L^-1)	126.00 (102.50, 149.50)	134.00 (112.00, 156.00)	0.005
Albumin/(g·L^-1)	40.51±6.15	40.93±4.63	0.540
Scr/(μmol·L^-1)	64.00 (36.00, 92.00)	67.00 (43.25, 90.75)	0.623
SUA/(μmol·L^-1)	297.00 (169.00, 425.00)	326.50 (213.00, 440.00)	0.016
Ferritin/(ng·mL^-1)	122.40 (10.00, 284.60)	142.20 (2.23, 321.07)	0.549
Osteoporosis/n(%)	71 (60.17)	134 (55.60)	0.051
Vitamin D/(ng·L^-1)	18.28 (4.40, 32.16)	19.37 (7.27, 31.47)	0.071
Smoking history/n(%)	15 (12.71)	33 (13.69)	0.576
TAG/(mmol·L^-1)	1.11 (0.45, 1.77)	1.33 (0.44, 2.22)	0.000
TC/(mmol·L^-1)	4.57±1.10	4.47±1.09	0.450
HDL/(mmol·L^-1)	1.33 (0.67, 2.00)	1.12 (0.67, 1.57)	0.000
LDL/(mmol·L^-1)	2.50 (1.08, 3.92)	2.53 (1.30, 3.76)	0.815
Grip strength^①/kg	22.40 (11.92, 32.88)	26.80 (16.08, 37.52)	0.028

Item	Muscle mass decline group (n=118)	Normal muscle mass group (n=241)	P value
Age/year	75.59±10.26	72.23±9.29	0.030
Gender/n(%)			0.090
Male	67 (56.78)	159 (65.98)
Female	51 (43.22)	82 (34.02)
BMI/(kg·m^-2)	20.00±2.81	24.89±2.94	0.005
Number of medications used/n	4 (0, 10)	3 (0, 9)	0.371
Number of comorbidities/n	9 (8, 10)	7 (6, 8)	0.033
aCCI	10 (6, 14)	9 (5, 13)	0.017
PhA/°	4.07±0.63	4.82±0.71	0.005
Hb/(g·L^-1)	126.00 (102.50, 149.50)	134.00 (112.00, 156.00)	0.005
Albumin/(g·L^-1)	40.51±6.15	40.93±4.63	0.540
Scr/(μmol·L^-1)	64.00 (36.00, 92.00)	67.00 (43.25, 90.75)	0.623
SUA/(μmol·L^-1)	297.00 (169.00, 425.00)	326.50 (213.00, 440.00)	0.016
Ferritin/(ng·mL^-1)	122.40 (10.00, 284.60)	142.20 (2.23, 321.07)	0.549
Osteoporosis/n(%)	71 (60.17)	134 (55.60)	0.051
Vitamin D/(ng·L^-1)	18.28 (4.40, 32.16)	19.37 (7.27, 31.47)	0.071
Smoking history/n(%)	15 (12.71)	33 (13.69)	0.576
TAG/(mmol·L^-1)	1.11 (0.45, 1.77)	1.33 (0.44, 2.22)	0.000
TC/(mmol·L^-1)	4.57±1.10	4.47±1.09	0.450
HDL/(mmol·L^-1)	1.33 (0.67, 2.00)	1.12 (0.67, 1.57)	0.000
LDL/(mmol·L^-1)	2.50 (1.08, 3.92)	2.53 (1.30, 3.76)	0.815
Grip strength^①/kg	22.40 (11.92, 32.88)	26.80 (16.08, 37.52)	0.028

Item	B	SE	Wald χ²	P value	OR	95%CI
Age	0.035	0.012	9.226	0.002	1.036	1.013‒1.060
BMI	-0.665	0.076	76.901	0.000	0.514	0.443‒0.597
Number of comorbidities	0.110	0.044	6.399	0.011	1.117	1.025‒1.217
aCCI	0.116	0.043	7.166	0.007	1.123	1.031‒1.222
PhA	-1.634	0.225	52.726	0.000	0.195	0.126‒0.303
Hb	-0.016	0.006	6.842	0.009	0.984	0.972‒0.996
SUA	-0.002	0.001	3.353	0.067	0.998	0.995‒1.000
HDL	1.305	0.299	19.109	0.000	3.688	2.065‒6.622
TAG	-0.501	0.182	7.567	0.006	0.606	0.424‒0.866
Grip strength	-0.031	0.017	3.222	0.073	0.970	0.937‒1.003

Item	B	SE	Wald χ²	P value	OR	95%CI
Age	0.035	0.012	9.226	0.002	1.036	1.013‒1.060
BMI	-0.665	0.076	76.901	0.000	0.514	0.443‒0.597
Number of comorbidities	0.110	0.044	6.399	0.011	1.117	1.025‒1.217
aCCI	0.116	0.043	7.166	0.007	1.123	1.031‒1.222
PhA	-1.634	0.225	52.726	0.000	0.195	0.126‒0.303
Hb	-0.016	0.006	6.842	0.009	0.984	0.972‒0.996
SUA	-0.002	0.001	3.353	0.067	0.998	0.995‒1.000
HDL	1.305	0.299	19.109	0.000	3.688	2.065‒6.622
TAG	-0.501	0.182	7.567	0.006	0.606	0.424‒0.866
Grip strength	-0.031	0.017	3.222	0.073	0.970	0.937‒1.003

Item	BE	SE	Wald χ²	P value	OR	95%CI
BMI	-0.459	0.146	9.745	0.002	0.634	0.476‒0.844
PhA	-1.099	0.532	4.155	0.039	0.338	0.119‒0.959