The Relationship Between Sarcopenia And Cardiac Structure And Function In The Elderly

Background and Objective:With the advent of the age of aging,Sarcopenia is getting more and more attention.It is an age-related syndrome of decreased skeletal muscle strength,muscle mass,muscle physiological function or physical activity.The purpose of this study was to investigate the relationship between sarcopenia and cardiac structure and function in the elderly,and to discuss whether sarcopenia is accompanied by myocardial ischemia,hypoxia,necrosis and the change of left ventricular myocardial mass.Muscle strength is an indicator to measure muscle function status,and grip strength is an effective measurement parameter of muscle strength,which is one of the criteria for diagnosing sarcopenia of Asian Working Group for Sarcopenia in 2014.Currently,there are few studies on the relationship between grip strength and heart structure at home and abroad,so this topic will fill in this blank.Thyroid hormone is an important endocrine factor that affects the body muscle mass and function,and plays an important role in skeletal muscle metabolism and function,the subject will focus on whether there is a difference in thyroid hormone between the sarcopenia group and non-sarcopenia group,further improve the understanding of sarcopenia,and provide theoretical basis for early prevention and treatment.Methods:From September 2019 to December 2019,the hospitalized patients(age≥60 years old)in the international diagnosis and treatment center of Tian Jing first central hospital were included in the study.Within 24 hours after admission,bio-electrical impedance technology was used to analyze the human body composition and obtain the relative skeletal muscle mass index and other human body composition data.According to the diagnostic criteria formulated by the Asian Working Group for Sarcopenia in 2014,they met the following a at the same time combing b or c,sarcopenia can be diagnosed:a.the relative skeletal muscle mass index,male<7.0kg/m~2,female<5.7 kg/m~2;b.dominant hand grip strength,male<26 kg,female<18kg;c.walking speed<0.8m/s.The subjects were divided into sarcopenia group and non-sarcopenia group.Baseline clinical data were recorded:gender,age,height,weight,body mass index,smoking history,drinking history,comorbidities(coronary heart disease,hypertension),nutritional assessment status,etc.Blood test results were recorded:hemoglobin,N-terminal pro-brain natriuretic peptide,hypersensitive C-reactive protein,free triiodothyronine,free thyroxine,hypersensitive thyrotropin.Echocardiography was used to obtain data:left ventricular end-diastole diameter,inter ventricular septum thickness,left ventricular posterior wall thickness and other related cardiac structural parameters.According to the data of echocardiography,the left ventricular mass and left ventricular mass index were calculated according to Devereux method.Statistical method:the inpatient data of the included subjects were collected and a database was established.IBM spss26 statistical software was used for analysis.The normal distribution of measurement data was mean±standard deviation,and the independent sample t test was used for comparison between the two groups;The counting data were expressed as a percentage,and the chi-square test was used to compare the counting data between the two groups.Pearson or Spearman correlation analysis was used to test the correlation of relevant data,and p<0.05 was considered as statistically significant by all statistical methods.Results:1.Comparison of baseline data between sarcopenia group and non-sarcopenia groupThe mean age of sarcopenia group was significantly higher than that of non-sarcopenia group(P<0.05),and the mean height,weight and BMI of the sarcopenia group were significantly lower than those of non-sarcopenia group(P<0.05).The proportion of coronary heart disease and hypertension in sarcopenia group was significantly higher than that in non-sarcopenia group(P<0.05).The nutritional status of sarcopenia group was worse than that of non-sarcopenia group(P<0.05).2.Comparison of blood test data between sarcopenia group and non-sarcopenia groupThe contents of average hemoglobin,albumin,N-terminal pro-brain natriuretic peptide,hypersensitive C-reactive protein and free triiodothyronine were significantly lower in sarcopenia group than those in non-sarcopenia group(P<0.05).There was no significant difference in the contents of free thyroxine and thyroid stimulating hormone between the two groups(P>0.05).3.Comparison of cardiac structural parameters between the sarcopenia group and non-sarcopenia groupThe left ventricular posterior wall thickness,E/A and right ventricular diameter of the sarcopenia group were significantly lower than those of the non-sarcopenia group(P<0.05).There was no significant difference in inter ventricular septum thickness,left ventricular end-diastole diameter,left ventricular mass,left ventricular mass index,left ventricular ejection fraction,left atrial diameter between the two groups(P>0.05).4.Correlation analysis of dominant hand grip strength with cardiac structural parameters,age,ASM and RSMIIn a certain range,the dominant hand grip strength was positively correlated with inter ventricular septum thickness(r=0.223,P=0.019),left ventricular posterior wall thickness(r=0.450,P<0.001),left ventricular end-diastole diameter(r=0.346,P<0.001),left ventricular mass(r=0.426,P<0.001),left atrial diameter(r=0.212,P=0.026),right ventricular diameter(r=0.186,P=0.052),left ventricular ejection fraction(r=0.050,P=0.602),left ventricular mass index(r=0.061,P=0.529),E/A(r=0.023,P=0.811)had no significant correlation.The dominant hand grip strength was negatively correlated with age(r=-0.537,P<0.001),and positively correlated with skeletal muscle mass(r=0.718,P<0.001)and relative skeletal muscle index(r=0.616,P<0.001).5.Correlation analysis of free triiodothyronine with age,dominant hand grip strength,ASM and RSMIFree triiodothyronine was negatively correlated with age(r=-0.260,p=0.006)and positively correlated with hand grip strength(r=0.370,P<0.001),skeletal muscle mass(r=0.302,p=0.001),and relative skeletal muscle index(r=0.313,p=0.001).Conclusions:1.Free triiodothyronine plays an important role in the metabolism and function of skeletal muscle,showing a progressive decline in age,and has a positive correlation with the skeletal muscle mass and relative skeletal muscle index.In the elderly with normal thyroid function,a higher level of free triiodothyronine is beneficial to the human body.2.The dominant hand grip strength is one of the diagnostic criteria of sarcopenia,it is a predictive index of the occurrence of cardiovascular disease.With the increase of age,it shows a downward trend.It has a positive correlation with the skeletal muscle mass and the relative skeletal muscle index.It has a correlation with the structural parameters of heart.3.Sarcopenia had a certain effect on cardiac structure,and there was no significant difference between the sarcopenia group and the non-sarcopenia group in left ventricular mass and left ventricular mass index(p>0.05).