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

摘要： 背景　肌少症与增龄相关，表现为进行性的全身肌量减少和/或肌强度下降或肌肉生理功能减退。不仅会引起疾病，还会导致高额的社会医疗支出。目的　调查住院老年慢性病患者肌少症的发生率，探究住院老年慢性病患者肌少症的相关因素，以利于肌少症的早期筛查和预防。方法　入选2017年11月—2018年11月于北京大学人民医院老年科住院的慢性病患者（≥60岁）共236例。收集患者人口学资料及慢性病、过去3个月用药情况、实验室检查指标，采用老年抑郁量表（GDS-30）、简易营养评价精法（MNA-SF量表）评估患者抑郁、营养状况。根据亚洲肌少症工作组（AWGS）诊断标准诊断肌少症，将患者分为肌少症组63例和非肌少症组173例，比较两组患者临床资料，采用多因素Logistic回归分析住院老年慢性病患者肌少症的相关因素。结果　肌少症组和非肌少症组患者性别、年龄、体质指数（BMI）、骨质疏松症发生率、血红蛋白（Hb）、血清白蛋白（Alb）、尿素氮（BUN）、总胆固醇（TC）、三酰甘油（TG）/高密度脂蛋白胆固醇（HDL-C）比值、估算肾小球滤过率（eGFR）、营养不良及风险、四肢骨骼肌质量指数（ASMI）、握力、步速比较，差异均有统计学意义（P<0.05）。多因素Logistic回归分析结果显示，年龄〔OR=1.052，95%CI（1.007，1.099）〕、BMI〔OR=0.885，95%CI（0.793，0.988）〕、骨质疏松症〔OR=2.217，95%CI（1.100，4.467）〕、Hb〔OR=0.936，95%CI（0.909，0.964）〕、TG/HDL-C比值〔OR=1.501，95%CI（1.074，2.099）〕与住院老年慢性病患者发生肌少症有回归关系（P<0.05）。根据BMI四分位数分组，不同BMI分组患者肌少症发生率比较，差异有统计学意义（P<0.05）；其中BMI 24.7~27.0 kg/㎡组患者肌少症发生率低于BMI≤22.4 kg/㎡组（χ2=12.844，P<0.001）。根据TG/HDL-C比值四分位数分组，不同TG/HDL-C比值患者肌少症发生率比较，差异无统计学意义（P>0.05）。结论　年龄、骨质疏松症、Hb水平降低、TG/HDL-C比值升高与住院老年慢性病患者肌少症的发生相关；BMI与肌少症的发生呈U型相关。

关键词: 肌少症, 老年人, 慢性病, 患病率, 影响因素分析