Correlation Between Sarcopenia And Nutritional Status And Quality Of Life In Elderly Patients With Chronic Heart Failure

Objective:Chronic heart failure(CHF)is a common clinical syndrome in the elderly.It is the end stage of the development of various heart diseases and an important cause of death in heart disease patients.Sarcopenia is closely related to CHF,and both tend to coexist.Studies abroad have shown that malnutrition is not only an important cause of adverse outcomes in elderly CHF patients,but also relate d to the occurrence and development of sarcopenia.At present,there are few studies on the nutritional status and quality of life of elderly patients with CHF complicated with sarcopenia.Therefore,this study will explore relationship between sarc openia and nutritional status and quality of life in patients with CHF over 60 years old.Methods:This trial design is a cross-sectional study,involving 120 patients with chronic heart failure aged≥60 years who were hospitalized in the Department of Geriatrics,Affiliated Hospital of Qingdao University from June 2017 to June 2018.According to the diagnostic criteria of the Asian Minisis Working Group(AWG S),the subjects were divided into sarcopenia and non-sarcopenia group,and general clinical data such as gender,age,height,weight,body mass index(BMI),medical history(such as hypertension,diabetes,old myocardial infarction),New York Heart Association heart function classification(NYHA classification),left ventricular ejection fraction(LVEF)and some serological indicators.Nutritional status was evaluated by Mini Nutritional Assessment-Short Form(MNA-SF).The health-related quality of life(HRQOL)was measured using the EuroQol-5 dimension(EQ-5D)questionnaire.SPSS 22.0 was used for statistical analysis,the measurement data were expressed as the means±SD,and the independent sample t-test was used to an alysis the measurement date,the counting data was represented by the number of cases and percentages,and theχ~2 test was used for comparing proportions.The general clinical data,MNA-SF score,nutritional status distribution and quality of life were compared between the two groups.At the same time,single factor logistic regression was used to analyze the risk factors of sarcopenia.Multivariate logistic regression was used to evaluate the correlation between sarcopenia and nutritional status and quality of life in elderly CHF patients.The difference was statistically significant at P<0.05.Results:1.Among the 120 subjects included in the study,94(78.3%)were males and 26(21.7%)were females,aged 60-85 years,with an average age of(73.8±5.8)years.A total of 42 patients(35.0%)met the diagnostic criteria for sarcopenia,including 34 males(81.0%)and 8 females(19.0%).Compared with the non-sarc openia group,the mean age of the patients with sarcopenia group was larger(75.7±5.1 vs 72.7±5.9,P<0.05),with higher NYHA classification and poor cardiac function(2.4±0.5 vs 2.1±0.7,P<0.05).The average body weight,body mass index(BMI),serum albumin level and MNA-SF score of the sarcopenia group were lower than those of the non-sarcopenia group[(56.6±7.4)kg vs(73.4±9.4)kg,(20.8±2.4)kg/m~2 vs(26.0±2.7)kg/m~2,(36.2±4.2)g/L vs(38.5±3.3)g/L,9.5±2.0 vs 12.9±1.3;all P values<0.05].2.Comparing the distribution of different nutritional status between the two groups showed that 30 patients(71.4%)were in malnutrition in the sarcopenia group,and 9 patients(21.4%)were at risk of malnutrition,only 3 patients(7.2%)with normal nutritional state.In the non-sarcopenia group,only 4(5.1%)patients were malnutrition,12(15.4%)patients were at risk of malnutrition,and 62(79.5%)patients were in normal nutritional status.The proportion of malnutrition in sarcopenia group was significantly higher than that in the non-sarcopenia group,and the difference was statistically significant(P<0.05).3.Correlation analysis between sarcopenia and nutritional status showed that MNA-SF scores(OR=0.336,95%CI:0.199-0.567,P<0.001)is an independent risk factor for sarcopenia,after adjusting for age,body weight,and BMI.4.Comparing the health-related quality of life between the two groups showed that the proportion of patients with difficulty in action and daily activities in the sarcopenia group was significantly higher than that in the non-sarcopenia group(64.3%vs 30.8%,61.9%vs 29.5%,P value<0.05).In the comparison of EQ-5D index score and EQ-visual scale(EQ-VAS),the average score of the sarcopenia group was lower than that of the non-sarcopenia group(0.60±0.35 vs 0.77±0.25,72.57±8.31 vs 78.59±8.03,all P values<0.05).Conclusions:1.The incidence of sarcopenia is higher in elderly CHF patients.Age,body weight,BMI,NYHA cardiac function grade,serum albumin level and MNA-SF score are all influencing factors of sarcopenia.2.The proportion of malnutrition patients with sarcopenia was significantly higher than that of non-sarcopenia.3.After adjusting for confounding factors,the MNA-SF score was an independent risk factor for the development of sarcopenia in elderly CHF patients.4.Compared with the non-sarcopenia group,the proportion of patients with sarcopenia who had difficulty in action and daily activities was higher,and the EQ-5D index score and the average score of EQ-VAS were lower.