Study On The Correlation Between Sarcopenia And Pulmonary Function In Elderly Hospitalized Patients

Objective:To compare the lung function of elderly patients with sarcopenia and non-sarcopenia in the hospital,and analyze the correlation between lung function parameters and sarcopenia and its indicators.Methods:213 elderly patients who hospitalized at geriatrics of the first affiliated hospital of Zhejiang university during June 2017 to July 2018 were recruited.General informations of these patients were recorded.Detected the biochemical indicators.Skeletal muscle quality index(SMI),grip strength,gait speed and forced expiratory volume in first second(FEV1)and forced vital capacity(FVC),forced vital capacity(VC),maximal voluntary ventilation(MVV),peak expiratory flow(PEF),FEV1 / FVC,The percentage of FEV1 to the expected value(FEV1%Pred)were also measured.Differences in general conditions,biochemical indicators and lung function between sarcopenia and non-sarcopenia patients were compared,and spearman test was used to analyze the correlation of each indicator.Partial correlation analysis was used to analyze the correlation between SMI,grip strength,gait speed and lung function with age controlled.Finally,the indicators of lung function,age,gender,smoking,BMI,CRP and albumin were included in the binary logistic regression model to test the predictors of sarcopenia.Results:(1)Compared with the non-sarcopenia group,the sarcopenia group was older(Z= 7.318,P<0.001),with higher CRP value(Z=2.372,P=0.018),lower albumin value and BMI(Z=-4.187,P<0.001;Z=-2.231,P=0.026)and decreased pulmonary function(FEV1,FVC,VC,MVV,PEF,fev1% pred)(Z=-4.187,P<0.001;Z=2.231,P=0.026;Z=5.135,P<0.001;Z=5.400,P<0.001;Z=5.135,P<0.001;Z=5.536,P<0.001;Z=4.492,P<0.001;Z=-2.827,P=0.005).There was no significant difference in gender,smoking,FEV1/FVC and creatinine between two groups(P>0.05).(2)FEV1(Z=3.502,P<0.001),FVC(Z=6.560,P<0.001),VC(Z=7.320,P<0.001),MVV(Z=3.352,P=0.001),SMI(Z=6.053,P<0.001)and grip strength(Z=7.858,P<0.001)were significantly higher in male,while albumin FEV1/FVC(Z=-3.294,P=0.001)was significantly higher than in female.(3)For both men and women,age was negatively correlated with FEV1(male r=-0.519,female r=-0.451),FVC(male r=-0.615,female r=-0.577),VC(male r=-0.586,female r=-0.492),MVV(male r=-0.518,female r=-0.397),PEF(male r=-0.402,female r=-0.473),grip strength(male r=-0.587,female r=-0.473),and gait speed(male r=-0.601,female r=-0.555)(P<0.05).Meanwhile,age(r=-0.333)was negatively correlated with SMI(P<0.05)in men,but this correlation was not observed in females(P>0.05).(4)While age was controlled,the grip strength was significantly positively correlated with FVC(r=0.322)and VC(r=0.339)in males and was significantly positively correlated with FEV1(r=0.303),FVC(r=0.376),VC(r=0.323)and MVV(r=0.313)in females.the gait speed was positively correlated with FVC(r=0.317),VC(r=0.271)and MVV(r=0.255)in females.SMI was not associated with all pulmonary function parameters in all genders(P>0.05).(5)Regression analysis showed that age(OR 1.148,[95%CI 1.098–1.201],P<0.001),BMI(OR 0.845,[95%CI 0.759–0.942],P=0.002)and VC(OR 0.941,[95%CI 0.895–0.955],P=0.015)were effective predictors of sarcopenia.Conclusion:(1)The pulmonary function of patients with sarcopenia was significantly reduced,and the change was mainly related to the decrease of respiratory muscle strength.(2)male grip strength was significantly positively correlated with FVC and VC,while female grip strength was significantly positively correlated with FEV1,FVC,VC and MVV.At the same time,female walking speed was also positively correlated with FVC,VC and MVV.Compared with SMI,the grip strength and gait speed were related to pulmonary function more significantly,which may reflect the prognosis of patients.(3)besides age and BMI,VC is also an effective predictor of sarcopenia.