血浆抵抗素作为初筛老年肌少症的标志物研究

doi:10.16150/j.1671-2870.2026.02.012

摘要/Abstract

摘要：

目的：探讨血浆抵抗素水平与老年肌少症的临床关联性，并评估其对老年肌少症的初步筛查价值，为老年肌少症的早期识别及干预提供参考。方法：采用病例对照研究设计，纳入2021年12月至2023年12月期间在兰州大学第一医院老年病科住院的符合纳排标准的363例老年患者作为研究对象。肌少症的诊断依据2019年亚洲肌少症工作组发布的诊疗共识，根据肌少症发生情况将患者分为肌少症组和非肌少症组，比较2组患者的血浆抵抗素水平差异。采用Pearson相关分析血浆抵抗素水平与肌少症指标，如握力、五次起坐时间、步速、四肢骨骼肌质量指数（appendicular skeletal muscle mass index，ASMI）等的相关性。采用Logistic回归分析血浆抵抗素水平与老年肌少症的独立相关性，并通过受试者操作特征（receiver operating characteristic， ROC）曲线评估其识别老年肌少症高危人群的效能。结果：共纳入363例老年住院患者，肌少症组178例（其中男性80例，女性98例），非肌少症组185例（其中男性98例，女性87例），肌少症组的血浆抵抗素水平明显高于非肌少症组[（7.04±1.63） ng/mL比（6.11±1.26） ng/mL，P<0.05]。Pearson相关分析显示，老年人群的血浆抵抗素水平与握力、步速、ASMI呈负相关（P<0.05）。同时，Mann-Whitney U检验显示老年男性与老年女性人群血浆抵抗素水平无差异（P>0.05），提示老年人抵抗素水平不受性别影响。在多因素Logistic回归分析中，校正年龄、吸烟史、饮酒史、老年营养风险指数（geriatric nutritional risk index， GNRI）、红细胞计数、体质量指数（body mass index， BMI）、高血压、甘油三酯及高密度脂蛋白混杂因素后，结果显示，血浆抵抗素水平仍为老年肌少症的独立危险因素（OR=1.663，P<0.01）。分层Logistic回归分析显示，在老年高血压人群与无高血压人群中，血浆抵抗素水平升高均为老年肌少症的危险因素（OR值分别为1.46、2.66，P<0.01）；然而，交互作用检验显示，高血压对血浆抵抗素与肌少症之间关联的效应修饰作用尚无统计学意义（交互项P=0.078）。ROC曲线分析显示，血浆抵抗素水平用于初筛识别老年肌少症的曲线下面积为0.712（P=0.027），最佳临界值为5.83 ng/mL，此时其灵敏度为87.1%，特异度为48.1%。结论：血浆抵抗素水平在老年肌少症患者中显著升高，且与肌少症独立相关，可能可作为老年肌少症的初筛生物标志物，而高血压对该关联未见显著效应修饰作用。

关键词: 肌少症, 抵抗素, 老年人, 生物标志物

Abstract:

Objective To investigate the clinical correlation between plasma resistin levels and sarcopenia in the elderly, and evaluate its preliminary screening value for sarcopenia in the elderly, providing a reference for early identification and intervention of sarcopenia in the elderly. Methods A case-control study design was used. A total of 363 elderly patients who met the inclusion and exclusion criteria in the Department of Geriatrics of the First Hospital of Lanzhou University from December 2021 to December 2023 were enrolled as research subjects. The diagnosis of sarcopenia was based on the 2019 consensus of the Asian Working Group for Sarcopenia. Patients were divided into sarcopenia group and non-sarcopenia group, according to the presence of sarcopenia, and the differences in plasma resistin levels between the two groups were compared. Pearson correlation analysis was conducted to analyze the correlation between plasma resistin levels and sarcopenia indicators, such as grip strength, five-time sit-to-stand test time, gait speed, and appendicular skeletal muscle mass index (ASMI). Logistic regression analysis was used to analyze the independent correlation between plasma resistin levels and sarcopenia in the elderly, and the receiver operating characteristic (ROC) curve was used to evaluate its performance in identifying elderly individuals at high risk for sarcopenia. Results A total of 363 elderly patients were included, including the sarcopenia group (178 cases, including 80 males and 98 females) and the non-sarcopenia group (185 cases, including 98 males and 87 females). The plasma resistin levels in the sarcopenia group were significantly higher than those in the non-sarcopenia group (7.04±1.63 ng/mL vs. 6.11±1.26 ng/mL, P<0.05). Pearson correlation analysis showed that plasma resistin levels in the elderly population were negatively correlated with grip strength, gait speed, and ASMI (P<0.05). Meanwhile, the Mann-Whitney U test showed no difference in plasma resistin levels between elderly males and females (P>0.05), indicating that resistin levels in the elderly were not influenced by gender. In multivariate logistic regression analysis, after adjusting for confounding factors including age, smoking history, alcohol consumption history, and geriatric nutritional risk index (GNRI), red blood cell count, body mass index (BMI), hypertension, triglycerides, and high-density lipoprotein, the results showed that plasma resistin level remained an independent risk factor for sarcopenia in the elderly (OR=1.663, P<0.01). Stratified logistic regression analysis showed that elevated plasma resistin levels were a risk factor for sarcopenia in older adults in both the hypertension subgroup (OR=1.46, P<0.01) and the non-hypertension subgroup (OR=2.66, P<0.01). However, the interaction test indicated that the effect modification of hypertension status on the association between plasma resistin and sarcopenia did not reach statistical significance (P for interaction=0.078). ROC curve analysis showed that the area under the curve for plasma resistin level in the preliminary screening of sarcopenia in the elderly was 0.712 (P=0.027), with an optimal cut-off value of 5.83 ng/mL, corresponding to a sensitivity of 87.1% and a specificity of 48.1%. Conclusions Plasma resistin levels are significantly elevated in elderly patients with sarcopenia and are independently associated with sarcopenia. It may serve as a preliminary screening biomarker for sarcopenia in the elderly. Howe-ver hypertension status did not show a significant effect modification on this association.

Key words: Sarcopenia, Resistin, Elderly, Biomarkers

中图分类号:

R446
R592

汤朝毅, 黄荣荣, 乔露, 李维辛. 血浆抵抗素作为初筛老年肌少症的标志物研究[J]. 诊断学理论与实践, 2026, 25(02): 209-217.

TANG Chaoyi, HUANG Rongrong, QIAO Lu, LI Weixin. Study on plasma resistin as a biomarker for preliminary screening of sarcopenia in elderly adults[J]. Journal of Diagnostics Concepts & Practice, 2026, 25(02): 209-217.

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Item	No sarcopenia（n=185）	Sarcopenia（n=178）	P value
Gender
Male(%)	98(52.97)	80(44.94)	0.126
Female(%)	87(47.03)	98(55.06)	0.126
Smoking(%)	30(16.22)	28(15.73)	0.899
Drinking(%)	19(10.27)	16(8.99)	0.679
Hypertension(%)	131(70.81)	96(53.93)	<0.001
Diabetes(%)	71(38.38)	52(29.21)	0.065
Stroke(%)	90(48.65)	93(52.25)	0.864
Fasting blood glucose (mmol/L)	5.40(4.71,6.28)	5.10(4.58,6.07)	0.117
Age(years)	72.06±7.89	74.25±8.54	0.006
Body weight(kg)	65.70（59.50,73.75）	56.00（49.45,68.70）	<0.001
Height(cm)	165.00（160.00,170.00）	164.22（158.00,170.00）	0.268
BMI(kg/m²)	24.20（22.50,26.45）	21.30（19.78,23.23）	<0.001
Grip strength(kg)	18.45±6.45	15.02±5.30	<0.001
Gait speed(m/s)	1.02±0.34	0.89±0.31	0.011
Chair stand(s)	11.91±3.65	13.55±4.31	0.020
ASMI(kg/m²)	7.51±1.25	5.58±0.94	<0.001
GNRI	109.89±9.40	102.81±9.55	<0.001
Resistin(ng/mL)	6.11±1.26	7.04±1.63	<0.001
Erythrocyte (×10¹²/L)	4.72（4.29,5.05）	4.41（4.11,4.77）	<0.001
Leukocyte (×10⁹/L)	5.43（4.57,6.51）	5.3（4.24,6.62）	0.249
Platelet (×10⁹/L)	192.00（152.00,229.00）	194.00（150.25,243.50）	0.420
Hemoglobin (g/L)	145.00（135.00,157.00）	137.5（125.75,147.25）	<0.001
Total protein (g/L)	72.80±6.90	71.20±7.30	0.038
Albumin (g/L)	43.9（40.70,46.70）	43.3（39.4,46.00）	0.084
Globulin (g/L)	29.00（26.25,32.05）	28.15（25.28,31.83）	0.081
Triglyceride (mmol/L)	1.34（1.02,1.82）	1.11（0.87,1.56）	<0.001
HDL-C(mmol/L)	1.11（0.98,1.35）	1.26（1.07,1.55）	<0.001
Total cholesterol (mmol/L)	4.17（3.51,4.91）	4.35（3.55,5.11）	0.239
LDL-C(mmol/L)	2.65（2.18,3.29）	2.69（2.09,3.36）	0.926
Apolipoprotein a (mmol/L)	1.32（1.15,1.56）	1.43（1.22,1.68）	0.060
Serum creatinine (ummol/L)	55.90（62.30,84.35）	67.15（58.18,78.18）	0.050

Item	Grip strength	Gait speed	Chair stand	ASMI	Age	BMI
Resistin
r	-0.192	-0.114	0.102	-0.274	0.108	-0.169
P	<0.001	0.030	0.051	<0.001	0.04	0.01

Model	Variable	β	SE	Wald χ²	OR（95%CI）	P value
1	Resistin	0.533	0.098	29.523	1.704（1.406-2.065）	<0.001
2	Resistin	0.501	0.103	23.803	1.651（1.350-2.019）	<0.001
	Age	0.031	0.016	3.862	1.031（1.000-1.064）	0.049
	BMI	0.288	0.056	26.535	0.749（0.672-0.836）	<0.001
	GNRI	0.019	0.017	1.165	0.981（0.948-1.016）	0.280
	Drinking	0.095	0.554	0.029	0.91（0.307-2.295）	0.864
	Smoking	0.332	0.437	0.574	1.393（0.591-3.283）	0.449
3	Resistin	0.509	0.104	23.938	1.663（1.357-2.039）	<0.001
	Age	0.037	0.016	5.159	1.037（1.005-1.071）	0.023
	BMI	0.285	0.056	25.526	0.752（0.673-0.840）	<0.001
	GNRI	0.021	0.018	1.349	0.980（0.946-1.014）	0.246
	Drinking	0.159	0.563	0.08	0.853（0.283-2.570）	0.777
	Smoking	0.252	0.443	0.323	1.286（1.540-3.064）	0.570
	Hypertension	0.859	0.264	10.578	0.423（0.252-0.711）	0.001
4	Resistin	0.509	0.108	22.324	1.663（1.347-2.054）	<.001
	Age	0.037	0.017	4.918	1.038（1.004-1.072）	0.027
	BMI	0.264	0.061	19.041	0.768（0.682-0.865）	<.001
	GNRI	0.023	0.021	1.209	0.978（0.939-1.018）	0.272
	Drinking	0.037	0.584	0.004	0.964（0.307-3.125）	0.950
	Smoking	0.463	0.425	0.843	1.529（0.617-3.789）	0.359
	Hypertension	0.743	0.273	7.393	0.476（0.279-0.813）	0.007
	Erythrocyte	0.401	0.227	3.116	0.670（0.429-1.045）	0.078
	Triglyceride	0.195	0.106	0.297	0.899（0.614-1.318）	0.586
	HDL-C	1.455	0.42	12.01	4.286（1.882-9.763）	<.001