中国全科医学2025，Vol.28Issue(17)：2134-2141,2148,9.DOI:10.12114/j.issn.1007-9572.2023.0575
老年胃癌患者术前衰弱与代谢综合征的临床特征及相关性研究
Clinical Characteristics and Correlation between Preoperative Frailty and Metabolic Syndrome among Older Patients with Gastric Cancer
摘要
Abstract
Background Frailty and metabolic syndrome(MetS)are both common geriatric conditions and may have potentially important links in terms of risk factors,body composition and metabolic mechanisms,which could jointly affect the prognosis of older patients with gastric cancer.Clearly distinguishing the characteristics of the two syndromes and elucidating their intrinsic relationship can help to develop precise and targeted preoperative management strategies.Objective To compare the characteristics of preoperative frailty and MetS in older patients with gastric cancer,focusing on general information,blood indicators and body compositions,then analyze their correlation.Methods A total of 286 patients aged 60 to 80 years who were admitted to the Gastrosurgery Department of the Jiangsu Province Hospital for gastric malignancy from August 2021 to August 2022 were included and divided into the four groups:the frailty group(n=45),the MetS group(n=58),the frailty+MetS group(n=12)and the normal group(n=171)based on the presence of frailty and MetS,and the clinical indicators of these groups were compared.With frailty as the dependent variable,Logistic regression analysis was conducted to investigate the correlation of MetS and the diagnostic indicators with preoperative frailty.Results Statistically significant differences were observed among the four groups in terms of age,comorbidities,Nutritional Risk Screening 2002(NRS2002)scores>3,fasting blood glucose,triglyceride,high-density lipoprotein cholesterol(HDL-C),C-reactive protein(CRP),hemoglobin,albumin,height,body mass,waist circumference,BMI,fat content,fat mass index,body fat percentage,visceral fat area,skeletal muscle content,skeletal muscle mass index,limb skeletal muscle mass index,muscle percentage,fat to muscle ratio and muscle to fat ratio(P<0.05).Multivariate Logistic regression analysis showed that age(OR=1.115,95%CI=1.046-1.190),history of smoking(OR=2.156,95%CI=1.134-4.096),NRS2002 score>3(OR=2.359,95%CI=1.159-4.802),CRP(OR=1.038,95%CI=1.003-1.073)and central obesity(OR=0.405,95%CI=0.183-0.896)were the risk factors for frailty in older patients with gastric cancer(P<0.05).Conclusion The frailty group showed advanced age,elevated levels of inflammation and increased nutritional risk,along with an overall decline in fat and muscle composition.The MetS group showed increased comorbidities,elevated inflammation and albumin levels,abnormal markers of glycolipid metabolism,and overall increased fat and muscle composition.The frailty+MetS group had increased comorbidities,abnormal fasting blood glucose and HDL-C levels with increases only in fat-related components but no significant changes in muscle components.Thus,frailty was not significantly associated with MetS in this study.关键词
胃肿瘤/衰弱/代谢综合征/老年人/临床特征/相关性Key words
Stomach Neoplasms/Frailty/Metabolic syndrome/Aged/Clinical characteristic/Correlation分类
医药卫生引用本文复制引用
蒋小曼,徐欣怡,丁玲玉,郭银宁,缪雪怡,陈丽,许勤..老年胃癌患者术前衰弱与代谢综合征的临床特征及相关性研究[J].中国全科医学,2025,28(17):2134-2141,2148,9.基金项目
国家自然科学基金面上项目(82073407) （82073407）
江苏高校优势学科建设工程项目"护理学"(苏政办发[2018]87号) （苏政办发[2018]87号）
