增加脂肪积累可能与重症患者的严重肌肉衰竭有关:一项前性观察性研究
Yasutaka Koga1, Motoki Fujita2, Kayoko Harada1
1Advanced Medical Emergency and Critical Care Center, Yamaguchi University Hospital, 1-1-1, Minami-Kogushi, Ube, Yamaguchi, 755-8505, Japan.
Scientific reports
|April 3, 2025
概括
与预期相反,重症患者的肥胖增加了肌肉衰竭的风险. 肥胖患者的低体水平与较大的肌肉损失相关,这表明受损的生成有助于这种效应.
科学领域:
- 关键护理医学 关键护理医学
- 代谢过程中的代谢.
- 身体组成 身体构成
背景情况:
- 肥胖在关键疾病肌肉消耗中的作用受到争论,一些假设表明通过生成产生保护作用.
- 了解脂肪质量,体和肌肉损失之间的相互作用对于优化患者护理至关重要.
研究的目的:
- 为了研究脂肪质量体积,体水平和重症患者的严重肌肉衰竭之间的关联.
- 为了确定肥胖是否会影响重症监护室 (ICU) 中肌肉消耗的风险.
主要方法:
- 紧急ICU中的前性观察研究 (2021年11月至2023年10月).
- 包括预期ICU停留时间≥7天和入院24小时内腹部CT扫描的成年患者.
- 通过超声波测试评估直骨横截面积变化 (1-7天) 的肌肉损耗;根据CT测量脂肪面积,患者被分类为脂肪或瘦.
主要成果:
- 严重的肌肉消耗 (>10%的减少) 在脂肪组 (48%) 与瘦肉组 (27%,p=0.023) 相比,明显更频繁.
- 多变量分析显示,脂肪群体肌肉消耗的风险更高 (调整OR为2.52,p=0.034).
- β-基酸盐 (BHB) 水平与脂肪面积相反相关,并与肌肉衰竭风险降低有关.
结论:
- 肥胖与重症患者严重肌肉衰竭的风险增加有关,这挑战了以前的假设.
- 在肥胖患者中减少生成可能会导致肌肉衰竭的风险增加.
- 需要进一步的研究,以阐明肥胖,生成和关键疾病中的肌肉代谢之间的机制.
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