老年人肌肉減少症指標與血液抗發炎/發炎指標之關係研究

The relationship between sarcopenia and pro/ anti-inflammatory cytokines in the elderly people

緒論： 老化與不活動所導致引發的一種漸進式綜合變化徵狀 -肌肉減少症 （sarcopenia），已知與全身性的發炎反應呈因果關係；反之，提升抗發炎能力將有助於提 供老化過程中組織的保護。由於較少文獻指出肌肉減少症指標是否同樣與抗發炎能力有 關，因此，本研究目的在探討老年人肌肉減少症指標 （骨骼肌肉量指數、呼氣流量峰值、 握力與 4 公尺行走速度） 與血液中抗發炎指標 IL-4 （interleukin -4）、IL-10 （interleukin -10）、發炎指標 hsCRP （high sensitivity C- reactive protein）、IL-6 （interleukin -6） 與 TNF-α （tumor necrosis factor alpha） 之相關性。方法：以 138 位 65 歲以上之老年人為研究對象， 在採集肘前靜脈血 5 毫升後，進行肌肉減少症檢測評估。所得資料以多元逐步迴歸進行 老年人肌肉減少症指標及血液中抗發炎/發炎指標之相關分析。顯著水準訂為 α = .05。結 果：握力及四肢肌肉量指數分別與 IL-10 濃度呈正相關 （r = .165, p = .031; r = .155, p = .039），而呼氣流量峰值更可預測血循環中 IL-10 濃度 （r = .230, p = .009）、IL-10/ IL-6 （r = .246, p = .005） 及 IL-10/ hsCRP 比值 （r = .268, p = .003）。結論：老年人呼氣流量越高血 液中抗發炎的能力越佳，建議未來針對老年人運動可多施行能改善呼吸肌力之運動訓 練，進而影響循環中細胞因子的相對豐度，做為改善老年人慢性發炎等之重要策略。

Introduction: Sarcopenia is a condition characterized by gradual and comprehensive changes caused by aging and inactivity, as well as systemic inflammation. Improving anti-inflammatory abilities can protect tissues as people age. Few studies have indicated, however, whether the sarcopenia index is related to anti-inflammatory abilities. Therefore, this study investigated indicators of sarcopenia (skeletal muscle mass index, peak expiratory flow, grip strength, and gait speed for 4 m) and anti-inflammatory indicators in the blood (interleukin [IL]-4, IL-10, inflammation index high sensitivity C-reactive protein [hsCRP], IL-6, and tumor necrosis factor alpha) of older patients, as well as the correlations among the indicators. Methods: The study participants consisted of 138 Taiwanese people aged older than 65 years. Each of the participants was evaluated for indicators of sarcopenia after 5 mL of blood was collected from the participant's antecubital vein. All the data were analyzed using multiple regression analysis. The α level was set to .05. Results: Handgrip strength and appendicular skeletal muscle mass index were positively correlated with IL-10 concentration (r = .165, p = .031 and r = .155, p = .039, respectively). Peak expiratory flow could predict IL-10 concentration (r = .230, p = .009), IL-10/IL-6 ratio (r = .246, p = .005), and IL-10/hsCRP ratio (r = .268, p = .003). Conclusion: The higher a patient's expiratory flow, the higher the anti-inflammatory performance in the blood is. In the future, older patients should receive more physical training to improve their respiratory muscle strength, which affects the relative abundance of circulating cytokines and can be a crucial strategy for improving chronic inflammation in older patients.