老年前列腺疾病患者肌少症、营养状况和衰弱状况调查分析

doi:10.3877/cma.j.issn.2095-8757.2025.02.003

目的

对老年前列腺疾病患者进行肌少症筛查、营养评估和衰弱评定，分析其中影响前列腺癌发生的危险因素。

方法

选取2024年1—6月天津医科大学第二医院收治的初次诊断为老年前列腺增生和前列腺癌疾病的患者，测量患者的身高、体重、腰围、小腿围、握力，使用SARC-CalF量表进行肌少症筛查，使用GLIM标准进行营养不良诊断，使用Fried标准进行衰弱诊断。采用t检验和χ²检验比较前列腺增生患者和前列腺癌患者的临床资料，采用多因素Logistic回归模型分析影响前列腺癌发生的危险因素。

结果

共入组656例患者，存在肌少症风险24例（3.66%），营养不良80例（12.20%），衰弱256例（39.02%）。其中前列腺增生患者424例（前列腺增生组），前列腺癌患者232例（前列腺癌组）。前列腺癌组低小腿围、低握力的发生率明显高于前列腺增生组（14.29%、1.92%，χ²=4.747，P<0.05；51.72%、28.30%，χ²=4.432，P<0.05），肌少症和衰弱的发生率显著高于前列腺增生组（10.34%、0，χ²=5.691，P<0.05；62.07%、26.42%，χ²=10.013，P<0.05）。Logistic回归分析显示，衰弱是前列腺癌发生的危险因素（OR=11.63，95%CI：1.05-125.00，P<0.05）。

结论

前列腺癌患者衰弱的发生率较高，衰弱是前列腺癌发生的危险因素之一。

关键词: 前列腺增生, 前列腺癌, 衰弱, 肌少症, 营养不良, 筛查, 评估

Objective

To screen for sarcopenia, assess nutritional status, and evaluate frailty in elderly hospitalized patients with prostate diseases, and to analyze the risk factors affecting the occurrence of prostate cancer among them.

Methods

Elderly patients with prostatic hyperplasia and prostate cancer initially diagnosed and admitted to the Second Hospital of Tianjin Medical University between January and June 2024 were selected. The patient's height, weight, waist circumference, calf circumference, and grip strength were measured. Sarcopenia was screened using the SARC-CalF scale, malnutrition was diagnosed using the GLIM criteria, and frailty was diagnosed using the Fried phenotype criteria. T test and χ² test were used to compare the clinical data of patients with benign prostatic hyperplasia and those with prostate cancer. Multivariate Logistic regression analysis was performed to identify risk factors influencing the occurrence of prostate cancer.

Results

A total of 656 patients were enrolled. Among them, 24 cases (3.66%) were at risk for sarcopenia, 80 cases (12.20%) had malnutrition, and 256 cases (39.02%) were frail. There were 424 cases of patients with benign prostatic hyperplasia (benign prostatic hyperplasia group) and 232 cases of patients with prostate cancer (prostate cancer group). The incidence of low calf circumference and low grip strength in the prostate cancer group was significantly higher than that in the benign prostatic hyperplasia group (14.29% vs 1.92%, χ²=4.747, P < 0.05; 51.72% vs 28.30%, χ²=4.432, P < 0.05). The incidence of sarcopenia and frailty was significantly higher in the prostate cancer group than in the benign prostatic hyperplasia group (10.34% vs 0, χ²=5.691, P < 0.05, 62.07% vs 26.42%, χ²=10.013, P < 0.05). Logistic regression analysis revealed that frailty was a risk factor for the occurrence of prostate cancer (OR=11.63, 95%CI: 1.05-125.00, P < 0.05).

Conclusion

The incidence of frailty among prostate cancer patients is relatively high, and frailty is one of the risk factors for the occurrence of prostate cancer.

Key words: Prostatic hyperplasia, Prostate cancer, Frailty, Sarcopenia, Malnutrition, Screening, Evaluation

表1 老年前列腺增生与前列腺癌患者身体状况的比较[

±s或例（%）]

组别	例数	年龄（岁）	BMI（kg/m²）	低小腿围	低握力	营养不良	肌少症	衰弱
前列腺增生组	424	68.30±6.32	24.44±2.96	8（1.92）	120（28.30）	32（7.55）	0（0）	112（26.42）
前列腺癌组	232	65.69±9.06	24.08±3.07	32（14.29）	120（51.72）	48（20.69）	24（10.34）	144（62.07）
检验值		t=-0.227	t=0.514	χ²=4.747	χ²=4.432	χ²=3.024	χ²=5.691	χ²=10.013
P值		>0.05	>0.05	<0.05	<0.05	>0.05	<0.05	<0.01

表1 老年前列腺增生与前列腺癌患者身体状况的比较[

±s或例（%）]

组别	例数	年龄（岁）	BMI（kg/m²）	低小腿围	低握力	营养不良	肌少症	衰弱
前列腺增生组	424	68.30±6.32	24.44±2.96	8（1.92）	120（28.30）	32（7.55）	0（0）	112（26.42）
前列腺癌组	232	65.69±9.06	24.08±3.07	32（14.29）	120（51.72）	48（20.69）	24（10.34）	144（62.07）
检验值		t=-0.227	t=0.514	χ²=4.747	χ²=4.432	χ²=3.024	χ²=5.691	χ²=10.013
P值		>0.05	>0.05	<0.05	<0.05	>0.05	<0.05	<0.01

表2 前列腺癌危险因素分析

自变量	β值	SE	Wald χ²	P值	OR（95%CI）
年龄	-0.011	0.043	0.112	0.732	0.978（0.914-1.069）
低握力	0.873	1.314	0.444	0.507	2.396（0.182-31.641）
低小腿围	-2.049	1.263	2.637	0.100	0.133（0.014-1.536）
NRS2002	0.453	0.268	2.716	0.100	1.566（0.922-2.682）
SARC-CalF	-0.042	0.112	0.154	0.703	0.964（0.773-1.193）
Fried	0.881	0.417	4.251	0.043	11.632（1.049-125.000）

表2 前列腺癌危险因素分析

自变量	β值	SE	Wald χ²	P值	OR（95%CI）
年龄	-0.011	0.043	0.112	0.732	0.978（0.914-1.069）
低握力	0.873	1.314	0.444	0.507	2.396（0.182-31.641）
低小腿围	-2.049	1.263	2.637	0.100	0.133（0.014-1.536）
NRS2002	0.453	0.268	2.716	0.100	1.566（0.922-2.682）
SARC-CalF	-0.042	0.112	0.154	0.703	0.964（0.773-1.193）
Fried	0.881	0.417	4.251	0.043	11.632（1.049-125.000）

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A survey study of sarcopenia screening, nutritional assessment and frailty assessment of elderly inpatients with prostate diseases

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A survey study of sarcopenia screening, nutritional assessment and frailty assessment of elderly inpatients with prostate diseases