急性心力衰竭患者血清尿酸、血清白蛋白水平与肌肉减少症的相关性研究OA

Objective To investigate the correlation between serum uric acid(UA),serum albumin(ALB)levels and sarcopenia in patients with acute heart failure.Methods A total of 150 patients with acute heart failure admitted to People's Hospital of Yangjiang from January 2024 to March 2025 were selected as the research objects.According to the Asian Working Group for Sarcopenia(AWGS)criteria,they were divided into the sarcopenia group(62 cases)and the non-sarcopenia group(88 cases).The appendicular skeletal muscle index(ASMI)was measured by bioelectrical impedance analysis,and the grip strength was measured by handgrip dynamometer.The physical performance of the patients was evaluated,and the serum UA,ALB and other indicators were detected,and the differences in various clinical data between the two groups were compared.Pearson correlation analysis was used to evaluate the correlation between the data.Multivariate logistic regression was used to analyze the influencing factors of sarcopenia,and prognostic events were recorded at 3 and 6 months of follow-up.Results The age,proportion of New York Heart Association functional class Ⅲ-Ⅳ,high-sensitivity C reactive protein and brain natriuretic peptide(BNP)in the sarcopenia group were higher than those in the non-sarcopenia group,and the levels of ALB,UA,body mass index(BMI),obesity proportion,grip strength,ASMI,gait speed,hemoglobin and left ventricular ejection fraction were lower than those in the non-sarcopenia group,and the differences were statistically significant(P＜0.05).There was a statistically significant difference in UA grade between the two groups(P＜0.05).Multivariate logistic regression analysis showed that age(β=0.045,OR=1.046,95％CI:1.010-1.084),UA＜280 μmol/L(β=0.851,OR=2.342,95％CI:1.175-4.669),UA＞420 pamol/L(β=1.062,OR=2.892,95％CI:1.326-6.310)were independent risk factors for sarcopenia in patients with acute heart failure(P＜0.05),while BMI(β=-0.156,OR=0.856,95％CI:0.783-0.934),ALB(β=-0.128,OR=0.880,95％CI:0.823-0.940)were independent pro-tective factors(P＜0.05).Pearson correlation analysis showed that ALB was positively correlated with ASMI,grip strength,and gait speed(r＞0,P＜0.001),and negatively correlated with age,high-sensitivity C-reactive protein,and BNP(r＜0,P＜0.001).The 3-month all-cause mortality rate,3-month all-cause re-hospitalization rate,6-month all-cause mortality rate,6-month all-cause re-hospitalization rate,and the number of re-hospitalizations within 6 months in the sarcopenia group were higher than those in the non-sarcopenia group,and the differences were statistically significant(P＜0.05).The 6-month cumulative survival rate of the sarcopenia group was lower than that of the non-sarcopenia group,and the difference was statistically significant(Log-rank x2=6.234,P=0.013).Conclusion The prevalence of sarcopenia is high in patients with acute heart failure,and serum ALB level is an independent protective factor.There is a U-shaped relationship between serum UA level and the prevalence of sarcopenia in patients with acute heart failure,and abnormal UA(＜280 μmol/L or＞420 μmol/L)is an independent risk factor for sarcopenia.Sarcopenia significantly increased short-term mortality and rehospitalization rates.Assessment of ALB and UA levels is helpful for early identification and risk stratification of sarcopenia in patients with acute heart failure.