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目的:探索肌肉生长抑素(myostatin, MST)及其抑制因子卵泡抑素(follistatin, FST)作为生物学标志物评估肌少症的临床价值。方法:设计回顾性横断面研究，招募2021年在上海华东manbet官网登录 体检的20～89岁女性350人。所有研究对象接受问卷调查，行肌肉质量、脂肪量、骨密度、握力和步速测定，空腹抽血测血清MST和FST。结果:血清MST随增龄变化不明显，血清FST随增龄升高。≥60岁女性中，MST与全身肌肉质量及四肢骨骼肌质量指数(appendicular skeletal muscle index, ASMI)呈正相关( r＝0.236, P＝0.041; r＝0.289, P＝0.014)，FST与ASMI呈负相关( r＝－0.265, P＝0.030)。在校正年龄、体重指数、髋部骨密度、全身脂肪量后，多元逐步回归分析显示，仅FST与ASMI独立相关( β＝－0.238, P＝0.006)，MST与ASMI不相关。以肌肉质量减少为状态变量，以血清FST水平为检验变量绘制受试者工作特征曲线，曲线下面积为0.753，FST截断值为17.49 ng/mL时，约登指数最大为0.46，灵敏度为77.3%，特异度为68.7%。将≥60岁女性按血清FST水平分为3组，与FST处于上三分之一的女性相比，FST处于下三分之一的女性罹患肌少症的风险显著减少( OR＝0.098, P＝0.036)。 结论:在老年女性中，FST与肌肉质量的相关性好，有望作为评估肌肉质量的生物学标志物。

Objective:This study aimed to explore the clinical value of myostatin(MST) and follistatin(FST) as biological biomarkers in evaluating sarcopenia in elderly women.Methods:This was a retrospective cross-sectional study that enrolled 350 females aged 20-89 years who underwent physical examinations in Shanghai Huadong Hospital in 2021. Demographic characteristics, muscle mass, fat mass, bone mineral density, hand grip strength, gait speed, and serum indices of MST and FST were collected.Results:The serum levels of MST did not change significantly with age. However, the serum levels of FST increased with age. In women aged≥60 years, MST was positively correlated with total lean mass and appendicular skeletal muscle index(ASMI; r=0.236, P=0.041; r=0.289, P=0.014), while FST was negatively correlated with ASMI( r=-0.265, P=0.030). In multivariate stepwise regression analysis, after adjusting for age, body mass index, hip bone mineral density, and total fat mass, only FST was independently correlated with ASMI( β=-0.238, P=0.006), while MST was not correlated with ASMI. The receiver operating characteristic curve was plotted using muscle mass reduction as the state variable and serum FST level as the test variable. The area under the curve was 0.753. And when the FST cutoff value was 17.49 ng/mL, the maximum Jordan index was 0.46, with a sensitivity of 77.3% and a specificity of 68.7%. Women aged ≥60 years were divided into three groups based on serum FST levels. Compared to the upper third of the serum FST level group, the low third of the FST level group had a significantly reduced risk of suffering from sarcopenia( OR=0.098, P =0.036). Conclusions:Serum FST lever has a better correlation with muscle mass among elderly women, making it a promising biomarker for evaluating muscle mass.