Janssen Ian, Baumgartner Richard N, Ross Robert, Rosenberg Irwin H, Roubenoff Ronenn
Department of Community Health and Epidemiology, Queen's University, Kingston, Ontario, Canada.
Am J Epidemiol. 2004 Feb 15;159(4):413-21. doi: 10.1093/aje/kwh058.
The purpose of this study was to determine skeletal muscle cutpoints for identifying elevated physical disability risk in older adults. Subjects included 4,449 older (> or = 60 years) participants from the Third National Health and Nutrition Examination Survey during 1988-1994. Physical disability was assessed by questionnaire, and bioimpedance was used to estimate skeletal muscle, which was normalized for height. Receiver operating characteristics were used to develop the skeletal muscle cutpoints associated with a high likelihood of physical disability. Odds for physical disability were compared in subjects whose measures fell above and below these cutpoints. Skeletal muscle cutpoints of 5.76-6.75 and < or =5.75 kg/m2 were selected to denote moderate and high physical disability risk in women. The corresponding values in men were 8.51-10.75 and < or =8.50 kg/m2. Compared with women with low-risk skeletal muscle values, women with moderate- and high-risk skeletal muscle values had odds for physical disability of 1.41 (95% confidence interval (CI): 0.97, 2.04) and 3.31 (95% CI: 1.91, 5.73), respectively. The corresponding odds in men were 3.65 (95% CI: 1.92, 6.94) and 4.71 (95% CI: 2.28, 9.74). This study presents skeletal muscle cutpoints for physical disability risk in older adults. Future applications of these cutpoints include the comparison of morbidity risk in older persons with normal muscle mass and those with sarcopenia, the determination and comparison of sarcopenia prevalences, and the estimation of health-care costs attributable to sarcopenia.
本研究的目的是确定用于识别老年人身体残疾风险升高的骨骼肌切点。研究对象包括1988 - 1994年第三次全国健康与营养检查调查中的4449名年龄≥60岁的老年人。通过问卷调查评估身体残疾情况，并使用生物电阻抗法估算骨骼肌，该值按身高进行了标准化处理。采用受试者工作特征曲线来确定与身体残疾高可能性相关的骨骼肌切点。比较了测量值高于和低于这些切点的受试者发生身体残疾的几率。女性的骨骼肌切点分别为5.76 - 6.75 kg/m²和≤5.75 kg/m²，用于表示中度和高度身体残疾风险。男性的相应值为8.51 - 10.75 kg/m²和≤8.50 kg/m²。与骨骼肌值为低风险的女性相比，骨骼肌值为中度和高度风险的女性发生身体残疾的几率分别为1.41（95%置信区间（CI）：0.97，2.04）和3.31（95%CI：1.91，5.73）。男性的相应几率分别为3.65（95%CI：1.92，6.94）和4.71（95%CI：2.28，9.74）。本研究给出了老年人身体残疾风险的骨骼肌切点。这些切点未来的应用包括比较肌肉量正常的老年人和患有肌肉减少症的老年人的发病风险、确定和比较肌肉减少症的患病率，以及估算因肌肉减少症导致的医疗保健费用。
