Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong.
J Am Geriatr Soc. 2009 Dec;57(12):2224-31. doi: 10.1111/j.1532-5415.2009.02566.x. Epub 2009 Nov 17.
To examine the definition of sarcopenia in Chinese subjects by relating the value of appendicular skeletal muscle mass (ASM) divided by height squared to physical functional outcomes after 4 years.
Four-year prospective study.
A Chinese community in Hong Kong SAR China.
Three thousand one hundred fifty-three community-living men and women aged 65 and older.
Information collected by questionnaire included demographics, health limitation on activities of daily living (ADLs), self-care, physical activity level, dietary intake, and psychosocial functioning. Measurements included height, weight, grip strength, step length in a 6-minute walk, and body composition. Four-year outcomes for those with ASM in kg per height in meters squared (ASM/ht(2)) less than 2 standard deviations (SDs) and 2 SDs or more below the young adult mean value were compared using analysis of variance and logistic regression, adjusting for potential confounding factors such as age, fat mass, presence or absence of malnutrition, dietary protein and vitamin D intake, comorbidity, and cognitive impairment.
Participants with ASM/ht(2) 2 SDs or more below the young adult mean had lower grip strength and greater limitation in climbing stairs and general ADLs after adjusting for confounding factors. A U-shaped relationship was observed between physical limitation and ASM/ht(2), with increasing physical limitation below or above a range of 7.25 to 6.75 kg/m(2) in men and 6.00 to 6.25 kg/m(2) in women. Values of 5.25 to 6.74 kg/m(2) in women were associated with approximately 30% less risk of functional limitation after 5 years. No clear cutoff was found in men.
Sarcopenia may be defined in terms of a range of values for ASM/ht(2) associated with the lowest risk of future physical limitations. The importance of establishing a quantitative value for the definition of sarcopenia may facilitate future interventional studies using pharmacological or nonpharmacological strategies.
通过比较四肢骨骼肌质量（ASM）除以身高的平方与 4 年后身体功能结局的关系，探讨中国人中肌少症的定义。
4 年前瞻性研究。
中国香港特别行政区的一个华人社区。
3153 名 65 岁及以上的社区居住的男女。
问卷调查收集的信息包括人口统计学资料、日常生活活动（ADL）受限、自我护理、身体活动水平、饮食摄入和社会心理功能。测量包括身高、体重、握力、6 分钟步行中的步长和身体成分。使用方差分析和逻辑回归比较 ASM/ht(2)低于 2 个标准差（SD）和 2 SD 或更多低于年轻成人平均值的参与者的 4 年结局，调整了年龄、脂肪量、是否存在营养不良、饮食蛋白质和维生素 D 摄入、合并症和认知障碍等潜在混杂因素。
在调整混杂因素后，ASM/ht(2)低于年轻成人平均值 2 SD 的参与者握力较低，爬楼梯和一般 ADL 受限较多。观察到身体受限与 ASM/ht(2)之间存在 U 形关系，男性低于或高于 7.25 至 6.75 kg/m(2)的范围和女性低于或高于 6.00 至 6.25 kg/m(2)的范围，身体受限增加。女性 5.25 至 6.74 kg/m(2)的值与大约 30%的 5 年后功能受限风险降低相关。男性未发现明确的截断值。
肌少症可能根据与未来身体受限风险最低相关的 ASM/ht(2)值范围来定义。确定肌少症定义的定量值的重要性可能有助于使用药理学或非药理学策略进行未来的干预研究。
