Gérontopôle de Toulouse, Department of Geriatric Medicine, Toulouse University Hospital bINSERM Unit 1027, University Toulouse-III, Toulouse, France.
Curr Opin Clin Nutr Metab Care. 2012 Sep;15(5):436-41. doi: 10.1097/MCO.0b013e328356bbf4.
The present review describes and discusses the currently available definitions for sarcopenia from consensus studies.
Different sarcopenia definitions have been proposed in these last years. Six main approaches to an operative definition of sarcopenia have been identified. Although the first definitions were solely based on the assessment of the amount of muscle mass, current definitions seem to consistently recognize a bi-dimensional nature of sarcopenia. So, these approaches imply the need of simultaneously assessing both age-related quantitative (i.e. amount of muscle mass) and qualitative (i.e. muscle strength and function) declines of skeletal muscle.
Although current consensus exists about a bi-dimensional nature, the proposed approaches to measure sarcopenia are characterized by methodological differences. The majority of the operative definitions proposes to assess muscle mass as an index of appendicular muscle mass divided by squared height (evaluated by dual energy X-ray absorptiometry), assess strength using hand-held dynamometers, and assess function by evaluating gait speed at habitual pace over a short distance. Nevertheless, the clinically relevant thresholds and how to combine the three aspects in an operative definition in order to identify sarcopenia are heterogeneous. A main drawback is that supportive empirical data are missing for these conceptual definitions regarding the risk-assessment of different clinically significant adverse outcomes.
本综述描述并讨论了目前共识研究中提出的肌少症的定义。
近年来提出了不同的肌少症定义。已经确定了六种操作性肌少症定义的主要方法。尽管最初的定义仅基于肌肉量的评估,但目前的定义似乎一致地认识到肌少症的二维性质。因此,这些方法意味着需要同时评估骨骼肌的年龄相关的定量(即肌肉量)和定性(即肌肉力量和功能)下降。
尽管目前存在关于二维性质的共识,但提出的测量肌少症的方法具有方法学差异。大多数操作性定义建议使用双能 X 射线吸收仪评估四肢肌肉质量除以身高平方(评估)作为肌肉质量的指标,使用手持测力计评估力量,并通过评估短距离常速步态来评估功能。然而,临床上相关的阈值以及如何将这三个方面结合到操作性定义中以识别肌少症是不同的。一个主要的缺点是,这些概念性定义在不同的临床重要不良结局的风险评估方面缺乏支持性的经验数据。