Cherin Patrick, Voronska Elena, Fraoucene Nadia, de Jaeger Christophe
Service de Médecine Interne I, CHU Pitié-Salpétrière, 47 bd de l'hôpital, 75013, Paris, France,
Aging Clin Exp Res. 2014 Apr;26(2):137-46. doi: 10.1007/s40520-013-0132-8. Epub 2013 Oct 16.
Sarcopenia has been indicated as a reliable marker of frailty and poor prognosis among the oldest individuals. There are only few data on sarcopenia in healthy general population. We evaluated the prevalence of sarcopenia and its association with functional and clinical status in a population of healthy ambulatory subjects over 45 years living at home, in Paris (France).
This study was conducted selecting all ambulatory participants (n = 1,445) aged 45 years and older from October 2008 to September 2011, consulting in the Institute of Physiology (Institut de Jaeger) from Paris (France) for a functional and muscular evaluation, and did not have limitations to moderate physical exercise. All were healthy people. All subjects performed a medical examination, associated with evaluation of muscle mass (body composition assessment using dual-energy X-ray absorptiometry) and of muscle function (by hand grip strength). Diagnosis of sarcopenia required the documentation of low muscle mass with low muscle strength according to the current international consensus definition of sarcopenia.
From 1,421 participants (553 males and 868 females) definitively enrolled, 221 subjects (135 females and 86 males) (15.5 %) were identified as sarcopenic. Results from multivariate logistic regression models showed that sarcopenia was inversely associated with BMI with those participants with BMI higher than 22 kg/m(2) showing a lower risk of sarcopenia relative to those with BMI less than 21 kg/m(2) (OR 0.72; 95 % CI 0.60-0.91). Similarly, probability of sarcopenia was lower among subjects involved in leisure physical activities for 3 h or more per week (OR 0.45; 95 % CI 0.24-0.93). According to the category of age [45-54; 55-64; 65-74; 75-84 and 85 years or more], the prevalence of sarcopenia in women increase from 9.1; 12.7; 14.5; 19.4; to 33.3 %, respectively. For the men, the percentage of sarcopenia increase with aging from 8.6; 15.6; 13.6; 63.8 to 45.5 %, respectively.
The present study suggests that among healthy ambulatory subjects over 45 years living at home, sarcopenia is frequent, even to the youngest subjects of the studied population, taking place from 9 % from 45 years, until 64.3 % for the subjects over 85 years. Our findings support the hypothesis that muscle mass and function are associated with BMI and physical activity, whatever the age of the subject.
肌肉减少症已被视为老年人群中虚弱和预后不良的可靠标志物。关于健康普通人群中肌肉减少症的数据较少。我们评估了法国巴黎居家生活的45岁以上健康非卧床受试者中肌肉减少症的患病率及其与功能和临床状态的关联。
本研究选取了2008年10月至2011年9月期间年龄在45岁及以上的所有非卧床参与者(n = 1445),这些参与者在法国巴黎的耶格尔生理研究所进行功能和肌肉评估,且进行适度体育锻炼无限制。所有均为健康人群。所有受试者均接受了医学检查,同时评估肌肉量(使用双能X线吸收法进行身体成分评估)和肌肉功能(通过握力)。根据当前国际肌肉减少症共识定义,肌肉减少症的诊断需要记录低肌肉量和低肌肉力量。
在最终纳入的1421名参与者(553名男性和868名女性)中,221名受试者(135名女性和86名男性)(15.5%)被确定为肌肉减少症患者。多因素逻辑回归模型结果显示,肌肉减少症与体重指数呈负相关,体重指数高于22kg/m²的参与者相对于体重指数低于21kg/m²的参与者,肌肉减少症风险较低(比值比0.72;95%置信区间0.60 - 0.91)。同样,每周进行3小时或更长时间休闲体育活动的受试者中肌肉减少症的概率较低(比值比0.45;95%置信区间0.24 - 0.93)。根据年龄类别[45 - 54岁;55 - 64岁;65 - 74岁;75 - 84岁和85岁及以上],女性肌肉减少症的患病率分别从9.1%;12.7%;14.5%;19.4%升至33.3%。对于男性,肌肉减少症的百分比随年龄增长分别从8.6%;15.6%;13.6%;63.8%升至45.5%。
本研究表明,在居家生活的45岁以上健康非卧床受试者中,肌肉减少症很常见,即使在所研究人群中最年轻的受试者中也是如此,45岁时为9%,85岁及以上受试者中高达64.3%。我们的研究结果支持这样的假设,即无论受试者年龄如何,肌肉量和功能都与体重指数和身体活动有关。