Alexandre T da Silva, Duarte Y A de Oliveira, Santos J L Ferreira, Wong R, Lebrão M L
Tiago da Silva Alexandre, Centro de Ciências Biológicas e da Saúde, Universidade Federal de São Carlos/UFSCar, Sala 16, Telefone 55 (16) 3306-6661, Brazil,
J Nutr Health Aging. 2014;18(8):751-6. doi: 10.1007/s12603-014-0540-2.
Sarcopenia and dynapenia have been associated with poorer physical performance, disability and death. The aim of this study was to compare the association between sarcopenia and dynapenia with mortality.
We studied 1,149 Brazilians aged 60 years or older residing in São Paulo. Sarcopenia was defined according to the consensus of the European Working Group on Sarcopenia in Older People (EWGSOP), which includes three components: low muscle mass (LMM) assessed by skeletal muscle mass index ≤ 8.90kg/m2 (men) and ≤ 6.37kg/m2 (women); low muscle strength (LMS) assessed by handgrip strength <30kg (men) and < 20kg (women); and low physical performance (LPP) assessed by walking speed ≤ 0.8m/s. Diagnosis of sarcopenia required presence of LMM plus LMS or LPP. Dynapenia was defined as handgrip strength < 30kg (men) and < 20kg (women). Covariates included socio-demographic and behavioral variables, medical conditions, hospitalization, depressive symptoms, cognition, and disability in activities of daily living or instrumental activities of daily living. The outcome was all-cause mortality over five-year follow-up.
During the five-year follow-up, 187 subjects died. The mortality rate for those with or without sarcopenia were 65.9/1,000 person/years and 20.1/1,000 person/years and for dynapenia were 44.3/1,000 person/years and 14.9/1,000 person/years. The adjusted model showed that sarcopenia (HR=1.52, 95%CI: 1.06 - 2.19) and dynapenia (HR=2.04, 95%CI: 1.24 - 3.37) are independent risk factors for death.
The EWGSOP definition of sarcopenia and dynapenia can help to determine risk for mortality and can be used as a screening instrument in public health.
肌肉减少症和肌肉功能减退与较差的身体表现、残疾和死亡相关。本研究的目的是比较肌肉减少症和肌肉功能减退与死亡率之间的关联。
我们研究了居住在圣保罗的1149名60岁及以上的巴西人。肌肉减少症根据欧洲老年人肌肉减少症工作组（EWGSOP）的共识进行定义，包括三个组成部分：通过骨骼肌质量指数评估的低肌肉量（LMM），男性≤8.90kg/m²，女性≤6.37kg/m²；通过握力评估的低肌肉力量（LMS），男性<30kg，女性<20kg；以及通过步行速度评估的低身体表现（LPP），≤0.8m/s。肌肉减少症的诊断需要存在LMM加LMS或LPP。肌肉功能减退定义为握力男性<30kg，女性<20kg。协变量包括社会人口统计学和行为变量、医疗状况、住院情况、抑郁症状、认知以及日常生活活动或工具性日常生活活动中的残疾情况。结局是五年随访期间的全因死亡率。
在五年随访期间，187名受试者死亡。有或无肌肉减少症者的死亡率分别为65.9/1000人/年和20.1/1000人/年，有或无肌肉功能减退者的死亡率分别为44.3/1000人/年和14.9/1000人/年。调整后的模型显示，肌肉减少症（HR=1.52，95%CI：1.06 - 2.19）和肌肉功能减退（HR=2.04，95%CI：1.24 - 3.37）是死亡的独立危险因素。
EWGSOP对肌肉减少症和肌肉功能减退的定义有助于确定死亡风险，并可作为公共卫生中的筛查工具。
