Dupuy Charlotte, Lauwers-Cances Valérie, Guyonnet Sophie, Gentil Catherine, Abellan Van Kan Gabor, Beauchet Olivier, Schott Anne-Marie, Vellas Bruno, Rolland Yves
Gérontopôle, Department of Internal Medicine and Geriatrics, Toulouse University Hospital, Toulouse, France.
INSERM U1027, University of Toulouse III, Toulouse, France.
J Cachexia Sarcopenia Muscle. 2015 Jun;6(2):144-54. doi: 10.1002/jcsm.12021. Epub 2015 Apr 27.
The diversity of definitions proposed for sarcopenia has been rarely tested in the same population, and so far, their clinical utilities for predicting physical difficulties could not be clearly understood. Our objective is to report the prevalence of sarcopenia and the characteristics of sarcopenic community-dwelling older women according to the different definitions of sarcopenia currently proposed. We also assessed these definitions for their incremental predictive value over currently standard predictors for some self-reported difficulties in physical function and knee extension strength.
Cross-sectional analysis included data from 3025 non-disabled women aged 75 years or older without previous history of hip fracture from the inclusion visit of the EPIDémiologie de l'OStéoporose study. A total body composition evaluation was available for 2725 women. Sarcopenia was defined using six different definitions of sarcopenia based on different muscle mass, gait speed, and grip strength cut-offs. Self-reported difficulties in physical function and knee extension strength were collected. Logistic regression and multiple linear regression models were built for each physical dysfunction, and the predictive capacity of sarcopenia (one model for each definition) was studied using the C-statistic, the net reclassification index, or adjusted R(2).
The estimated prevalence of sarcopenia ranged from 3.3-20.0%. Only 85 participants (3.1%) were identified having sarcopenia according to all definitions. All definitions were, to some degree, associated with self-reported difficulties in physical function and knee extension strength, but none improved the predictive ability of the self-reported difficulties in physical function. Conversely, all definitions accounted for a small but significant amount of explained variation for predicting knee extension strength.
Prevalence of sarcopenia varies widely depending on the definition adopted. Based on this research, the current definitions for sarcopenia does not substantially increment the predictive value of clinical characteristics of patients to predict self-reported physical difficulties and knee extension strength.
目前针对肌肉减少症提出的多种定义，很少在同一人群中进行检验，到目前为止，尚无法清楚了解它们在预测身体功能障碍方面的临床效用。我们的目的是根据目前提出的肌肉减少症的不同定义，报告社区居住的老年女性肌肉减少症的患病率及其特征。我们还评估了这些定义相对于目前标准预测指标在预测某些自我报告的身体功能困难和膝关节伸展力量方面的增量预测价值。
横断面分析纳入了来自骨质疏松症流行病学研究纳入访视的3025名75岁及以上、无髋部骨折既往史的非残疾女性的数据。2725名女性进行了全身成分评估。基于不同的肌肉量、步速和握力临界值，使用六种不同的肌肉减少症定义来定义肌肉减少症。收集自我报告的身体功能困难和膝关节伸展力量数据。针对每种身体功能障碍建立逻辑回归和多元线性回归模型，并使用C统计量、净重新分类指数或调整后的R²研究肌肉减少症（每个定义一个模型）的预测能力。
肌肉减少症的估计患病率在3.3%-20.0%之间。根据所有定义，仅85名参与者（3.1%）被确定患有肌肉减少症。所有定义在一定程度上都与自我报告的身体功能困难和膝关节伸展力量相关，但没有一个能提高自我报告的身体功能困难的预测能力。相反，所有定义在预测膝关节伸展力量方面都占了一小部分但显著的解释变异量。
根据所采用的定义，肌肉减少症的患病率差异很大。基于本研究，目前的肌肉减少症定义并未显著提高预测患者自我报告的身体功能困难和膝关节伸展力量的临床特征的预测价值。
