Bahat Gulistan, Tufan Asli, Tufan Fatih, Kilic Cihan, Akpinar Timur Selçuk, Kose Murat, Erten Nilgun, Karan Mehmet Akif, Cruz-Jentoft Alfonso J
Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390 Istanbul, Turkey.
Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Capa, 34390 Istanbul, Turkey.
Clin Nutr. 2016 Dec;35(6):1557-1563. doi: 10.1016/j.clnu.2016.02.002. Epub 2016 Feb 11.
The reported prevalence of sarcopenia ranges widely depending on its definition criterion. European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria. This definition recommends using normative data of the study population rather than other reference populations.
We aimed to define the reference cut-off values for muscle mass, muscle strength and calf circumference in Turkey in order to improve general applicability of EWGSOP criteria.
Healthy young adults between 18 and 39 years of age with no known chronic disease or chronic drug usage were included in our study to serve as reference population for assessing muscle mass. Community-dwelling older outpatients were prospectively recruited from the geriatrics outpatient clinics of a university hospital for assessing hand grip strength and calf circumference. Body composition was assessed by bioimpedance analysis. Muscle strength was assessed measuring hand grip strength with a Jamar hand dynamometer. The cut-off thresholds for muscle mass were defined as the mean-2SD of the values of the young reference study population; for grip strength were calculated from ROC analyses using cut-off values that predicted gait speed < 0.8 m/s; and for calf circumference were calculated from ROC analyses using cut-off values that predicted low muscle mass.
The young reference group included a total of 301 participants (187 male, 114 female; mean age: 26.5 ± 4.6 years). The cut-off thresholds for skeletal muscle mass indexes were 9.2 kg/m and 7.4 kg/m in males and females, respectively. The older community dwelling group included 406 subjects (123 male, 283 female, mean age: 76.6 ± 6.7 years). The cut-off thresholds for hand grip strength were 32 kg and 22 kg for males and females. The cut-off threshold for calf circumference was 33 cm for both males and females.
The cut-off thresholds for muscle mass, grip strength and calf circumference were somewhat higher but comparable with other reference populations. Further worldwide studies from different nations and countries are needed to obtain better reference values.
根据肌肉减少症的定义标准,其报告的患病率差异很大。欧洲老年人肌肉减少症工作组(EWGSOP)制定了实用的临床定义和共识诊断标准。该定义建议使用研究人群的规范数据而非其他参考人群的数据。
我们旨在确定土耳其肌肉量、肌肉力量和小腿围的参考临界值,以提高EWGSOP标准的普遍适用性。
纳入18至39岁无已知慢性病或长期用药史的健康年轻成年人作为评估肌肉量的参考人群。从大学医院老年门诊前瞻性招募社区居住的老年门诊患者,以评估握力和小腿围。通过生物电阻抗分析评估身体成分。使用Jamar握力计测量握力来评估肌肉力量。肌肉量的临界阈值定义为年轻参考研究人群值的均值减2个标准差;握力的临界阈值通过预测步速<0.8m/s的临界值进行ROC分析计算得出;小腿围的临界阈值通过预测低肌肉量的临界值进行ROC分析计算得出。
年轻参考组共有301名参与者(男性187名,女性114名;平均年龄:26.5±4.6岁)。男性和女性骨骼肌量指数的临界阈值分别为9.2kg/m和7.4kg/m。老年社区居住组包括406名受试者(男性123名,女性283名,平均年龄:76.6±6.7岁)。男性和女性握力的临界阈值分别为32kg和22kg。男性和女性小腿围的临界阈值均为33cm。
肌肉量、握力和小腿围的临界阈值略高,但与其他参考人群相当。需要在全球不同国家和地区开展进一步研究以获得更好的参考值。