Dawson-Hughes B, Bischoff-Ferrari H
Jean Mayer USDA Human Nutrition Research Center on Aging, Bone Metabolism Laboratory, Tufts University, 711 Washington St, Boston, Massachusetts, 02111, USA.
Department of Geriatrics and Aging Research, University of Zurich and University Hospital of Zurich, Zurich, Switzerland.
Osteoporos Int. 2016 Nov;27(11):3139-3144. doi: 10.1007/s00198-016-3674-8. Epub 2016 Jun 21.
In this commentary, we describe the sarcopenia spectrum that results in frailty and consider the impact of several components of the frailty definition on its global prevalence. We review proposed operational definitions of sarcopenia and the extent to which they have been shown to predict hard clinical outcomes, such as hip fracture, falls, and mortality. A head-to-head comparison of nine proposed operational definitions of sarcopenia as predictors of falls revealed that the definition involving appendicular lean mass (ALM)/ht alone was a significant predictor; the prevalence of sarcopenia by this definition was 11 %. We consider the strengths and limitations of definitions that include functional measurements, such as gait speed and grip strength, along with measures of lean tissue mass. The functional assessments are harder to standardize than the more objective ALM measurements. The prevalence of sarcopenia by definitions that include functional and lean mass measurements tends to be lower than the prevalence by definitions that include lean mass alone. A low prevalence limits opportunity for early identification and application of prevention strategies. For these and other reasons, it seems advantageous to base the operational definition of sarcopenia on ALM/ht alone. This commentary addresses the importance of a globally applicable operational definition of sarcopenia and both desirable and undesirable features of such a definition.
在本评论中，我们描述了导致衰弱的肌少症谱系，并考虑了衰弱定义的几个组成部分对其全球患病率的影响。我们回顾了肌少症的拟运行定义以及它们在多大程度上已被证明可预测诸如髋部骨折、跌倒和死亡率等严重临床结局。一项对九种拟肌少症运行定义作为跌倒预测指标的直接比较显示，仅涉及四肢瘦体重（ALM）/身高的定义是一个显著的预测指标；根据该定义，肌少症的患病率为11%。我们考虑了包括功能测量（如步速和握力）以及瘦组织质量测量在内的定义的优点和局限性。功能评估比更客观的ALM测量更难标准化。包括功能和瘦体重测量的定义所确定的肌少症患病率往往低于仅包括瘦体重的定义所确定的患病率。低患病率限制了早期识别和应用预防策略的机会。出于这些以及其他原因，仅基于ALM/身高来确定肌少症的运行定义似乎是有利的。本评论阐述了全球适用的肌少症运行定义的重要性以及此类定义的理想和不理想特征。
