Choe Yu-Ri, Joh Ju-Youn, Kim Yeon-Pyo
Department of Family Medicine, Chonnam National University Hwasun Hospital, Korea.
Department of Family Medicine, Chonnam National University School of Medicine, Gwangju, Korea.
J Gerontol A Biol Sci Med Sci. 2017 Nov 9;72(12):1724-1731. doi: 10.1093/gerona/glx052.
The optimal criteria applied to older Korean people have not been defined. We aimed to define clinically relevant cut-off points for older Korean people and to compare the predictive validity with other definitions of sarcopenia.
Nine hundred and sixteen older Koreans (≥65 years) were included in this cross-sectional observational study. We used conditional inference tree analysis to determine cut-off points for height-adjusted grip strength (GS) and appendicular skeletal muscle mass (ASM), for use in the diagnosis of sarcopenia. We then compared the Korean sarcopenia criteria with the Foundation for the National Institutes of Health and Asian Working Group for Sarcopenia criteria, using frailty, assessed with the Korean Frailty Index, as an outcome variable.
For men, a residual GS (GSre) of ≤ 0.25 was defined as weak, and a residual ASM (ASMre) of ≤ 1.29 was defined as low. Corresponding cut-off points for women were a GSre of ≤ 0.17 and an ASMre of ≤ 0.69. GSre and ASMre values were adjusted for height. In logistic regression analysis with new cut-off points, the adjusted odds ratios for pre-frail or frail status in the sarcopenia group were 3.23 (95% confidence interval [CI] 1.33-7.83) for the men and 1.74 (95% CI 0.91-3.35) for the women. In receiver operating characteristic curve analysis, the unadjusted area under the curve for Korean sarcopenia criteria in men and women were 0.653 and 0.608, respectively (p < .001).
Our proposed cut-off points for low GS and low ASM should be useful in the diagnosis of sarcopenia in older Korean people.
适用于韩国老年人的最佳标准尚未明确。我们旨在确定韩国老年人临床相关的切点，并比较与其他肌肉减少症定义的预测效度。
916名韩国老年人（≥65岁）纳入了这项横断面观察性研究。我们使用条件推断树分析来确定用于诊断肌肉减少症的身高调整握力（GS）和四肢骨骼肌质量（ASM）的切点。然后，我们将韩国肌肉减少症标准与美国国立卫生研究院基金会和亚洲肌肉减少症工作组标准进行比较，将使用韩国衰弱指数评估的衰弱作为结果变量。
对于男性，残余GS（GSre）≤0.25被定义为虚弱，残余ASM（ASMre）≤1.29被定义为低。女性相应的切点为GSre≤0.17和ASMre≤0.69。GSre和ASMre值根据身高进行了调整。在使用新切点的逻辑回归分析中，肌肉减少症组中虚弱前期或虚弱状态的调整比值比，男性为3.23（95%置信区间[CI]1.33 - 7.83），女性为1.74（95%CI 0.91 - 3.35）。在受试者工作特征曲线分析中，韩国肌肉减少症标准在男性和女性中未经调整的曲线下面积分别为0.653和0.608（p <.001）。
我们提出的低GS和低ASM切点应有助于诊断韩国老年人的肌肉减少症。
