社区居住老年人肌少症筛查：SARC-F 与 SARC-F 联合小腿围（SARC-CalF）。

Screening Sarcopenia in Community-Dwelling Older Adults: SARC-F vs SARC-F Combined With Calf Circumference (SARC-CalF).

机构信息

The Center of Gerontology and Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China.

出版信息

J Am Med Dir Assoc. 2018 Mar;19(3):277.e1-277.e8. doi: 10.1016/j.jamda.2017.12.016.

DOI:10.1016/j.jamda.2017.12.016

PMID:29477774

Abstract

OBJECTIVES

To compare the diagnostic value of the 5-component questionnaire that measures strength, assistance walking, rise from a chair, climb stairs, and falls (SARC-F) and SARC-F combined with calf circumference (SARC-CalF) for screening sarcopenia in community-dwelling older adults.

DESIGN

A diagnostic accuracy study.

SETTING

A community in Chengdu, China.

PARTICIPANTS

Older adults aged 60 years or older.

MEASUREMENTS

Muscle mass, muscle strength, and physical performance were estimated using a bioimpedance analysis device, handgrip strength, and gait speed, respectively. Four commonly used diagnostic criteria [European Working Group on Sarcopenia in Older People (EWGSOP), Asian Working Group for Sarcopenia (AWGS), International Working Group on Sarcopenia (IWGS), and Foundation for the National Institutes of Health (FNIH) criteria] were applied as the reference standard, separately. The sensitivity/specificity analyses of the SARC-F and SARC-CalF methods were evaluated. The receiver operating characteristics curves and the area under the receiver operating characteristics curves were used to compare the overall diagnostic accuracy of the SARC-F and SARC-CalF for identifying sarcopenia.

RESULTS

We included 160 men and 224 women. Based on the 4 diagnostic criteria, the prevalence of sarcopenia ranged from 11.7% to 25.0%. Using the AWGS criteria as the reference standard, the SARC-CalF had a sensitivity of 60.7% and a specificity of 94.7% in the whole study population, whereas the SARC-F had a sensitivity of 29.5% and a specificity of 98.1%. The area under the receiver operating characteristics curves for SARC-CalF and SARC-F were 0.92 (95% confidence interval 0.89‒0.94) and 0.89 (95% confidence interval 0.86‒0.92), respectively (P = .003). We obtained similar results when using the other 3 criteria as the reference standard. Subgroup analyses revealed similar results in both men and women.

CONCLUSIONS

SARC-CalF significantly improves the sensitivity and overall diagnostic accuracy of SARC-F for screening sarcopenia in community-dwelling older adults.

摘要

目的

比较评估社区居住老年人肌肉减少症的 5 分量表问卷（测量力量、辅助行走、从椅子上起身、爬楼梯和跌倒[SARC-F]）和 SARC-F 联合小腿围（SARC-CalF）的诊断价值。

设计

诊断准确性研究。

地点

中国成都的一个社区。

参与者

年龄在 60 岁及以上的老年人。

测量

使用生物阻抗分析设备分别估计肌肉质量、肌肉力量和身体机能，使用握力和步态速度。分别应用四种常用的诊断标准[欧洲肌肉减少症工作组（EWGSOP）、亚洲肌肉减少症工作组（AWGS）、国际肌肉减少症工作组（IWGS）和美国国立卫生研究院基金会（FNIH）标准]作为参考标准。评估 SARC-F 和 SARC-CalF 方法的灵敏度/特异性分析。受试者工作特征曲线和受试者工作特征曲线下面积用于比较 SARC-F 和 SARC-CalF 整体诊断准确性，以识别肌肉减少症。

结果

我们纳入了 160 名男性和 224 名女性。根据 4 种诊断标准，肌肉减少症的患病率从 11.7%到 25.0%不等。以 AWGS 标准为参考标准，SARC-CalF 在整个研究人群中的灵敏度为 60.7%，特异性为 94.7%，而 SARC-F 的灵敏度为 29.5%，特异性为 98.1%。SARC-CalF 和 SARC-F 的受试者工作特征曲线下面积分别为 0.92（95%置信区间 0.89～0.94）和 0.89（95%置信区间 0.86～0.92）（P=0.003）。当使用其他 3 种标准作为参考标准时，我们也得到了类似的结果。亚组分析显示，男性和女性的结果相似。