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dynapenia 但无肌肉减少症的老年患者四肢肌肉质量和数量:超声影像学研究。

Limb muscle quality and quantity in elderly adults with dynapenia but not sarcopenia: An ultrasound imaging study.

机构信息

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taiwan; Community and Geriatric Medicine Research Center, National Taiwan University Hospital, Bei-Hu Branch, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University College of Medicine, Taipei, Taiwan.

Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Bei-Hu Branch, Taiwan.

出版信息

Exp Gerontol. 2018 Jul 15;108:54-61. doi: 10.1016/j.exger.2018.03.019. Epub 2018 Mar 28.

Abstract

BACKGROUND

Dynapenia is prevalent in people with reduced skeletal muscle mass, i.e. sarcopenia, but a certain population develops muscle strength loss despite having normal skeletal muscle volume. To date, studies investigating muscle quality and quantity in groups with dynapenia but not sarcopenia are limited.

METHODS

Echogenicity and thickness of the biceps brachii, triceps brachii, rectus femoris, and medial gastrocnemius muscles were measured using high-resolution ultrasonography in 140 community-dwelling elderly adults. Participants with decreased handgrip strength but normal muscular volume were diagnosed as having dynapenia without sarcopenia. A multivariate regression model was used to analyze the association between dynapenia and ultrasound indicators of the sampled muscle expressed as odds ratio (OR) and 95% confidence interval (CI).

RESULTS

A total of 140 participants were recruited for the study, 12.6% (n = 18) of whom had dynapenia. The dynapenia group had a higher mean age, higher proportion of women, slower fast gait speed, reduced handgrip strength, and decreased thicknesses of the biceps brachii, rectus femoris, and medial gastrocnemius muscles. On multivariate logistic regression analysis, dynapenia was associated with older age (OR, 1.18; 95% CI, 1.05 to 1.33), higher body mass index (OR, 1.28; 95% CI, 1.05 to 1.64), and decreased thicknesses of the rectus femoris (OR, 0.01; 95% CI, <0.01 to 0.24) and medial gastrocnemius muscles (OR, 0.03; 95% CI, <0.01 to 0.61).

CONCLUSION

Dynapenia without sarcopenia is associated with decreased thicknesses of the rectus femoris and medial gastrocnemius muscles, an association that remains significant after adjustment for demographics, body composition, and physical performance. Ultrasound measurements of lower-limb muscle thickness can be considered an auxiliary criterion for evaluating dynapenia.

摘要

背景

动力不足在骨骼肌减少的人群中很常见,即肌少症,但某些人群尽管骨骼肌体积正常,但肌肉力量仍会下降。迄今为止,研究肌肉质量和数量的研究仅限于动力不足但没有肌少症的人群。

方法

使用高分辨率超声测量 140 名社区居住的老年人肱二头肌、肱三头肌、股直肌和内侧腓肠肌的回声和厚度。手部握力下降但肌肉体积正常的患者被诊断为动力不足但没有肌少症。使用多元回归模型分析动力不足与作为比值比(OR)和 95%置信区间(CI)表示的抽样肌肉超声指标之间的关联。

结果

共有 140 名参与者入组研究,其中 12.6%(n=18)患有动力不足。动力不足组的平均年龄较大,女性比例较高,快速步态速度较慢,握力较弱,肱二头肌、股直肌和内侧腓肠肌的厚度减小。多元逻辑回归分析显示,动力不足与年龄较大(OR,1.18;95%CI,1.05 至 1.33)、体重指数较高(OR,1.28;95%CI,1.05 至 1.64)和股直肌(OR,0.01;95%CI,<0.01 至 0.24)和内侧腓肠肌(OR,0.03;95%CI,<0.01 至 0.61)厚度减小有关。

结论

不伴肌少症的动力不足与股直肌和内侧腓肠肌厚度减小有关,这种关联在调整人口统计学、身体成分和身体表现后仍然显著。下肢肌肉厚度的超声测量可作为评估动力不足的辅助标准。

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