Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Physical Therapy, Osaka Yukioka College of Health Science, Department of Physical Therapy, Faculty of Health Science, Ibaraki, Osaka, Japan.
Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan.
J Am Med Dir Assoc. 2019 Sep;20(9):1185.e1-1185.e8. doi: 10.1016/j.jamda.2019.01.152. Epub 2019 Mar 20.
Sarcopenia is diagnosed on the basis of skeletal muscle mass and muscle strength/function; however, simpler and more accurate measures for muscle mass and muscle strength/function should be explored using ultrasonography. This study aimed to investigate a new screening method using ultrasonography to diagnose sarcopenia of lower leg muscles in older males.
Cross-sectional study.
A total of 60 males, aged 65 years or older, participated in this study.
The muscle thickness (MT) and echo intensity (EI) of the lower leg muscles were measured using ultrasonography, and the physical functions were examined. The MT and EI values of the lower leg muscles for predicting low appendicular skeletal muscle mass index (ASMI) and low grip strength were analyzed using receiver operating characteristic curve analysis and significant cutoff values were observed. A binary logistic regression analysis was performed with an MT below the cutoff value or an EI above the cutoff value as the independent variable, and with sarcopenia according to the Asian Working Group for Sarcopenia criterion as the dependent variable.
Using the optimal cutoff points of MT and EI for predicting a low ASMI and low grip strength, the MT of the tibialis anterior (TA), the EI of the TA and gastrocnemius, and the MT/EI index of the TA and soleus were found to be associated with sarcopenia after adjusting for age, body mass index, calf circumference, presence of diabetes mellitus, and statin use in the binary logistic regression model. In addition, the combined MT and EI of the TA showed predictability with respect to sarcopenia.
CONCLUSIONS/RELEVANCE: Ultrasonographic assessment of lower leg muscles might be useful as a convenient approach for detecting sarcopenia. In particular, the determination of both MT and EI of the TA should be considered as an alternative method of screening for sarcopenia.
肌少症是基于骨骼肌质量和肌肉力量/功能来诊断的;然而,应该探索使用超声检查来评估更简单、更准确的肌肉质量和肌肉力量/功能的方法。本研究旨在探讨一种新的筛选方法,使用超声检查来诊断老年男性小腿肌肉的肌少症。
横断面研究。
共有 60 名年龄在 65 岁或以上的男性参与了这项研究。
使用超声检查测量小腿肌肉的肌肉厚度(MT)和回声强度(EI),并检查身体功能。使用接收者操作特性曲线分析来分析小腿肌肉的 MT 和 EI 值,以预测低四肢骨骼肌质量指数(ASMI)和低握力,并观察显著的截断值。使用截断值以下的 MT 或截断值以上的 EI 作为自变量,以亚洲肌少症工作组标准的肌少症作为因变量,进行二元逻辑回归分析。
使用 MT 和 EI 预测低 ASMI 和低握力的最佳截断点,调整年龄、体重指数、小腿围、糖尿病和他汀类药物使用后,发现胫骨前肌(TA)的 MT、TA 和腓肠肌的 EI 以及 TA 和比目鱼肌的 MT/EI 指数与肌少症相关。此外,TA 的联合 MT 和 EI 对肌少症具有预测性。
结论/相关性:小腿肌肉的超声评估可能是一种有用的简便方法,用于检测肌少症。特别是,应该考虑同时测定 TA 的 MT 和 EI,作为肌少症筛查的替代方法。