Postgraduate School of Geriatrics, University of Siena, Siena, Italy.
Postgraduate School of Public Health, University of Siena, Siena, Italy.
Arch Gerontol Geriatr. 2019 Jul-Aug;83:151-154. doi: 10.1016/j.archger.2019.03.021. Epub 2019 Mar 27.
Sarcopenia is a geriatric syndrome related to loss of muscle mass and function, leading to disability, frailty and higher mortality. According to European Working Group on Sarcopenia in Older People (EWGSOP) the diagnosis of sarcopenia requires the assessment of muscle mass, muscle force and function, that is time-consuming and not easily at hand in everyday clinical practice. We propose the B-mode ultrasound measurement of muscle thickness as a quick screening test to assess the presence of sarcopenia.
A cross-sectional study was realized, 119 patients (average age 82 years, 50.4% females) from the Department of Internal Medicine of the University Hospital of Siena (Italy) were enrolled. The diagnosis of sarcopenia was assessed according to EWGSOP criteria. Rectus femoris muscle (RFM) thickness (in cm) was measured by ultrasound B-mode scanning. Sensibility and specificity of the test was evaluated and Receiver Operating Analysis (ROC) was performed to assess the accuracy of the test.
Average RFM thickness was 0.78 ± 0.26, significantly lower in sarcopenic patients (0.55 ± 0.2 vs. 0.9 ± 0.3; Mann-Whitney; p < 0.001) and females (0.7 ± 0.3 vs 0.86 ± 0.3; Mann-Whitney; p < 0.001). The cut-off point of 0.7 cm for females and 0.9 cm for males was established as a threshold to assess the presence of sarcopenia by ultrasound. Sensibility of ultrasound measurement of RFM thickness was 100%, specificity 64%, positive predictive value (PPV) 64.3% and negative predictive value (NPV) 100%. ROC analysis was performed in order to quantify how accurately RFM thickness can discriminate between sarcopenia and non-sarcopenia state. AUC for all patients was 0.9 and after a comparative analysis for gender higher values for males (0.94 vs. 0.92) were observed.
We suggest a screening test for sarcopenia based on the ultrasound measurement of RFM thickness, as a not invasive and easy to perform method even in elderly patients with functional or cognitive impairment.
肌少症是一种与肌肉质量和功能丧失相关的老年综合征，可导致残疾、虚弱和更高的死亡率。根据欧洲老年人肌少症工作组（EWGSOP）的定义，肌少症的诊断需要评估肌肉质量、肌肉力量和功能，这既耗时又难以在日常临床实践中进行。我们提出使用 B 型超声测量肌肉厚度作为快速筛查试验来评估肌少症的存在。
进行了一项横断面研究，共纳入了来自意大利锡耶纳大学医院内科的 119 名患者（平均年龄 82 岁，50.4%为女性）。肌少症的诊断根据 EWGSOP 标准进行评估。通过 B 型超声扫描测量股直肌（RFM）厚度（以厘米为单位）。评估了该检测的敏感性和特异性，并进行了接收器操作分析（ROC）以评估该检测的准确性。
平均 RFM 厚度为 0.78±0.26，肌少症患者显著较低（0.55±0.2 比 0.9±0.3；Mann-Whitney；p<0.001），女性也较低（0.7±0.3 比 0.86±0.3；Mann-Whitney；p<0.001）。确定女性 RFM 厚度为 0.7cm，男性为 0.9cm 作为通过超声评估肌少症存在的阈值。RFM 厚度超声测量的敏感性为 100%，特异性为 64%，阳性预测值（PPV）为 64.3%，阴性预测值（NPV）为 100%。为了定量评估 RFM 厚度区分肌少症和非肌少症状态的准确性，进行了 ROC 分析。所有患者的 AUC 为 0.9，经过性别比较分析，发现男性的 AUC 值更高（0.94 比 0.92）。
我们建议基于 RFM 厚度的超声测量作为肌少症的筛查试验，这是一种非侵入性且易于实施的方法，即使在功能或认知障碍的老年患者中也是如此。
