Abbott Nutrition Research and Development, Asia-Pacific Center, Singapore.
Department of Geriatric Medicine, Changi General Hospital, Singapore.
PLoS One. 2019 Oct 9;14(10):e0223222. doi: 10.1371/journal.pone.0223222. eCollection 2019.
Aging is associated with low muscle mass and has been linked to adverse health outcomes. The objectives of this cross-sectional study were: (1) to describe anthropometry, body composition, appendicular skeletal muscle mass index (ASMI; appendicular skeletal muscle mass/height2), and prevalence of low ASMI in older people with normal nutritional status (Malnutrition Universal Screening Tool score = 0); (2) to determine factors associated with ASMI, and odds ratios of having low ASMI.
SHIELD is a study of community-dwelling older people aged 65 years and above in Singapore. ASMI was determined using bioelectrical impedance analysis and low ASMI was defined as <7.0 kg/m2 for males and <5.7 kg/m2 for females (Asian Working Group for Sarcopenia, 2014).
A total of 400 older people (183 males and 217 females) took part in this study. The overall prevalence of low ASMI was 20.6% (15.5% in males and 24.9% in females). Females had significantly lower ASMI than males (P < 0.0001), age was inversely associated with ASMI (P = 0.0024) while BMI and calf circumference were positively associated with ASMI (both P < 0.0001) in the total cohort. In addition, ASMI was positively associated with bone mass in both genders (both P < 0.0001). After adjusting for covariates, the odds ratios of having low ASMI with every 1 year and 10 years increase in age were 1.13 (95% CI: 1.06, 1.20) and 3.36 (95% CI: 1.82, 6.21) respectively.
The high prevalence of low ASMI in community-dwelling older people with normal nutritional status highlights the need for early screening. There was a strong inverse association between age and ASMI while BMI, calf circumference and bone mass were positively associated with ASMI. These findings will give further weight to the importance and development of public health strategies in maintaining and improving muscle health in this population group.
衰老与肌肉量减少有关，并与不良健康结局相关。本横断面研究的目的为：（1）描述营养状况正常（营养不良通用筛查工具评分=0）的老年人的人体测量学、身体成分、四肢骨骼肌质量指数（ASMI；四肢骨骼肌质量/身高 2 ）以及低 ASMI 的流行情况；（2）确定 ASMI 的相关因素以及低 ASMI 的比值比。
SHIELD 是一项在新加坡开展的社区居住的 65 岁及以上老年人的研究。采用生物电阻抗分析法测定 ASMI，男性 ASMI<7.0kg/m2 和女性 ASMI<5.7kg/m2 定义为低 ASMI（亚洲肌少症工作组，2014 年）。
共 400 名老年人（男性 183 名，女性 217 名）参与了本研究。低 ASMI 的总体患病率为 20.6%（男性为 15.5%，女性为 24.9%）。女性的 ASMI 明显低于男性（P<0.0001），年龄与 ASMI 呈负相关（P=0.0024），而在总队列中，BMI 和小腿围与 ASMI 呈正相关（均 P<0.0001）。此外，ASMI 与两性的骨量均呈正相关（均 P<0.0001）。在校正了协变量后，年龄每增加 1 年和 10 年，低 ASMI 的比值比分别为 1.13（95%CI：1.06，1.20）和 3.36（95%CI：1.82，6.21）。
营养状况正常的社区居住老年人中低 ASMI 的高患病率凸显了早期筛查的必要性。年龄与 ASMI 呈强负相关，而 BMI、小腿围和骨量与 ASMI 呈正相关。这些发现进一步强调了在这一人群中维持和改善肌肉健康的公共卫生策略的重要性和发展。
