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肌肉减少症定义:肌肉减少症定义和结局共识联盟的立场声明。

Sarcopenia Definition: The Position Statements of the Sarcopenia Definition and Outcomes Consortium.

机构信息

Boston Claude D. Pepper Older Americans Independence Center, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.

Department of Medicine Beth Israel Deaconess Medical Center and Harvard Medical School, Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, Massachusetts.

出版信息

J Am Geriatr Soc. 2020 Jul;68(7):1410-1418. doi: 10.1111/jgs.16372. Epub 2020 Mar 9.

Abstract

OBJECTIVES

To develop an evidence-based definition of sarcopenia that can facilitate identification of older adults at risk for clinically relevant outcomes (eg, self-reported mobility limitation, falls, fractures, and mortality), the Sarcopenia Definition and Outcomes Consortium (SDOC) crafted a set of position statements informed by a literature review and SDOC's analyses of eight epidemiologic studies, six randomized clinical trials, four cohort studies of special populations, and two nationally representative population-based studies.

METHODS

Thirteen position statements related to the putative components of a sarcopenia definition, informed by the SDOC analyses and literature synthesis, were reviewed by an independent international expert panel (panel) iteratively and voted on by the panel during the Sarcopenia Position Statement Conference. Four position statements related to grip strength, three to lean mass derived from dual-energy x-ray absorptiometry (DXA), and four to gait speed; two were summary statements.

RESULTS

The SDOC analyses identified grip strength, either absolute or scaled to measures of body size, as an important discriminator of slowness. Both low grip strength and low usual gait speed independently predicted falls, self-reported mobility limitation, hip fractures, and mortality in community-dwelling older adults. Lean mass measured by DXA was not associated with incident adverse health-related outcomes in community-dwelling older adults with or without adjustment for body size.

CONCLUSION

The panel agreed that both weakness defined by low grip strength and slowness defined by low usual gait speed should be included in the definition of sarcopenia. These position statements offer a rational basis for an evidence-based definition of sarcopenia. The analyses that informed these position statements are summarized in this article and discussed in accompanying articles in this issue of the journal. J Am Geriatr Soc 68:1410-1418, 2020.

摘要

目的

制定一个基于证据的肌少症定义,以方便识别有临床相关结局风险的老年人(例如,自我报告的活动受限、跌倒、骨折和死亡)。肌少症定义和结局联合会(SDOC)在文献回顾的基础上制定了一套立场声明,并对八项流行病学研究、六项随机临床试验、四项特殊人群队列研究和两项全国代表性的基于人群的研究进行了 SDOC 分析。

方法

13 项与肌少症定义的潜在成分相关的立场声明,根据 SDOC 分析和文献综合,由一个独立的国际专家小组(小组)进行了反复审查,并在肌少症立场声明会议上由小组进行了投票。四项与握力有关的立场声明,三项与双能 X 射线吸收法(DXA)测定的瘦体重有关,四项与步速有关;两项是总结性声明。

结果

SDOC 分析确定握力(无论是绝对握力还是按身体大小进行了缩放)是运动缓慢的重要判别指标。握力低和步速慢都独立预测了社区居住的老年人跌倒、自我报告的活动受限、髋部骨折和死亡。DXA 测定的瘦体重与社区居住的老年人的不良健康相关结局无关,无论是否根据身体大小进行了调整。

结论

专家组一致认为,弱(握力低定义)和慢(步速慢定义)都应包含在肌少症定义中。这些立场声明为肌少症的循证定义提供了合理的依据。本文总结了为这些立场声明提供信息的分析,并在本期杂志的相关文章中进行了讨论。美国老年学会杂志 68:1410-1418, 2020。

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