Department of Endocrinology, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Department of Radiodiagnosis and Imaging, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India.
Eur Geriatr Med. 2020 Oct;11(5):725-736. doi: 10.1007/s41999-020-00332-z. Epub 2020 Jun 5.
Comprehensive data on diagnosis and prevalence of sarcopenia in India are lacking. The present study was undertaken to determine cut-offs for low muscle strength (MS) and low muscle mass (MM), and find out the prevalence of sarcopenia in Indians.
Apparently healthy individuals aged ≥ 20 years with no prior history of any co-morbidities were recruited from community by door-to-door survey. Participants eligible for study underwent blood sampling. Individuals identified as having biochemical abnormalities that could potentially affect MS and MM were excluded. Enrolled participants underwent DEXA. Muscle mass, MS, and physical performance were expressed as appendicular skeletal muscle index (ASMI), dominant handgrip strength (HGS), and usual gait speed (GS), respectively. Cut-offs for low MS and MM were defined as HGS and ASMI 2SD < mean of young reference population (20-39 years). A GS ≤ 0.8 m/s defined poor physical performance. Using them, the prevalence of sarcopenia was estimated as per EWGSOP2 recommendations.
After exclusion, 804 participants were enrolled (mean age = 44.4 years). Peak HGS, ASMI, and GS were achieved in the 3rd/4th decades. Muscle strength/mass was lower than Caucasians. A HGS < 27.5 kg (males)/18.0 kg (females) and an ASMI < 6.11 kg/m (males)/4.61 kg/m (females) defined low MS and MM, respectively. Accordingly, prevalence of 'probable sarcopenia', 'sarcopenia', and 'severe sarcopenia' was 14.6%, 3.2%, and 2.3%, respectively. Corresponding values were higher when European cut-offs were used. Only serum testosterone positively predicted HGS/ASMI/GS in males.
Indians have low MS/MM, and hence, indigenous and not Western cut-offs should be used to define sarcopenia in Indians.
印度缺乏有关肌少症诊断和患病率的综合数据。本研究旨在确定低肌肉力量（MS）和低肌肉质量（MM）的截止值，并找出肌少症在印度人中的患病率。
通过挨家挨户的调查，从社区招募年龄≥20 岁且无任何合并症既往史的健康个体。符合研究条件的参与者接受血液采样。排除有潜在影响 MS 和 MM 的生化异常的个体。入组的参与者接受 DEXA 检查。肌肉质量、MS 和身体表现分别用四肢骨骼肌指数（ASMI）、优势手握力（HGS）和常规步速（GS）表示。低 MS 和 MM 的截止值定义为 HGS 和 ASMI 低于年轻参考人群（20-39 岁）的 2SD<平均值。GS≤0.8 m/s 定义为身体表现差。根据这些标准，按照 EWGSOP2 建议估算肌少症的患病率。
排除后，共纳入 804 名参与者（平均年龄 44.4 岁）。HGS、ASMI 和 GS 的峰值出现在 3/4 十年代。肌肉力量/质量低于白种人。男性 HGS<27.5 kg 和女性 HGS<18.0 kg 以及男性 ASMI<6.11 kg/m 和女性 ASMI<4.61 kg/m 分别定义为低 MS 和 MM。因此，“可能的肌少症”、“肌少症”和“严重肌少症”的患病率分别为 14.6%、3.2%和 2.3%。当使用欧洲截止值时，相应的数值更高。只有血清睾酮在男性中对 HGS/ASMI/GS 有积极的预测作用。
印度人 MS/MM 较低，因此，在定义印度人的肌少症时，应该使用本土而不是西方的截止值。
