Division of Nutrition and Dietetics of Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Geriatric Division of Hospital das Clinicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Exp Gerontol. 2020 Sep;138:111020. doi: 10.1016/j.exger.2020.111020. Epub 2020 Jul 9.
To evaluate lean mass index (LMI) measured by bioimpedance (BIA) and anthropometry compared to densitometry (DXA) in elderly outpatients from a tertiary care hospital.
Participants were over 60-year-old men, presenting no dementia or disability, from a tertiary geriatric ambulatory. LMI obtained by BIA, anthropometry and DXA were submitted to Baumgartner, Janssen and Delmonico calculations respectively. Sarcopenia was calculated as LMI by DXA and handgrip strength. Data were analyzed by T student's test, ANOVA for repeated measures and pos hoc Bonferroni test, Pearson's correlation test, regression equation and Bland Altman analysis, ROC curve and contingency table 2 × 2 for sensitivity, specificity and predictive values.
A total of 92 participants completed the study. Most of them were married, aged 72.9 ± 6.6, lived a sedentary lifestyle, presented multiple morbidities, and in use of polypharmacy. Appendicular lean mass was lower in sarcopenic participants when compared to that in nonsarcopenic ones (20.2 kg/m and 23 kg/m respectively, p < 0.0001). BIA sensitivity, specificity and correlation to DXA were 37%, 98% and r = 0.81 (p < 0.001), and for anthropometry 67%, 92% and r = 0.77 (p < 0.0001) respectively. Bland Altman's analysis showed congruence between methods and DXA (anthropometry: bias = -0,05 ± 0,66, limits of agreement (LoA) = -1.37 and 1.26; BIA: bias = 2,2; LoA = 0,7 and 3,7).
Aging and multiple chronic and degenerative morbidities affect LM in vulnerable elderly patients. Both anthropometry and BIA, are accurate to measure LMI independently in this population but Anthropometry presented better agreement to DXA than Bioimpedance and has the advantage of lower price, easier application and cheaper equipment to be applied.
评估生物电阻抗（BIA）和人体测量法测量的瘦体重指数（LMI）与密度仪（DXA）相比，在一家三级保健医院的老年门诊患者中的表现。
参与者为年龄在 60 岁以上、无痴呆或残疾的男性，来自三级老年门诊。分别通过 BIA、人体测量法和 DXA 获得的 LMI 分别通过 Baumgartner、Janssen 和 Delmonico 计算。通过 DXA 和握力测定计算 LMI 得出肌少症。采用 T 学生检验、重复测量方差分析和事后 Bonferroni 检验、Pearson 相关检验、回归方程和 Bland Altman 分析、ROC 曲线和 2×2 列联表进行灵敏度、特异性和预测值分析。
共有 92 名参与者完成了研究。他们大多数已婚，年龄 72.9±6.6 岁，生活方式久坐，患有多种疾病，并接受多种药物治疗。与非肌少症患者相比，肌少症患者的四肢瘦体重较低（分别为 20.2kg/m 和 23kg/m，p<0.0001）。BIA 的灵敏度、特异性和与 DXA 的相关性分别为 37%、98%和 r=0.81（p<0.001），而人体测量法的灵敏度、特异性和与 DXA 的相关性分别为 67%、92%和 r=0.77（p<0.0001）。Bland Altman 分析显示，两种方法与 DXA 之间具有一致性（人体测量法：偏差=0，05±0.66，一致性界限（LoA）=-1.37 和 1.26；BIA：偏差=2.2；LoA=0.7 和 3.7）。
衰老和多种慢性和退行性疾病会影响脆弱的老年患者的 LM。人体测量法和 BIA 均可独立准确地测量该人群的 LMI，但人体测量法与 DXA 的一致性优于 BIA，并且具有价格更低、应用更简单、设备更便宜的优势。
