Division of Endocrinology, Endocrine Research Institute, Department of Internal Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Korea.
Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
Osteoporos Int. 2021 May;32(5):939-949. doi: 10.1007/s00198-020-05708-2. Epub 2020 Oct 30.
Low phase angle, a non-invasive bioimpedance marker, is associated with elevated odds of dysmobility syndrome and its components. Phase angle (estimated cutoffs: < 4.8° in men; < 4.5° in women) can be used to detect dysmobility syndrome in community-dwelling older adults as a simple, integrative screening tool.
Dysmobility syndrome uses a score-based approach to predict fracture risk that incorporates the concepts of osteoporosis, sarcopenia, and obesity. Low phase angle (PhA), a simple, non-invasive bioelectrical impedance marker, was associated with low lean mass, high fat mass, and poor muscle function. We aimed to investigate the association between PhA and dysmobility syndrome, with the exploration of the diagnostic cutoffs.
In a community-dwelling Korean older adult cohort, dysmobility syndrome was defined as the presence of ≥ 3 of the following components: osteoporosis, low lean mass, falls in the preceding year, low grip strength, high fat mass, and poor timed up and go performance.
Among the 1825 participants (mean age 71.6, women 66.7%), subjects were classified into sex-stratified PhA tertiles. The prevalence of dysmobility syndrome increased from the highest PhA tertile group to the lowest (15.50 to 2.45% in men; 33.41 to 12.25% in women, P for trend < 0.001). The mean PhA values decreased as the dysmobility score increased (5.33° to 4.65° in men; 4.76° to 4.39° in women, P for trend < 0.001). Low PhA (cutoff: < 4.8° in men; < 4.5° in women) was associated with twofold elevated odds of dysmobility syndrome after adjusting for age, sex, and conventional risk factors. Low PhA improved the identification of individuals with dysmobility syndrome when added to the conventional risk model (area under the curve, 0.73 to 0.75, P = 0.002).
Low PhA was associated with dysmobility syndrome and its components, independent of age, sex, body mass index, nutritional status, and inflammation.
使用基于评分的方法来预测骨折风险，该方法结合了骨质疏松症、肌肉减少症和肥胖症的概念， Mobility 综合征可以作为一种简单、综合的筛查工具来检测社区居住的老年人中的 Mobility 综合征。
在一个社区居住的韩国老年人队列中，Mobility 综合征定义为存在以下 3 种或以上的情况：骨质疏松症、低瘦体重、过去 1 年跌倒、握力低、高脂肪量和较差的计时起立行走表现。
在 1825 名参与者（平均年龄 71.6 岁，女性 66.7%）中，根据性别将参与者分为 PhA 三分位组。Mobility 综合征的患病率从 PhA 最高三分位组到最低三分位组逐渐增加（男性从 15.50%增加到 2.45%；女性从 33.41%增加到 12.25%，趋势 P<0.001）。随着 Mobility 评分的增加，平均 PhA 值降低（男性从 5.33°降低到 4.65°；女性从 4.76°降低到 4.39°，趋势 P<0.001）。调整年龄、性别和常规危险因素后，低 PhA（男性<4.8°；女性<4.5°）与 Mobility 综合征的两倍高几率相关。当将低 PhA 添加到常规风险模型中时，它可以改善对 Mobility 综合征患者的识别（曲线下面积，0.73 至 0.75，P=0.002）。
低 PhA 与 Mobility 综合征及其组成部分相关，独立于年龄、性别、体重指数、营养状况和炎症。
