Department of Dysphagia Rehabilitation, Tokyo Medical and Dental University, Tokyo, Japan.
Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan.
Geriatr Gerontol Int. 2021 Jan;21(1):14-19. doi: 10.1111/ggi.14079. Epub 2020 Nov 23.
The aim of this study was to investigate digastric muscle mass and intensity between no sarcopenic dysphagia and sarcopenic dysphagia.
Patients aged ≥65 years were enrolled. According to the diagnostic algorithm for sarcopenic dysphagia, the patients were divided into two groups, no sarcopenic dysphagia and sarcopenic dysphagia. Handgrip strength, gait speed, skeletal muscle mass, tongue pressure, Mini Nutritional Assessment-Short Form and Food Intake LEVEL Scale were investigated. Digastric muscle mass and intensity were examined by ultrasonography. Univariate and multivariate analyses were performed to analyze two groups. Multivariate logistic regression analysis was performed to determine independent factors for the presence of sarcopenic dysphagia. To estimate the accuracy of diagnosing sarcopenic dysphagia, a receiver operating characteristic curve analysis was performed for digastric muscle mass and intensity.
Forty-five patients (mean ± SD, 84.3 ± 7.8 years, 22 men, 23 women) including 19 no sarcopenic dysphagia and 26 sarcopenic dysphagia were examined. In sarcopenic dysphagia, lower BMI, Food Intake LEVEL Scale, Mini Nutritional Assessment-Short Form and smaller muscle mass and greater muscle intensity were found compared with no sarcopenic dysphagia. In multivariate logistic regression analysis, digastric muscle mass and intensity were identified as independent factors for sarcopenic dysphagia. The cut-off value of muscle mass was 75.1 mm (area under curve: 0.731, sensitivity: 0.692, specificity: 0.737) and muscle intensity was 27.8 (area under curve: 0.823, sensitivity: 0.923, specificity: 0.632).
Digastric muscle mass was smaller and muscle intensity was greater in sarcopenic dysphagia than no sarcopenic dysphagia. Ultrasonography of digastric muscle, as well as the tongue and geniohyoid muscle, is useful. Geriatr Gerontol Int 2021; 21: 14-19.
本研究旨在探讨无吞咽困难的肌少症和肌少症吞咽困难患者的二腹肌肌肉量和强度。
纳入年龄≥65 岁的患者。根据肌少症吞咽困难的诊断算法,将患者分为无吞咽困难的肌少症和肌少症吞咽困难两组。检测握力、步速、骨骼肌量、舌压、微型营养评估-简短表格和食物摄入水平量表。通过超声检查二腹肌的肌肉量和强度。进行单变量和多变量分析以分析两组。进行多变量逻辑回归分析以确定存在肌少症吞咽困难的独立因素。为了估计诊断肌少症吞咽困难的准确性,对二腹肌的肌肉量和强度进行了受试者工作特征曲线分析。
共检查了 45 名患者(平均年龄±标准差,84.3±7.8 岁,男性 22 名,女性 23 名),包括 19 名无吞咽困难的肌少症和 26 名肌少症吞咽困难患者。在肌少症吞咽困难患者中,与无吞咽困难的肌少症患者相比,BMI、食物摄入水平量表、微型营养评估-简短表格和较小的肌肉量和较大的肌肉强度较低。在多变量逻辑回归分析中,二腹肌的肌肉量和强度被确定为肌少症吞咽困难的独立因素。肌肉量的截断值为 75.1mm(曲线下面积:0.731,敏感性:0.692,特异性:0.737),肌肉强度为 27.8(曲线下面积:0.823,敏感性:0.923,特异性:0.632)。
与无吞咽困难的肌少症患者相比,肌少症吞咽困难患者的二腹肌肌肉量较小,肌肉强度较大。二腹肌的超声检查以及舌和颏舌骨肌的超声检查均具有一定的诊断价值。