初始和修订的欧洲共识对肌少症的定义和诊断标准在 HIV 感染者中的应用具有低一致性。
Low Agreement Between Initial and Revised European Consensus on Definition and Diagnosis of Sarcopenia Applied to People Living With HIV.
机构信息
Department of Physical Education, Londrina State University, Londrina, Paraná, Brazil.
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH.
出版信息
J Acquir Immune Defic Syndr. 2021 Apr 1;86(4):e106-e113. doi: 10.1097/QAI.0000000000002576.
BACKGROUND
In 2019, the European Working Group on Sarcopenia in Older People (EWGSOP2) proposed low muscle strength as the primary outcome for sarcopenia diagnosis instead of low muscle mass, as proposed in 2010 (EWGSOP1). Therefore, the aim of this study was to compare the prevalence of sarcopenia using both EWGSOP1 and EWGSOP2 operational definitions in people living with HIV (PLHIV) and to determine the agreement and correlation between different tests proposed by EWGSOP2.
SETTING
Cross-sectional study, where 302 PLHIV (151 men), 51.7 ± 9.0 years old were evaluated for the presence of sarcopenia using both EWGSOP1 and EWGSOP2 operational definitions.
METHODS
Appendicular skeletal muscle was estimated using bioimpedance analysis. Handgrip strength, chair stand, gait speed, and static balance were used as muscle function measures. Agreement was determined using Cohen kappa and Pearson correlation coefficient was calculated.
RESULTS
Sarcopenia prevalence was 4.3% using EWGSOP1 and 1.0% using EWGSOP2. Agreement for sarcopenia diagnosis between EWGSOP1 and EWGSOP2 was fair (k = 0.37, P < 0.01). From the 13 cases of sarcopenia diagnosed using EWGSOP1, only 3 cases (23.1%) were also diagnosed using EWGSOP2. A medium correlation (r = -0.32, P < 0.01) and poor agreement (k = 0.14, P < 0.01) between muscle strength tests (handgrip strength and chair stand) were observed. Concordance between handgrip and chair stand was observed in 11 participants only, whereas 65 participants were considered to have low muscle strength using chair stand but not using handgrip.
CONCLUSIONS
Lower sarcopenia prevalence using EWGSOP2 and low agreement between EWGSOP1 and EWGSOP2 operational definitions in diagnosing sarcopenia were observed in PLHIV.
背景
2019 年，欧洲老年人肌肉减少症工作组（EWGSOP2）提出将低肌肉力量作为肌肉减少症诊断的主要结果，而不是 2010 年提出的低肌肉质量（EWGSOP1）。因此，本研究的目的是比较使用 EWGSOP1 和 EWGSOP2 操作定义在 HIV 感染者（PLHIV）中诊断肌肉减少症的患病率，并确定 EWGSOP2 提出的不同测试之间的一致性和相关性。
地点
横断面研究，评估了 302 名 PLHIV（151 名男性），年龄 51.7±9.0 岁，使用 EWGSOP1 和 EWGSOP2 操作定义评估肌肉减少症的存在。
方法
使用生物阻抗分析估计四肢骨骼肌。握力、椅子站立、步态速度和静态平衡用于肌肉功能测量。一致性通过 Cohen kappa 确定，Pearson 相关系数用于计算。
结果
使用 EWGSOP1 诊断肌肉减少症的患病率为 4.3%，使用 EWGSOP2 诊断肌肉减少症的患病率为 1.0%。EWGSOP1 和 EWGSOP2 诊断肌肉减少症的一致性为中等（k=0.37，P<0.01）。在使用 EWGSOP1 诊断的 13 例肌肉减少症患者中，只有 3 例（23.1%）也使用 EWGSOP2 诊断。肌肉力量测试（握力和椅子站立）之间存在中等相关性（r=-0.32，P<0.01）和较差的一致性（k=0.14，P<0.01）。仅观察到 11 名参与者的握力和椅子站立之间的一致性，而 65 名参与者使用椅子站立但不使用握力被认为具有低肌肉力量。
结论
在 PLHIV 中，使用 EWGSOP2 诊断肌肉减少症的患病率较低，使用 EWGSOP1 和 EWGSOP2 操作定义诊断肌肉减少症的一致性较低。
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