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新加坡社区居住成年人的营养不良和肌肉减少症:义顺健康研究。

Malnutrition and Sarcopenia in Community-Dwelling Adults in Singapore: Yishun Health Study.

机构信息

Shiou-Liang Wee, Geriatric Education and Research Institute (GERI), 2 Yishun Central 2, Tower E Level 4 GERI Admin, 768024, Singapore, Phone: +65 6592 4606,

出版信息

J Nutr Health Aging. 2021;25(3):374-381. doi: 10.1007/s12603-020-1542-x.

Abstract

OBJECTIVES

To determine the overlapping prevalence of malnutrition and sarcopenia and the association between parameters of malnutrition with muscle mass and strength in a community-dwelling Singaporean adult population.

DESIGN

This was a cross-sectional study.

SETTING

Large north-eastern residential town of Yishun in Singapore.

PARTICIPANTS

Random sampling of community-dwelling Singaporeans aged 21-90 years old (n=541).

MEASUREMENTS

Anthropometry, body composition and handgrip strength (muscle strength) were measured. Sarcopenia was identified using dual-energy x-ray absorptiometry scan (muscle mass). Nutritional status was measured using Mini Nutritional Assessment (MNA-SF). Other questionnaires collected included physical activity and cognition. Associations between nutritional status with sarcopenia as well as with muscle mass and strength were analysed using multinomial logistics and linear regressions.

RESULTS

The overall population-adjusted prevalence of those at nutritional risk and malnourished were 18.5% and 0.1% respectively. More than a third of participants (35%) who were at nutritional risk were sarcopenic. Malnourished participants were all sarcopenic (100%, N=2) whereas those who were sarcopenic, 27.0% (N=37) were at nutritional risk/malnourished. Being at nutritional risk/malnourished was significantly associated with 2 to 3 times increased odds of sarcopenia in multivariate analyses adjusting for age, gender, physical activity level and cognition, and fat mass index. Favourable MNA parameter scores on food intake and BMI were positively associated with greater muscle mass and handgrip strength (p<0.05).

CONCLUSION

Given the overlapping clinical presentation of malnutrition and sarcopenia, community screening protocols should include combination screening of nutritional status and sarcopenia with appropriate interventions to mitigate risk of adverse health outcomes.

摘要

目的

确定营养不良和肌肉减少症的重叠患病率,以及社区居住的新加坡成年人人群中营养不良参数与肌肉质量和力量之间的关系。

设计

这是一项横断面研究。

地点

新加坡东北部的义顺大型住宅区。

参与者

随机抽取年龄在 21-90 岁之间的社区居住的新加坡人(n=541)。

测量

测量人体测量学、身体成分和握力(肌肉力量)。使用双能 X 射线吸收法扫描(肌肉质量)确定肌肉减少症。使用微型营养评估(MNA-SF)测量营养状况。其他问卷收集包括身体活动和认知。使用多项逻辑回归和线性回归分析营养状况与肌肉减少症以及与肌肉质量和力量的关系。

结果

总体人群中营养风险和营养不良的调整后患病率分别为 18.5%和 0.1%。超过三分之一(35%)有营养风险的参与者患有肌肉减少症。营养不良的参与者均患有肌肉减少症(100%,N=2),而患有肌肉减少症的参与者中有 27.0%(N=37)有营养风险/营养不良。在调整年龄、性别、身体活动水平和认知以及脂肪质量指数的多变量分析中,有营养风险/营养不良与肌肉减少症的发生风险增加 2 至 3 倍显著相关。在食物摄入和 BMI 方面,MNA 参数评分较好与更大的肌肉质量和握力呈正相关(p<0.05)。

结论

鉴于营养不良和肌肉减少症的临床表现重叠,社区筛查方案应包括营养状况和肌肉减少症的联合筛查,并采取适当的干预措施,以减轻不良健康后果的风险。

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