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墨西哥城50 - 64岁成年人及老年人的相角截止点及其与肌肉减少症和衰弱的关联

Phase Angle Cut-Off Points and Their Association With Sarcopenia and Frailty in Adults of 50-64 Years Old and Older Adults in Mexico City.

作者信息

Rosas-Carrasco Oscar, Ruiz-Valenzuela Roxana E, López-Teros Miriam T

机构信息

Health Department, Ibero American University, Mexico City, Mexico.

Instituto Nacional de Geriatría, Mexico City, Mexico.

出版信息

Front Med (Lausanne). 2021 Mar 15;8:617126. doi: 10.3389/fmed.2021.617126. eCollection 2021.

Abstract

In recent studies, the usefulness of the phase angle (PA) to assess geriatric conditions such as sarcopenia and frailty has been evaluated. However, there are no useful cut-off points for clinical research and/or practice. To analyze PA cut-off points associated with sarcopenia and frailty in adults of 50-64 years old and older adults in Mexico City. Cross-sectional analysis of the FraDySMex cohort study (Frailty, Dynapenia, and Sarcopenia in Mexican Adults). 498 people were included, 78.7% women, aged 71.1 ± 9.5 years. Methods: The sarcopenia measurements were made according to the European Working Group on Sarcopenia in Older People (EWGSOP) (2019) (by dynamometer to evaluate hand grip strength and dual energy X-ray absorptiometry (DXA) for appendicular muscle mass), and the frailty through the physical frailty phenotype with cut-off points adjusted to the Mexican population. The PA was evaluated by bioelectrical impedance analysis (BIA), tetrapolar to 50 Hz, other variables such as socio-demographic, comorbidity, cognitive status, and functional dependence were evaluated. The prevalence of frailty was 10.6% and sarcopenia 10.0%. The mean of the PA was 4.6° ± 0.70°. The PA cut-off point for frailty in adults 50 to 64 years was ≤4.3° [sensitivity (S) = 91.95%, specificity (Sp) 66.77%, AUROC (Area Under the Receiver Operating Characteristic) curve = 0.9273 95% CI (0.8720-0.9825)]; the PA cut-off point for sarcopenia was ≤4.3 [S = 91.95%, Sp = 66.77%, AUROC = 0.9306 95% CI (0.8508-1.000)]. The PA cut-off for frailty in adults ≥ 65 years was ≤4.1° [S = 72.37%, Sp 71.43%, AUROC = 0.7925 95%, CI (0.7280-0.8568)] for sarcopenia was ≤4.1° [S = 72.76%, Sp 73.81%, AUROC = 0.7930 95% CI (0.7272-0.8587)]. These cut-off points showed a significant association between PA with frailty (OR 4.84; 95% CI 2.61-8.99) and sarcopenia (OR 8.44; 95% CI 3.85-18.4) after adjusted by age, sex, BMI, comorbidity index and cognitive impairment. These cut-off points of PA could be useful for the screening of sarcopenia and frailty in Mexican adults of 50 years and older in centers that have BIA.

摘要

在最近的研究中,已经评估了相位角(PA)在评估诸如肌肉减少症和衰弱等老年疾病方面的有用性。然而,对于临床研究和/或实践而言,尚无有用的临界点。旨在分析墨西哥城50 - 64岁成年人及老年人中与肌肉减少症和衰弱相关的PA临界点。对FraDySMex队列研究(墨西哥成年人的衰弱、肌肉减少和肌少症)进行横断面分析。纳入了498人,其中78.7%为女性,年龄为71.1±9.5岁。方法:根据老年人肌肉减少症欧洲工作组(EWGSOP)(2019年)进行肌肉减少症测量(通过测力计评估握力,通过双能X线吸收法(DXA)测量四肢肌肉量),并通过根据墨西哥人群调整了临界点的身体衰弱表型评估衰弱情况。通过生物电阻抗分析(BIA),以四极法在50Hz频率下评估PA,还评估了其他变量,如社会人口统计学、合并症、认知状态和功能依赖情况。衰弱的患病率为10.6%,肌肉减少症的患病率为10.0%。PA的平均值为4.6°±0.70°。50至64岁成年人衰弱的PA临界点为≤4.3°[敏感度(S)= 91.95%,特异度(Sp)= 66.77%,受试者工作特征曲线下面积(AUROC)= 0.9273,95%置信区间(CI)(0.8720 - 0.9825)];肌肉减少症的PA临界点为≤4.3°[S = 91.95%,Sp = 66.77%,AUROC = 0.9306,9�%CI(0.8508 - 1.000)]。65岁及以上成年人衰弱的PA临界点为≤4.1°[S = 72.37%,Sp = 71.43%,AUROC = 0.7925,95%CI(0.7280 - 0.8568)],肌肉减少症的PA临界点为≤4.1°[S = 72.76%,Sp = 73.81%,AUROC = 0.7930,95%CI(0.7272 - 0.8587)]。在根据年龄、性别、体重指数、合并症指数和认知障碍进行调整后,这些临界点显示PA与衰弱(比值比(OR)4.84;95%CI 2.61 - 8.99)和肌肉减少症(OR 8.44;95%CI 3.劜5 - 18.4)之间存在显著关联。这些PA临界点对于在拥有BIA设备的中心对50岁及以上墨西哥成年人进行肌肉减少症和衰弱的筛查可能是有用的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2218/8005522/220dc0b0f1ec/fmed-08-617126-g0001.jpg

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