Zigong Mental Health Center, Zigong, Sichuan, China.
National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang Renmin Nan Lu Chengdu, Sichuan, China.
BMC Geriatr. 2021 May 8;21(1):296. doi: 10.1186/s12877-021-02244-4.
Sarcopenia is a disorder associated with age that reduces the mass of skeletal muscles, the strength of muscles, and/or physical activity. It increases the risk of fall incidence which can result in fractures, hospitalizations, limited movement, and considerably decreased quality of life. Hence, it is needed to explore candidate screening tools to evaluate sarcopenia in the initial phases. The reported studies have been revealed that the sensitivity and specificity of the Ishii score chart are higher. However, the Ishii score chart is principally based on the European Working Group on Sarcopenia in Older People (EWGSOP) consensus. Recently, the Asian Working Group for Sarcopenia (AWGS) 2019 consensus has updated its diagnostic criteria for sarcopenia,which was previously similar to the EWGSOP. Hence, it is necessary to determine whether the Ishii score chart is appropriate for use among the elderly population in China. The current study aimed to validate the precision of the Ishii score chart, within the Chinese old aged community to establish an effective model for the evaluation of sarcopenia.
The AWGS2019 sarcopenia diagnostic criteria were used as a standard, and among the elderly community, the accuracy of the Ishii score chart was determined by using indicators, including specificity, sensitivity, negative and positive predictive values, negative and positive likelihood ratios, Youden index, and receiver operating characteristic (ROC) curve.
In the elderly Chengdu community, the prevalence rate of sarcopenia was 18.38 %, 19.91 % for males and 16.91 % for females. The Ishii score chart predicts sarcopenia at an AUC value of 0.84 with 95 % confidence interval (CI), ranging between 0.80 and 0.89 for females, and at an AUC value of 0.81 with 95 % CI, ranging between 0.75 and 0.86 for males.According to the original cut-off, which was set at 120 points for females, the corresponding sensitivity was 46.91 % and the specificity was 93.22 %. The 105 cut-off points (original) set for males revealed a corresponding sensitivity of 64.94 % and the specificity of 85.46 %. However, the original cut-off value exhibited low sensitivity, hence, we selected a new cut-off value. With the new cut-off value, the sensitivity, specificity, positive and negative predictive values for sarcopenia were 75.31 %, 79.9 %, 43 %, and 94 % for females, and 70.65 %, 81.35 %, 49 %, and 92 % for males, respectively.
The Ishii score chart was used for the prediction of sarcopenia in the old-age people of the Chengdu community and the obtained results showed a high value of predictability. Hence, more than 95 and 102 points were suggested for males and females, accordingly which can set to be the diagnostic cut-off values for the prediction of sarcopenia.
肌少症是一种与年龄相关的疾病,会减少骨骼肌的质量、肌肉力量和/或身体活动能力。它会增加跌倒发生率的风险,从而导致骨折、住院、活动受限以及生活质量明显下降。因此,需要探索候选筛查工具来评估肌少症的早期阶段。报告的研究表明,Ishii 评分表的灵敏度和特异性更高。然而,Ishii 评分表主要基于欧洲老年人肌少症工作组(EWGSOP)共识。最近,亚洲肌少症工作组(AWGS)2019 年共识更新了其肌少症的诊断标准,此前与 EWGSOP 相似。因此,有必要确定 Ishii 评分表是否适用于中国的老年人群体。本研究旨在验证 Ishii 评分表在中国老年人群体中的精确性,以建立一种评估肌少症的有效模型。
使用 AWGS2019 肌少症诊断标准作为标准,在老年人群体中,通过特异性、敏感性、阴性和阳性预测值、阴性和阳性似然比、Youden 指数和受试者工作特征(ROC)曲线等指标来确定 Ishii 评分表的准确性。
在成都老年社区,肌少症的患病率为 18.38%,男性为 19.91%,女性为 16.91%。Ishii 评分表预测女性肌少症的 AUC 值为 0.84,95%置信区间(CI)为 0.80 至 0.89,男性的 AUC 值为 0.81,95%CI 为 0.75 至 0.86。根据女性设定的 120 分原始截断值,相应的灵敏度为 46.91%,特异性为 93.22%。男性设定的 105 分(原始)截断值,相应的灵敏度为 64.94%,特异性为 85.46%。然而,原始截断值的灵敏度较低,因此我们选择了一个新的截断值。使用新的截断值,女性肌少症的灵敏度、特异性、阳性和阴性预测值分别为 75.31%、79.9%、43%和 94%,男性分别为 70.65%、81.35%、49%和 92%。
Ishii 评分表用于预测成都社区老年人的肌少症,得到的结果显示出较高的预测价值。因此,建议男性和女性分别超过 95 分和 102 分作为诊断肌少症的截断值。