Medizinische Klinik und Poliklinik IV, Schwerpunkt Geriatrie, LMU Klinikum München, Bavaria, Germany.
Medizinische Klinik und Poliklinik IV, Schwerpunkt Geriatrie, LMU Klinikum München, Bavaria, Germany.
Arch Gerontol Geriatr. 2021 Nov-Dec;97:104512. doi: 10.1016/j.archger.2021.104512. Epub 2021 Aug 26.
The assessment of body composition is an integral part in diagnosing sarcopenia. The purpose of this study was to determine the relationships between peripheral quantitative computed tomography (pQCT)-derived measures of body composition and measures of physical performance in older adults.
Muscle density, muscle area, and fat area of 168 patients aged 65 years and older (76.3±6.5) were measured with pQCT at the distal forearm additionally to clinical assessment consisting of medical history, physical examination and physical assessment including hand grip strength, gait speed and chair rise tests. Regression analyses assessed associations between patients' physical performance and pQCT derived data.
Among the three pQCT parameters, especially muscle density was significantly correlated with all of the three measures of physical performance even after adjusting for sex, age, BMI, vitamin D serum level and the level of physical activity. The same analysis for muscle area achieved significance level only for handgrip strength but not for gait speed nor for chair rise time. Fat area was significantly correlated only with gait speed after adjusting for sex and age. The association of muscle density with physical performance held up in an additional subanalysis stratified by body mass index.
Muscle density, a proxy for muscle fat infiltration, seems to be better than muscle area or fat area at assessing muscle quality and physical performance in older adults. This association seems to be independent of the body mass index.
身体成分评估是诊断肌肉减少症的一个组成部分。本研究的目的是确定老年人外周定量计算机断层扫描(pQCT)得出的身体成分测量值与身体表现测量值之间的关系。
使用 pQCT 对 168 名年龄在 65 岁及以上的患者(76.3±6.5)的前臂远端进行肌肉密度、肌肉面积和脂肪面积测量,临床评估包括病史、体检和身体评估,包括握力、步态速度和坐起测试。回归分析评估了患者身体表现与 pQCT 衍生数据之间的关系。
在这三个 pQCT 参数中,肌肉密度与所有三种身体表现测量值都有显著相关性,即使在调整了性别、年龄、BMI、维生素 D 血清水平和身体活动水平后也是如此。对肌肉面积的相同分析仅在握力测试中达到显著水平,而在步态速度或坐起时间测试中则没有。脂肪面积仅在调整性别和年龄后与步态速度显著相关。肌肉密度与身体表现的相关性在按体重指数分层的亚分析中仍然存在。
肌肉密度作为肌肉脂肪浸润的替代指标,在评估老年人的肌肉质量和身体表现方面似乎优于肌肉面积或脂肪面积。这种关联似乎独立于体重指数。